Heel Fissures Treatment: How to Heal Deep Cracked Heels

Heel fissures heal best with a two-step routine: soften and thin the thick skin with a urea or other keratolytic cream, then seal it with an occlusive layer such as petroleum jelly under cotton socks at night. Deep, bleeding, painful or infected cracks, or any cracks in a person with diabetes, need a podiatrist.

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TL;DR

Most shallow heel cracks improve in a few weeks with moisturizing twice a day, gentle removal of dead skin and an occlusive layer at bedtime.
Urea creams are the most studied ingredient. Heavy petroleum-based ointments seal in the moisture.
If you have diabetes or nerve damage, do not treat cracks alone. Call a foot doctor the same week, and right away if you see redness, swelling, pus or an open sore.
Cracks that do not improve may be eczema or a fungal infection, and they need a different treatment than lotion.
Deep heel pain without visible cracks can come from a thinned heel fat pad, which is a separate problem with a different fix.

What are heel fissures, and why do they form?
Are heel fissures only a cosmetic problem?
How do you treat heel fissures at home?
Which cream works best for heel fissures?
Is a vitamin deficiency behind your cracked heels?
When are cracked heels actually eczema or a fungal infection?
Heel fissures and diabetes: why the rules change
When should you see a podiatrist for heel fissures?
What about heel fat pad atrophy and heel pad pain?
Mistakes that keep heel cracks from healing
Our perspective: treat the cause, not just the crack
Get your heels checked in Las Vegas
FAQ
Sources

What are heel fissures, and why do they form?

Heel fissures are splits in thick, dry skin on the rim of the heel. They start as rough lines and can deepen until they bleed or hurt with every step. Dryness, pressure and calluses are the usual causes, and each one needs to be addressed.

The skin of the heel is thick and has few oil glands. When it dries, it loses flexibility. Every time you put weight on the heel, the fat pad underneath spreads outward and the stiff outer skin has to stretch with it. Dry, callused skin cannot stretch, so it splits.

Common contributors include:

Dry air and long, hot showers. Board-certified dermatologists at the American Academy of Dermatology note that bathing too long or in hot water strips natural oils and makes cracked heels worse. Dry desert air in Las Vegas adds to the problem, especially in winter.
Thick calluses. Pressure from walking and standing builds a callus, and the callus is where cracks start. Our guide to corns and calluses explains how that buildup happens.
Open-back shoes and sandals. They let the heel fat spread sideways without support and expose the skin to air.
Diabetes. In people with diabetes, nerve damage can reduce sweating, which dries the skin. A 2025 scoping review describes how this dryness can progress from fissures to ulcers.
Skin conditions. Eczema or athlete’s foot (tinea pedis) can look like plain dryness.

Are heel fissures only a cosmetic problem?

No. A fissure is a break in the skin barrier. In most healthy people it is an annoyance. In people with diabetes, poor circulation or numb feet, it is an entry point for bacteria and should be managed clinically.

The Mayo Clinic describes dry, hardened heels as common, especially in winter, and lists self-care steps for them. A split that is deep enough to bleed is different. Bacteria can enter, and what began as a dry crack can become a painful infection.

A practical example: a retired man who walks daily in sandals notices a crack along the inner heel. It stings, and he covers it with a bandage and keeps walking. Two weeks later the edge is red and warm. That is the pattern we want people to catch early, because a split that is cleaned, protected and unloaded early usually settles quickly.

How do you treat heel fissures at home?

Soak briefly, thin the callus gently, apply a urea-based cream, then seal with an occlusive ointment and cotton socks. Repeat daily. Consistency matters more than any single product.

These steps apply to adults without diabetes, nerve damage or poor circulation. If you have any of those, skip to the section on high-risk feet below.

Step-by-step routine

Wash once a day in warm, not hot, water. The AAD advises limiting baths and showers to 5 to 10 minutes and using mild soap.
Soften and gently thin the callus. After washing, a pumice stone or foot file used lightly on damp skin can remove dead surface skin. Mayo Clinic notes it is safe to remove some of the dead skin. Never cut or shave the heel, and stop if the skin feels tender or you see blood.
Moisturize within five minutes of bathing. The AAD recommends applying moisturizer while the skin is still damp to trap water before it evaporates.
Choose a keratolytic cream. Creams with urea, salicylic acid or alpha hydroxy acid soften and loosen dead skin, according to Mayo Clinic. Mayo suggests moisturizing at least twice a day.
Seal it in at night. Put on petroleum jelly or a thick ointment, then clean cotton socks. Without the occlusive layer, water escapes and healing slows.
Protect the heel by day. Wear closed-back shoes with a snug heel counter and avoid going barefoot on hot or hard surfaces.

What to expect

Shallow cracks often feel better within one to two weeks of steady care, and the skin generally looks smoother after several weeks. Deep fissures take longer. If you see no improvement after about two to three weeks of the full routine, stop experimenting and have the heel examined.

Which cream works best for heel fissures?

