Cracked Heels: Causes, Treatment, and Prevention
Cracked Heels: Causes, Treatment, and Prevention
By Sylke Bommel · Updated July 2026 · 7 min read
Key Takeaways
- Cracked heels, known as heel fissures, form when the thick skin on the heel dries out, thickens, and loses the flexibility to bend without splitting.
- A randomized, placebo-controlled clinical trial found a urea-based moisturizer healed significantly more foot fissures than placebo within 2 to 4 weeks.
- Standing for long periods, dry climates, open-backed shoes, and thin or worn out skin around the heel all raise the risk of cracking.
- Daily moisturizing with a urea-based cream and gentle exfoliation are the two habits shown to make the biggest difference.
- Deep, bleeding, or painful cracks, especially in people with diabetes, need a podiatrist rather than home treatment alone.
What Are Cracked Heels?
Cracked heels, or heel fissures, are splits in the thickened, dry skin around the rim of the heel that form when the skin loses moisture and elasticity.
The skin on the bottom of the heel is naturally thicker than skin elsewhere on the body because it absorbs the full weight of the body with every step. When that thick skin also becomes dry, it stiffens and cannot flex normally under the pressure of walking, so it splits instead of bending.
Mild fissures are a cosmetic and comfort issue, but deeper cracks can bleed, become painful, and in some cases allow bacteria to enter, which is why persistent or deep fissures deserve attention rather than being left to worsen.
What Causes Cracked Heels?
Cracked heels are caused by a combination of dry skin, thickened callus tissue, and repeated pressure on the heel that the skin can no longer absorb without splitting.
Standing for long periods, especially on hard floors, increases pressure on the heel's fat pad and encourages callus buildup around the rim. Open-backed shoes and sandals remove the support that normally keeps the fat pad from spreading sideways under the heel, which stretches the surrounding skin. Cold, dry weather, frequent hot showers, and skin conditions such as eczema or psoriasis all reduce the skin's ability to hold onto moisture, compounding the problem.
Who Is Most at Risk for Heel Fissures?
People who stand for long shifts, those with diabetes, and anyone with naturally dry or thickened skin on their feet face a higher risk of developing cracked heels.
Diabetes deserves particular attention, since reduced circulation and nerve sensitivity in the feet can allow a fissure to worsen unnoticed and heal more slowly. Being overweight adds pressure to the heel's fat pad, and older age brings naturally drier, thinner skin, both of which make cracking more likely.
Signs of a Cracked Heel That Needs Attention
Most cracked heels start as surface dryness and progress to visible splits if left untreated.
| Mild Fissure | Fissure Needing Professional Care |
|---|---|
| Surface dryness, flaking skin | Deep cracks that reach the lower layers of skin |
| Thickened, hard rim of skin | Bleeding or oozing from the crack |
| Mild discomfort in bare feet | Pain when standing or walking |
| No redness or swelling | Redness, swelling, or signs of infection |
Anyone in the second column, especially with diabetes or poor circulation, should see a podiatrist rather than continuing home treatment alone.
How to Treat Cracked Heels at Home
Treating cracked heels starts with rehydrating the skin daily and gently reducing the thickened, hardened tissue around the rim of the heel.
Clinical research supports this approach directly. A randomized, double-blind, placebo-controlled study of people with diabetes found that a urea-based moisturizer healed significantly more deep, open heel fissures than a placebo cream, with a clear difference visible within 2 to 4 weeks of daily use. Urea works as a humectant, drawing moisture into the outer layer of skin, and at higher concentrations it also helps soften and gently break down thickened, hardened tissue.
Imperial Feet's Foot Fissure Cream is built around this same urea-based approach, formulated to rehydrate the deeper, harder skin at the rim of the heel while helping soften the built-up tissue that keeps the crack from closing. Applying it to clean, dry feet, ideally after a shower while skin is still slightly damp, helps the cream absorb into the thickened skin rather than sit on top of it.
How to Prevent Cracked Heels From Coming Back
Preventing cracked heels means keeping the skin consistently moisturized and reducing the pressure and friction that cause the thick skin to build up in the first place.
