Cracked heels: causes, treatment and when to see a podiatrist

South Tees Hospitals NHS Foundation Trust podiatry says dry and cracked heels are generally caused by a lack of moisture in the skin, which can be worse when wearing open-backed shoes such as sandals.

Oxford Health NHS Foundation Trust podiatry describes very dry skin as predisposing to more hard skin formation, and says that on the heels there is often splitting skin. Pressure can contribute too: the NHS explains that corns and calluses are caused by pressure or rubbing of the skin, for example from high heels, uncomfortable shoes or shoes that are the wrong size, a problem with the bones of the feet, losing fat on the bottom of the feet as you get older, or not wearing socks with shoes.

South Tees podiatry gives a simple routine, and Oxford Health adds more options.

• File the hard skin once or twice weekly with a foot file when the skin is dry. South Tees suggests sitting on a chair and bringing your foot back to meet the file.

• Cream your feet daily after a bath or shower with a thick moisturising hand or foot cream.

• Continue applying cream daily when the skin is better to prevent recurrence.

• Use a simple moisturiser at least once a day, ideally morning and night. Emulsifying ointment or aqueous cream is often sufficient and it need not be a specific foot cream (Oxford Health).

• Try soaking the feet in an oily water foot bath, for example baby oil (Oxford Health).

• For an intensive overnight treatment, thickly apply petroleum jelly, wrap cling film over the feet so it can only soak in, and go to bed wearing cotton socks (Oxford Health).

• Heel balms made for dry cracked heels may be bought over the counter and can be helpful (Oxford Health).

South Tees advises considering socks, stockings or closed-in shoes even in hot weather if the dry skin is worse or the skin cracks. This is because open-backed shoes such as sandals can worsen heel dryness.

The NHS advice on corns and calluses suggests wearing thick, cushioned socks, wide, well-fitting, supportive shoes with a low heel and soft sole that do not rub, and soft insoles or heel pads. It says not to cut off corns or calluses yourself and not to wear high heels or tight pointy shoes. The same advice is sensible for hard skin at the heel.

The NHS advises that if you have diabetes, problems with your circulation, a weakened immune system, or are an older person, you should not try to treat corns and calluses yourself because these conditions can make foot problems more serious; see a GP or foot specialist instead.

For hard skin in general the NHS says to see a GP if it bleeds or has any pus or discharge, if it has not improved after treating it at home for 3 weeks, if the pain is severe or stopping you doing normal activities, or if you have diabetes, circulation problems or a weakened immune system. Cracks that are deep, bleeding, sore, red or hot, or that do not improve with regular moisturising, should also be looked at.

The NHS says a podiatrist may be able to cut away hard skin, provide patches or creams to soften it, or provide specially made soft pads or insoles to take pressure off. It says you might be able to refer yourself directly to a podiatrist without seeing a GP, and that referral to a podiatrist on the NHS may not be available to everyone and waiting times can be long. You can pay to see a podiatrist privately.

Several conditions can cause cracking, flaking or redness of the heels. South Tees describes athlete's foot (tinea pedis) as having an appearance of redness and flaking with small red spots and usually itchy, and says it is commonly found between the toes but can affect or spread to other areas of the foot. People with diabetes, sweaty feet or a reduced immune system are more prone to it. It advises continuing treatment for a fortnight after you think the condition has cleared, to lessen the chance of re-infection.

Oxford Health separately describes sweaty feet, corns and calluses and chilblains, which can be mistaken for dry cracked skin. If the skin is itchy, scaly or red rather than just dry, ask a pharmacist or GP to check for athlete's foot or eczema.

South Tees says to continue to apply cream daily when the skin is better, to prevent the problem from returning. Pairing that with regular gentle filing, and avoiding long periods in open-backed shoes or sandals if you are prone to splits, is the simplest approach described by the podiatry services.

Oxford Health notes that very dry skin is more likely to form hard skin, so keeping heels moisturised also helps reduce the build-up of hard skin that cracks.

Most people manage cracked heels with home care and over-the-counter products, with a pharmacist able to suggest creams and heel balms. NHS podiatry may be available for people at higher risk, such as those with diabetes or poor circulation, but the NHS notes access is not available to everyone and waits can be long. Many people choose a private registered podiatrist for hard skin removal. In every case, painful, bleeding or infected cracks need clinical review.