Heel Pain In the Winter: The Return of the Heel Skin Fissure

Happy 2012 everyone!

For those of you in colder climates, now is the time of year that heel fissures make their return.  This painful and annoying condition causes heel discomfort and makes walking difficult for those who suffer from it.  As I have done before, I will offer everyone a sort of survival guide to help minimize this difficult-to-treat condition.

A heel fissure is a calloused crack in the bottom of the heel skin, in which the tissue splits open and becomes painful as a result of the split and the inflammation that follows.  The crack can range from superficial to deep, and can sometimes even bleed.  It forms as a result of dry skin that lacks the usual oils and moisture seen in skin in warmer weather where there is more sweating and gland production.  The winter weather allows for greater dryness to form in the heel skin, which is thicker as a result of the pressure the heel sustains during walking.  As this thick skin dries, it forms shallow cracks that deepen as more pressure is applied.

Treatment is tough, to put it lightly.  Regular and aggressive attention is often necessary to reduce the cracking.  This includes regular filing of the heel with an emery board or pumice stone after bathing, as well as the use of heavy duty moisturizers twice a day, with use at night under a sock to help lock in the moisture.  The use of gel padding under the heel can help to displace the pressure applied to the heel during walking.  The use of sharp instruments like knives and scissors should be avoided, as unintentional cuts caused by these instruments can make matters worse.  This is especially true for diabetics, who are at risk for serious infections in such situations.  Deep fissures, and ones that bleed, may need antibiotic ointment applied to their bases to protect from bacteria.  Above all, barefoot walking should be avoided, and specialty shoe inserts (orthotics) may be needed to functionally alter the pressure pattern across the heel tissue.

Heel fissures are an ongoing problem for many, and require diligent treatment for relief.  If one is diabetic, or if home care is not helping to provide relief, a visit to a podiatrist is recommended to optimize treatment.

Until next time,
Scott R. Kilberg DPM

www.inpodiatrygroup.com - foot surgeon, podiatrist in Indianapolis
thediabeticfoot.blogspot.com - diabetic foot problems
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A foot doctor in Indianapolis Noblesville Fishers Carmel Westfield and Fortville Indiana.