Daily moisturizing, even once the visible cracks have healed, keeps the skin flexible enough to withstand daily pressure. Wearing shoes with proper heel support rather than open-backed sandals for extended standing, gently filing away thickened skin once or twice a week rather than letting it build up, and staying hydrated all help maintain the improvement. For anyone with diabetes, a podiatrist can also check that footwear and daily habits are not putting unnecessary pressure on the heel.
2-4 wks
A randomized, placebo-controlled trial found a urea-based moisturizer produced a significant improvement in diabetic foot fissures within 2 to 4 weeks of daily use (Gin et al., 2017, Diabetic Medicine).
When to See a Podiatrist for Cracked Heels
- ✓The crack is deep, bleeding, or oozing
- ✓Walking or standing is painful
- ✓You have diabetes, poor circulation, or nerve damage in your feet
- ✓The area around the crack is red, warm, or swollen
- ✓Home moisturizing has not improved things after several weeks
⚠️ Important: if you have diabetes or poor circulation, check with a podiatrist before self-treating a deep or open heel fissure, since healing is often slower and the risk of infection is higher.
Foot Fissure Cream
Foot Fissure Cream uses a urea-based formula to rehydrate thickened heel skin and help soften the hardened tissue around a crack, supporting the daily routine that clinical research links to faster healing.
View Foot Fissure CreamFrequently Asked Questions
How long does it take for cracked heels to heal?
Mild cracked heels can improve within 1 to 2 weeks of daily moisturizing and gentle exfoliation. Deeper fissures, especially in people with diabetes, may take several weeks, and clinical research on urea-based creams shows measurable improvement within 2 to 4 weeks of consistent use.
What ingredient works best for cracked heels?
Urea is one of the most studied ingredients for cracked heels. It draws moisture into the skin as a humectant and, at higher concentrations, helps soften thickened tissue, which clinical trials have linked to faster fissure healing than moisturizer without it.
Can cracked heels be a sign of a health problem?
Occasional dry, cracked heels are usually just a skin issue, but persistent or worsening fissures can be linked to diabetes, thyroid conditions, or nutritional deficiencies. Anyone with diabetes should treat cracked heels seriously and involve a podiatrist rather than relying on home care alone.
Should you file cracked heels or just moisturize?
Both help, but in a specific order. Gently filing away thickened, dead skin once or twice a week, followed by a urea-based moisturizer on clean, slightly damp skin, allows the cream to absorb into the skin rather than sit on top of a hardened surface.
How can you prevent cracked heels in the future?
Daily moisturizing, wearing supportive closed-back shoes during long periods of standing, gentle weekly exfoliation, and staying hydrated all reduce the buildup of thick, dry skin that leads to cracking. Consistency matters more than any single treatment.
Clinical Sources
- Gin H, Rorive M, Garrigue E, et al. Treatment by a moisturizer of xerosis and cracks of the feet in men and women with diabetes: a randomized, double-blind, placebo-controlled study. Diabetic Medicine. 2017;34(9):1309-1317. doi:10.1111/dme.13402.
- Parker J, Scharfbillig R, Jones S. Moisturisers for the treatment of foot xerosis: a systematic review. Journal of Foot and Ankle Research. 2017;10:9. doi:10.1186/s13047-017-0190-9.
- DermNet NZ. Cracked heels. dermnetnz.org/topics/cracked-heel
- Mayo Clinic. How to heal cracked heels. mayoclinic.org/diseases-conditions/dry-skin/expert-answers/cracked-heels-treatment/faq-20455140
Related Reading
Owner, Imperial Feet — Third-Generation Foot Care
Sylke Bommel is the owner and third-generation leader of Imperial Feet, the Dutch professional foot care brand her grandfather founded in 2001. Raised in Aruba and based in Haarlem, just outside Amsterdam, she has led the brand's international expansion for over a decade, growing Imperial Feet from a single Dutch distributor to a professional range used by pedicurists, podiatrists, and pharmacies in more than 20 countries, including the United States.
Editorial note: Sylke writes from the perspective of a foot care brand owner and formulator, not a medical practitioner. Content is educational and does not replace individual medical advice from a qualified foot care professional.
Disclaimer: This article is for informational purposes only and does not replace individual medical advice from a qualified foot care professional. If you have diabetes, poor circulation, or a persistent infection, consult a podiatrist before self-treating.
