Heel fissures seem to form at the junction of the two types of skin in the foot, glabrous and hairy skin (for additional information on skin, refer to the Foot and Ankle Knowledge Base'). These two types of skin come together at the rim, or junction of the side and bottom of the heel. For most people, the rim is a smooth transition between these two types of skin. For those folks that are over weight, the rim becomes an abrupt turn caused by over loading. This abrupt turn seems to stimulate the formation of callus around the rim of the heel.

Heel fissures are actually a problem that is secondary to recurrent callus formation. As the callus surrounding the rim of the heel thickens, the callus will crack or fissure. Fissures of the heel can become so deep and problematic that the bleed and become infected. Heel fissures can be particularly troublesome for those people that lack sensation in the foot such as diabetics.

Heel fissures have no cure. Prevention is the best medicine. The best that we can hope for with heel fissures is to prevent deep, painful cracks. This requires ongoing care. Care may include periodic debridement after a shower or soaking the feet. Softening creams that have "softening agents' are helpful. Some of these creams may use additives such as urea or salicylic acid to chemically debride away some of the callus. Occasionally heel pads or heel cups are helpful to redistribute the weight of the heel over a softer, more broad area.