Urea creams have the strongest evidence. Lower strengths (about 10 to 25%) soften callused skin, and a petrolatum-based ointment on top locks it in. Higher-strength prescriptions are decided case by case.

The best-studied example is in people with diabetes. In a randomized, double-blind, placebo-controlled study of 167 participants, a moisturizer containing urea, glycerine and petrolatum significantly reduced deep open fissures compared with placebo. The prevalence fell from over 40% to about 6% after four weeks. This was a specific product tested in people with diabetes, so it does not prove that every urea cream works equally well for everyone. It does support urea plus an occlusive base as a sound combination.

Product type	What it does	Best used
Urea cream (about 10 to 25%)	Softens and loosens thick dead skin so moisture can enter	Twice daily on heels
Salicylic acid or AHA cream	Exfoliates dead skin	Calluses without open cracks, never on broken or diabetic skin without medical advice
Petroleum jelly or healing ointment	Seals in moisture, protects the split	Over cream at bedtime, under cotton socks
Plain thin lotion	Light hydration only	Maintenance, rarely enough for fissures
Liquid bandage	Holds the edges of a shallow, clean split together	Short-term, only on clean cracks

A caution on acids: salicylic acid and alpha hydroxy acid can sting or irritate cracked skin. If a product burns, stop using it.

Is a vitamin deficiency behind your cracked heels?

Rarely the sole cause. Dryness, pressure and skin conditions explain most cracks. Supplements are not a proven fix for healing.

Readers often ask about vitamin deficiency. We would not start supplements on a guess. For diabetic foot wounds, the 2023 IWGDF guideline found insufficient evidence to recommend nutritional supplementation specifically for wound healing. The focus there stays on offloading pressure, keeping wounds clean and treating infection. If you suspect a nutrition problem, ask your primary care doctor about blood tests rather than self-prescribing.

When are cracked heels actually eczema or a fungal infection?

If cracks keep returning despite good moisturizing, the cause may be a skin condition. Eczema and athlete’s foot (tinea pedis) can look like dryness but need targeted treatment, not just lotion.

Clues that point beyond simple dryness:

Itching, scaling or redness along the sole and sides of the foot, not only the heel rim
Peeling between the toes
A rash elsewhere on the body
Cracks that improve a little and return within days

The CDC’s diabetes foot guidance lists signs such as redness, swelling and pus as reasons to get care, and persistent cracks that do not respond to moisturizing deserve an exam to rule out these causes. For a general overview of how eczema is approached, this explainer on whether eczema can be treated is a useful read. It comes from an Irish telehealth service, so its booking details do not apply in Nevada. A podiatrist can examine the foot, and a scraping or culture can confirm a fungal infection when needed.

Heel fissures and diabetes: why the rules change

If you have diabetes, treat any heel crack as a medical issue. Call your foot doctor promptly, never use medicated corn or callus removers, and let a podiatrist manage calluses.

The CDC says that nerve damage and poor blood flow put people with diabetes at risk of foot ulcers, and that an ulcer can become infected and heal poorly. It advises people with diabetes to get medical care for dry, cracked heels, and warns against trying to remove corns or calluses yourself. Over-the-counter removers contain acids that can burn vulnerable skin.

The American Academy of Dermatology adds that diabetes often causes very dry skin and that cracks can grow deep and bleed. When you cannot feel your feet well, a crack can go unnoticed until it is infected.

What we recommend for diabetic heels:

Check both heels daily, using a mirror or asking a family member.
Moisturize daily but not between the toes, where trapped moisture invites fungus.
Never walk barefoot, even indoors.
Do not apply acid-based removers or cut calluses yourself.
Read our pages on diabetic foot callus risks and antibiotic ointment versus antiseptic for diabetic foot wounds before reaching for a first aid product.

The CDC’s guidance on preventing diabetes-related amputations notes that with nerve damage and circulation problems, even a small cut can become a serious infection. That is why we treat a crack in a diabetic heel as urgent rather than cosmetic.

When should you see a podiatrist for heel fissures?

See a podiatrist if cracks are deep, bleed, hurt, show redness, warmth, swelling or pus, do not improve within two to three weeks, or if you have diabetes, neuropathy or poor circulation.

Specific situations:

You have diabetes or numb feet. Make an appointment as soon as you notice a crack.
The crack is open and draining, or the skin around it is red or warm. This can mean infection. Same-day evaluation is appropriate. If you also have fever or red streaks moving up the leg, go to urgent care or an emergency department.
A thick callus keeps rebuilding. The cause may be pressure from foot structure or footwear, which a clinician can assess.
You are older or have limited mobility and cannot inspect or reach your heels easily.
Your child has cracks or peeling that do not respond to simple moisturizing.

What a podiatrist does that home care cannot

Safely thins thick calluses with sterile instruments, which lets creams penetrate
Looks for infection, eczema, fungus or an underlying pressure problem
Cleans and dresses an open fissure and, if needed, debrides it. See our explanation of foot wound debridement.
Evaluates footwear and whether orthotics or heel cups would reduce pressure

What about heel fat pad atrophy and heel pad pain?

