Are Cracking Heels Related To Diabetes?

The onset of diabetes can present many symptoms, including increased thirst, frequent urination, weight loss, blurred vision, and very dry skin. Diabetes also takes a huge toll on your feet, reducing blood flow and depriving your feet of nutrients and oxygen, making it difficult to heal blisters, sores, and cuts.

Some people with diabetes will also experience numbness in their feet because of peripheral neuropathy. Because of the impact diabetes has on the feet and the fact that it causes dry skin, cracked heels are thought to be a sign of diabetes. But are they? 

What are cracked heels? 

Cracked heels are a common problem among adults in the United States. When the sensitive skin on the bottoms of your feet and heels becomes too dry, it can split, leaving cracks called heel fissures. For most people, the fissures don't present any health challenges, but in others, the cracks can make it difficult to walk and even lead to serious infections.

The fissures often extend through the inner layers of the skin, causing bleeding. Sometimes, it's difficult to get the two edges of the crack to knit back together, increasing the chances of a serious infection in the bloodstream. 

Complications of cracked heels

Generally, most heel fissures result in superficial complications. But deeper cracks can cause more problems which include:

• Pain

• Stress

• Anxiety

• Risk of infections (cellulitis)

• Risk of amputation among people with diabetes (in case of an infection that is not properly cared for or treated)

• Swelling, redness, and/or drainage of pus for infected fissures 

What causes cracked heels in relation to diabetes? 

People with diabetes often present with heel fissures, but other factors can cause cracked heels. Diabetes can damage the nerves in the feet, affecting the functioning of sweat glands in that area. When the sweat glands can't produce sweat, the skin around the feet doesn't receive moisture, causing it to become dry.

Over time, the heels develop fissures that can lead to deep ulcers and open sores on the heels. For people with diabetes, such fissures present significant health concerns because they can easily become infected. This results in complications that sometimes lead to amputation.

It's crucial to note that having cracked heels is not an indication of diabetes. However, diabetes increases the chances of developing cracked heels because of its negative impact on the functioning of sweat glands. 

Treatment for cracked heels

Because cracked heels are common, there are numerous treatments available at home and even in a hospital, depending on the seriousness of the situation. 

Home remedies 

You can easily manage mild cases of cracked heels by moisturizing the heel area two or three times per day. Home remedies are perfect if you're not experiencing any discomfort or if the cracks have just started appearing. Other home remedies include:

• Using emollient or humectant moisturizer - Emollients help the skin reduce water loss. They penetrate the skin and fill the gaps between skin flakes for a smooth, soft, and flexible feel. Humectants attract water from the air to maintain moisture. They can also help to increase the water capacity of the skin.

• Wearing 100% cotton socks to bed - Wearing socks to bed is not just good for cracked heels but also for people with diabetes. Before putting on the socks, make sure you apply petroleum jelly to the skin at the heels to help maintain moisture. You will need to repeat this for a few days for the skin to soften.

• Gently rubbing the skin with a pumice stone - You can remove some of the thick dead skin by rubbing it with a pumice stone. It helps reduce the thickness of hard skin and calluses.

Medical treatments

If home remedies aren't working or you suspect an infection, and the fissures make it painful for you to stand or put pressure on your heels, it's highly recommended to see a doctor, especially if you have diabetes. Common treatments prescribed include:

• Strapping around the heel

• Debridement

• Prescription medication for pain and infections

• Skin glue

• Prescription shoe inserts 

What should I do to avoid getting cracked heels?

You can save yourself a lot of trouble and pain by following simple procedures that reduce your chances of getting cracked heels:

• Avoid open shoes like flip-flops and sandals that increase the chances of your feet drying out. 

• Avoid open shoes that don't provide enough heel support.

• Avoid shoes with a skinny heel which can cause your heel to expand sideways.

• Avoid shoes that are too tight.

• Don't stand in one position for too long or sit with your legs crossed for too long.

• Apply thick foot cream at night and wear cotton socks to bed

• Check your feet daily.

• Wear custom shoe inserts to cushion your heel and distribute the weight.

• Drink plenty of water to stay hydrated. 

• Wear silicone heel cups to promote moisturization and prevent the heel pad from expanding. 

When should I see a podiatrist (a foot doctor)?

Most cracked heel conditions are easy to take care of by yourself with home remedies. But when the fissures become dry, cracked, and start bleeding and hurting when you walk, it is time to seek professional care from a podiatrist. If such deep cracks aren't treated, they can cause an infection, leading to potential amputation for diabetics. 

Other symptoms that might go with cracked heels

Besides the cracked heels, you might notice other symptoms such as itching, varying levels of pain, ulcerations, flaky skin, inflammation, and warmth and redness in infected cases. If you experience any of these symptoms, consult your doctor as soon as possible.

The lowdown

Cracked heels can occur in anyone but are of special concern if you have diabetes. When you have cracked heels with diabetes, make sure you pay a lot more attention to the condition of your feet, inspect your feet regularly, and use the suggested home treatments discussed in this article. If you experience any pain or suspect an infection, seek medical attention as soon as possible.