Therapeutic pedicure in Coimbra
Cracked heels and fissures in Coimbra
Heel fissures
Cracks start as dry skin and end up as splits that hurt and bleed. The skin is treated and, more importantly, whatever is drying it out and splitting it is corrected.
What it is
Fissures are splits in the skin that appear mainly on the rim of the heels, where the skin is thickest and bears the most load. Dry skin loses its elasticity; when the heel lands on the ground, the fat pad spreads sideways and the hardened skin, instead of stretching, cracks.
Superficial cracks are merely uncomfortable. Deep ones reach the dermis, hurt when walking, bleed and are an entry point for bacteria and fungi — in people with diabetes or poor circulation they can lead to serious infections.
Signs and symptoms
- Dry, thick, yellowish skin on the rim of the heel, sometimes flaking.
- Linear splits, fine or deep.
- Pain when putting the foot down, especially in the morning or after sitting.
- Bleeding or small scabs in the splits.
- Itching, redness or whitish, macerated skin if there is a fungal infection.
Most common causes
- Dry skin (xerosis), more common with age, in winter and in dry environments.
- Thick calluses on the heel, which do not stretch.
- Open-backed footwear — flip-flops, sandals, clogs — that lets the heel pad spread without containment.
- Long hours standing, excess weight, flat feet or uneven loading.
- Skin conditions (eczema, psoriasis, fungal infections) and conditions such as diabetes, hypothyroidism or nutritional deficiencies.
- Very hot baths, harsh soaps and lack of moisturising.
How it is treated
At the appointment the thick, dry skin at the edges of the fissures — which is what stops the split from closing — is precisely removed. Then the split itself is treated: cleaning and, when indicated, laser therapy, which helps calm inflammation and stimulate healing. For deep cracks a dressing or a product that keeps the edges together while the skin regenerates may be applied.
The new skin only stays healthy with proper daily moisturising — usually a urea cream, with the concentration chosen according to skin thickness — and with footwear that encloses the heel. Without that, cracks return within a few weeks.
When there are signs of fungal or bacterial infection, or an undiagnosed skin condition, Priscila treats what is within her scope as a nurse and refers to a doctor whatever needs a prescription.
What happens at the appointment
- 1Assessment of the skin, the depth of the fissures, footwear and foot loading.
- 2Debridement of the callus and the hardened edges of the cracks.
- 3Cleaning of the fissures and laser therapy to promote healing, when indicated.
- 4Dressing or protection of the area for deep cracks.
- 5Moisturising plan and footwear advice; review in 2 to 4 weeks in the more severe cases.
What you can do at home
- Urea cream (10 to 25%) every day, preferably at night, massaged into the heels; on open cracks use the healing product recommended at the appointment.
- Avoid flip-flops and open-backed shoes while the heels are cracked; prefer closed shoes with a cushioning sole.
- A gentle file or pumice stone after bathing, in moderation — never blades or “graters”.
- Warm rather than very hot baths, and mild soaps; dry feet well.
- Drink enough water and keep your weight under control; cotton socks that do not rub.
- Silicone heel cups help contain the heel pad and reduce load on the fissures.
When not to wait
Book without delay — or see a doctor — if you notice any of these signs:
- Cracks that bleed, with pus, redness, warmth or increasing pain.
- You have diabetes, poor circulation or reduced sensation in your feet: a deep crack must be treated by a professional without delay.
- Splits that do not close after 2 to 3 weeks of moisturising and suitable footwear.
- Intense itching, peeling skin between the toes or changed nails: there may be a fungal infection to treat at the same time.
Frequently asked questions
Why do the cracks always come back?+
Because the cause remains: dry skin, thick callus or open shoes. Debridement treats the split; daily urea moisturising and closed shoes are what stop it returning. On heavily loaded feet, a periodic maintenance appointment keeps the skin under control.
Which cream should I use?+
Urea creams, between 10 and 25% depending on skin thickness, applied daily. On open cracks, a healing product or protective film recommended at the appointment. Ordinary body moisturisers are usually not enough for heel skin.
Can I cut the hard skin with a blade?+
No. At home, a blade cuts healthy skin, creates wounds, and the skin responds by thickening even more. Debridement with a scalpel and micromotor is done at the appointment, with controlled depth.
What does laser therapy do for cracks?+
It is used as a complement: laser light has an anti-inflammatory effect and stimulates circulation and tissue regeneration, helping the split close faster. It does not replace debridement or moisturising.
This information is general and meant to help you understand the problem. It does not replace an individual assessment or medical follow-up. If in doubt, book an appointment. Content reviewed by Priscila Arantes, registered nurse (Ordem dos Enfermeiros no. 117508).
Other problems we treat
Corns and calluses
Debridement takes the pain away the same day. What stops the corn coming back is understanding where the pressure comes from — and that is what the appointment assesses.
Learn more →Wounds and dressings
A wound on the foot has body weight, shoes and, often, circulation that is no longer at its best working against it. Healing well depends on cleaning, protecting and relieving pressure — and on seeing the wound at the right intervals.
Learn more →Podiatric risk
With diabetes, and other conditions that affect circulation or sensation, the feet need monitoring even without complaints — because the problem is often that you stop feeling. The appointment is there to see what you cannot feel and to treat safely what would be a risk at home.
Learn more →Ingrown toenail · Nail fungus · Plantar wart · Thick or deformed nails