Heel fat pad atrophy is thinning of the cushion under the heel bone. It causes deep, central heel pain, often worse on hard floors, and is a different problem from cracked skin. A podiatrist can tell them apart.

Many people searching for cracked heels also search for heel fat pad syndrome or heel pad atrophy, so it is worth separating them. Cracks are a skin problem on the rim of the heel. A thinned fat pad is a cushioning problem beneath the bone. People with fat pad problems often describe a bruised feeling in the middle of the heel, and walking barefoot or on tile tends to make it worse. Heel pain more broadly is often caused by overuse or shoes with poor support or shock absorption, according to MedlinePlus.

Why does it matter for cracked heels? A heel that lacks cushioning takes more impact, and the extra pressure can encourage calluses and splits. Both problems can occur in the same foot.

How the conservative approach usually works:

Examination. The doctor presses on the heel, checks the thickness and feel of the pad, and rules out plantar fasciitis, a stress fracture or nerve irritation. Imaging is used when the diagnosis is unclear.
Cushioning. Supportive shoes, heel cups or custom orthotics spread pressure. Read about what custom orthotics are and how they work and orthotics for foot pain.
Activity changes. Reduce barefoot walking and high-impact activity on hard surfaces while the heel calms down.
Further options. If pain persists, a physician can discuss additional nonsurgical options. Which ones fit depends on the exam, and we do not promise that any one will rebuild a thinned pad.

If your heel pain is deep and constant rather than a surface sting, do not wait for lotion to fix it.

Mistakes that keep heel cracks from healing

Moisturizing once a day with a thin lotion. For fissures, you need a keratolytic cream plus an occlusive layer.
Soaking for a long time in hot water. It dries the skin further.
Aggressive filing. Taking off too much skin makes tender spots and encourages the heel to thicken again.
Using medicated callus pads or acid removers. These are especially risky with diabetes. See our safe home guide to corn and callus removal.
Barefoot walking or open-back sandals on hot, dry days. Desert heat and hard surfaces are hard on heels.
Ignoring a crack that has become painful. Pain, warmth or drainage means it is time for an exam.

Our perspective: treat the cause, not just the crack

In our practice we see heel fissures as a symptom. The crack is where the problem shows up, but the cause may be dryness, pressure, footwear, a skin condition or diabetes. Treating only the crack with lotion can leave the real problem in place.

That is why we start conservatively. Dr. Nahad Wassel is a board-certified foot and ankle surgeon, and surgery is not the answer for cracked heels. Our approach is to look at the whole foot: the skin, the shape of the foot, the shoes you wear and your health history. For most people, that means a clear home routine, careful callus care, and orthotics or footwear changes if pressure is the driver. For people with diabetes or open wounds, it means closer follow-up and professional wound care.

One thing we would tell any friend: do not wait until a crack hurts. A heel that is dry and rough in October is easier to fix than one that is split and bleeding in January. And if you have diabetes, call us when you see the first line.

— Ramil

Get your heels checked in Las Vegas

If your heel cracks are deep, painful, recurring or you have diabetes, we can examine the foot, treat the callus and any open skin, look for the pressure that caused it and plan prevention. We also provide orthotics and general foot and ankle care and wound care for heels that have broken down. You can request an appointment with Dr. Wassel through the Stride Foot & Ankle website. For everyday habits that protect your feet, see our preventive foot care tips.

This article is general information and does not replace an examination. A person’s treatment depends on their health history and a clinician’s assessment.

FAQ

How do you heal a heel fissure fast?

There is no safe shortcut, but the quickest route is consistent care. Soak briefly, gently thin the callus, apply a urea cream, and seal with petroleum jelly under cotton socks every night. If the crack is deep, bleeding or you have diabetes, have a podiatrist treat it instead.

What causes deep fissures in the heels?

Thick, dry calluses that cannot stretch under the pressure of walking are the usual cause. Hot water, open-back shoes, dry air, skin conditions such as eczema or athlete’s foot, and diabetes-related dryness all contribute. Deep cracks that keep returning deserve an exam to find the cause.

What is the best cream for heel fissures?

Look for a cream with urea, which softens thick dead skin, and follow it with a petroleum-based ointment to lock in moisture. The study of people with diabetes found a urea and petrolatum moisturizer cut deep fissures sharply in four weeks. Ask a podiatrist before using acid-based products if your skin is broken or you have diabetes.

Can a vitamin deficiency cause cracked heels?

It can contribute in some cases, but dryness and pressure are far more common causes. Guidelines do not support taking supplements to speed wound healing without a diagnosed need. Talk to your doctor about testing instead of guessing.

Is heel fat pad atrophy the same as cracked heels?

No. Cracked heels are a skin problem, while fat pad atrophy is thinning of the cushion beneath the heel bone, which causes deep central pain. They can occur together, and a podiatrist can tell which one you have.