Dry Skin / Heel Fissures
By: Corinne Gehegan, DPM
From time to time most people have experienced dry skin. For some, the
skin may be become so dry that fissures (cracks) develop. The likelihood
is increased if callused skin is present to begin with. The medical term
for this condition is xerosis. Aside from it being an unattractive
condition; it can also be painful and prone to infection.
There are a multitude of systemic and mechanical sources that contribute
to the development of xerosis and fissures. Diabetes and hypothyroidism
(under active thyroid) are two endocrine abnormalities that affect
hydration of the skin. Foot structure, being overweight, standing for
prolonged periods of time, and backless shoes are also factors in its
development. In these cases the heel’s natural fat pad is displaced
sideways, thereby adding tension to the skin. The result is weakening
and eventually fissuring of the skin. Additionally, a backless shoe
exposes the skin to the environment leaving it vulnerable to being
stripped of its natural oils and moisture. For example, moving from an
air conditioned car in the summer to the heat outdoors, and then back
again into an air conditioned environment does not leave the skin with
much time to adapt.
If skin is callused, it is recommended that it be debrided (removed)
professionally. This is followed by multiple applications of a hydrating
cream throughout the day. Once the callused skin is removed, the cream
will more effectively penetrate and hydrate. It is also recommended that
creams be applied under occlusion. Socks and gloves are available for
this specific condition, but plastic wrap can be just as effective.
Prescription strength creams are available that contain urea and lactic
acid. Several over the counter products contain glycolic acid and
salicylic acid. It is best to check with your doctor if these products
are right for you. Tinea pedis (a fungal infection also known as
athlete’s foot) should be ruled out, as well as psoriasis, eczema, and
contact dermatitis. Of course, addressing the source is key to
successful management of this condition.
Article written by Dr. Corinne Gehegan
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