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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