Cracked heels or heel fissures are a common problem seen in podiatric practice. The most common predisposing factors for cracked heels are being overweight, wearing open back shoes and having dry and thick sign around the periphery of the heel. On weight bearing, the fat pad under the heel expands out sideways, this puts pressure on the dry and hard skin to crack it. Wearing closed in shoes helps keep the fat pad under the heel and prevents the expansion. Being overweight, means that there is a greater expansion of the fat pad under the heel. The best way to prevent cracked heels is to ensure that the skin is supple, so that when it expands the cracks do not happen. This is best done by the regular removal of the dry hard skin by a podiatrist and the regular use of emollients and creams. Wearing closed in shoes will also help prevent it. Once a cracked heel develops, then it is important that the hard skin be removed and care taken to heal the fissure.
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