The heel problem that threatens your mobility

As we grow older, our feet can develop patches of thick, dead skin called calluses. Calluses are especially common on the heels, because they take a lot of pressure as we walk. That pressure, combined with older skin that's often thin and dry, makes us susceptible to a common and potentially debilitating condition called cracked heels.

Why do we get calluses?

Calluses form as a result of friction. "Sometimes it's caused by the way your foot strikes the floor, and sometimes it's due to loose shoes like sandals, which cause your feet to move around and rub against the shoe. With all of that friction, the body protects itself by forming thicker skin on the heels," explains Sara Rose-Sauld, a podiatric surgeon with Harvard-affiliated Mass General Brigham Integrated Health.

When callused skin is very dry, it tends to crack. "If you picture a piece of dry, brittle bread, you can imagine that it would crack open if you stepped on it," Rose-Sauld says.

Cracked heel risks

Painful cracked calluses on the heels make it hard to walk and increase the risk for infection, since cracks open the door for bacteria to enter the body.

If infected, cracked heels can turn into foot wounds, which can be hard to heal. This is especially true in people with diabetes or peripheral artery disease (PAD) who have poor circulation in their legs and feet.

Treatment

Cracked heels can usually be treated at home if they aren't infected, and if you're sure that the affected areas are calluses and not plantar warts or psoriasis, which would require different treatment.

For cracked heels, Rose-Sauld recommends that you

• put over-the-counter antibiotic ointment on the cracks to prevent infection
• cover the area with a bandage that you change daily
• wear socks and cushioned shoes
• adjust activities to take pressure off your heels and promote healing.

Follow this routine until the cracks heal and pain eases.

Infection

If there is any pain, redness, pus, or swelling, contact your doctor or podiatrist. It could indicate an infection — an urgent health matter for anyone, especially if you have diabetes or PAD. To treat the infection, your doctor will prescribe a topical or oral antibiotic. Then you have to return two weeks later, to make sure you're healing correctly and the pain is going away.

The doctor may also remove the callus with special tools such as scalpels and power sanders made for the feet.

After that, you'll need to try to prevent cracked heels from developing again. (See "Preventing cracked heels.")

Foot maintenance

It's hard to prevent calluses completely, but you can keep them from growing and causing problems by getting a pedicure regularly.

If you have diabetes or PAD, talk to your doctor about whether this would be a good idea.

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