Cracked Heels: Why They Happen and How to Fix Them

Cracked heels are one of the most common foot complaints seen by Australian podiatrists — and one of the most preventable. While they might seem like a purely cosmetic issue, deep heel fissures can be painful, bleed, and become a point of entry for infection. Here's how to prevent and treat them effectively.

Why do heels crack?

The skin around the heel is naturally prone to dryness because it has no oil glands — unlike most skin on the body. This means it relies entirely on sweat glands and topical moisturiser for hydration. When the heel skin becomes very dry, it thickens into callus, loses its elasticity, and begins to crack under the weight-bearing pressure of each step.

Common contributing factors include:

Standing for long periods on hard floors
Open-backed footwear (thongs, slides, backless slippers) that allow the heel fat pad to splay outward
Low humidity environments — particularly relevant in dry Australian climates
Medical conditions including diabetes, hypothyroidism, and psoriasis
Obesity — increases downward pressure through the heel
Ageing — skin becomes thinner and less elastic over time

When are cracked heels a medical concern?

Superficial heel dryness and mild cracking is a cosmetic issue. However, deep fissures that bleed, cause pain with walking, or show signs of infection (redness, warmth, discharge) should be assessed by a podiatrist — particularly in people with diabetes or peripheral vascular disease, where even minor wounds carry a higher risk of complications.

How to treat cracked heels at home

Step 1: Exfoliate

Before applying moisturiser, gently remove the thickened callus skin using a foot file or pumice stone. Do this on dry skin — wet skin is more fragile and easier to over-file. Remove only what sloughs off easily; aggressive filing causes micro-trauma.

Step 2: Apply a high-urea foot cream

Urea is the gold standard ingredient for cracked heels. It is a natural humectant that draws moisture into the skin, and a keratolytic that chemically breaks down thickened, hardened skin over time. The higher the urea concentration, the more powerful the effect:

10% urea — suitable for mild dryness and daily maintenance
15% urea — effective for moderate dry skin and early heel cracking
25% urea — clinical strength, ideal for severe heel cracking and callused skin

Apply generously to clean, dry heels morning and night. For best results, apply at night and cover with a sock to prevent transfer and maximise absorption.

Step 3: Protect

Avoid open-backed footwear at home. Wearing supportive slippers with a closed back keeps the heel fat pad contained and prevents the outward splaying that causes fissures to deepen.

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