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Ask Val
Are the pedicures you are getting safe? O's beauty director, Valerie Monroe, gets to the bottom.
Heel and skin fissures can be found year 'round but are often seen in the winter months when the air is dry. Fissures can occur at any site, but tend to be more common in areas where the skin is either (a) changing from one type of skin to another or (b) areas that are prone to callus.
Most of us would tend to think of a callus forming as the result of friction. But the formation of a heel fissure is very different. Heel fissures form a unique type of callus that is created by tension on the skin. Tension at the rim of the heel is created with weight bearing.
To explain this concept, let's use an example; fill a water balloon at the sink and set the filled balloon on the counter. The weight of the water in the balloon will cause the balloon to spread putting tension on the walls of the balloon. Callus forms on the rim of the heel in much the same manner. When weight is applied to the heel the skin surrounding the rim of the heel is placed under tension. The higher the tension and the greater the load applied to the heel, the greater the chance for the formation of callus. As the callus becomes thicker and tension continues to be applied to the rim of the heel, cracks will occur in the callus. These cracks progressively deepen to become heel fissures.
Fissures aren't just specific to the heel though. Fissure can also be found on finger and toes, particularly in areas that are prone to callus.
Knowing that fissures occur secondary to the formation of callus, the best way to prevent fissures is to prevent the formation of callus. Most skin softeners are inadequate when treating stubborn heel callus and heel fissures. Periodic debridement with a callus file is also a must.
We recommend that you keep a “Thee Heeler” in the shower and simply make debridement of the callus a part of your daily shower routine. Fissured or cracked heels are deep splits in the skin on the rim of the heel. Heel fissures are seen more in the winter months when the air is dry. Also, heel fissures are more common in folks that are moderately to severely obese.
Heel fissures form at the junction of the two types of skin, glabrous and hairy skin. Glabrous skin is the skin on the bottom of the foot. Hairy skin is on the top of the foot. Glabrous and hairy 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 who are over weight, the rim becomes an abrupt turn caused by excessive load applied to the heel. This abrupt turn stimulates the formation of callus.
Why do heel fissures form? The formation of a heel fissure can be compared to the force generated in the walls of a water balloon when the balloon is set on a hard flat surface. As the weight of the water in the balloon expands, the walls of the balloon are put under tension. In the case of heel fissures, tension occurs in the rim of the heel each time the heel strikes the ground. The skin responds to this tension by forming callus. Repeated tension on the callus causes the callus to split. The cycle of callus and splitting repeats itself with each step.
Fissures of the heel can become so deep and problematic that they bleed and become infected. Heel fissures can be particularly troublesome for those people that lack sensation in the foot such as diabetics.
Treatment of Heel Fissures
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. Prevention will require ongoing care. Care may include periodic debridement after a shower or soaking the feet with “ Thee Heeler”.
Infection, likely from a high-end salon
bacterial infection sent her in and out of the hospital for a year
