MEDICAL FOOT CARE

What is Heel Thickening and Heel Cracks?

Heel thickening also causes thickening in the pressure-exposed areas of the heel and sole of the foot, which are exposed to long-term pressure for reasons similar to callus.

On the sole of the foot, it is not only limited to the heel, but can also be seen in the areas of the sole of the foot that are exposed to pressure, that is, the foot touches the ground.

Due to the pressure, the skin is trying to prevent damage to the subcutaneous tissues by thickening it to protect itself with the same mechanisms in calluses.

However, pressure is not the only reason for heel thickening in some patients. In addition to callus-like heel thickening, it should not be forgotten that there are some diseases associated with hyperkeratosis in dermatology practice. Thickening of the heels may occur due to reasons such as thyroid diseases, diabetes, skin dryness, circulatory disorder, and menopause in women.

These are not diseases in themselves, but show themselves as skin manifestations of some diseases.

In addition, some skin diseases called keratoderma, localized skin thickening on the palms and soles, as well as the presence of genetic diseases manifesting with some developmental anomalies should be considered. Whether the palm sole thickening that begins at an early age is accompanied by abnormalities of the hair, nails, teeth, and sweat glands should be carefully examined by a dermatologist. Important diseases can be found under many conditions called heel cracks.

In addition, it should be kept in mind that some skin diseases such as psoriasis (palmoplantar psoriasis), eczema (contact dermatitis), pityriasis, and rubra pilaris tend to settle on the palms and soles of the feet. Another important issue is that in the presence of these diseases, rubbing with pumice stone and scraping during foot care can make the current situation of these diseases worse. The reason is that there is a condition called Koebner phenomenon in psoriasis and similar diseases. Traumas in the areas with this disease both increase the existing disease and cause new lesions to appear. Trauma application is absolutely contraindicated in Koebner (+) diseases. These diseases should be treated by a Skin and Venereal Diseases (dermatologist) specialist with special treatment protocols. In addition, rubbing operations performed in cases such as eczema may cause the cracks to deepen and become open to the entry of infection through the opened cracks.

Again, it should be known that diseases such as fungi can go away with the appearance of thick and flaky skin, which is called as hyperkeratosis, and in suspected cases, microscopic fungal examination should be performed by your dermatologist to confirm the diagnosis. If the treatment for fungus is to be applied, the importance of the correct diagnosis before treatment emerges once again, since the form of the treatment will completely change.

How is Heel Thickening and Treatment Done?

Correct and differential diagnosis, which is the first step of treatment, brings success together. It also prevents the exacerbation of diseases such as psoriasis and eczema and provides guidance for the right treatment.

It is important to reduce the pressure on the heel cracks. It is important to lose weight, choose suitable shoes (low-heeled, orthopedic 5-point pressure, use of orthopedic insoles if necessary) and support with appropriate splints in the patients having walking and stepping problems. Orthopedic slippers are known to prevent and treat heel cracks, even when used alone.

Treatment

One of the mistakes made in the treatment is the dry rasping of the heel thickening. In this case, although the skin seems to have thinned a little at first, it tries to repair itself by thickening it later for protection purposes. The recommended point here is that the feet should be rasped after bathing or soaked in warm water, and then moisturizing creams should be applied frequently to prevent recurrence by providing appropriate moisture during tissue recovery.

Salicylic acid is frequently used in home peelings for cracked heels to take advantage of its keratolytic effect, which eliminates the slough. The issue here that should be taken into account is that the ratios of salicylic acid used for the heels should not exceed 15-20% at home care. Care should be taken as dense acid contents can damage normal tissue.

In medical foot care, thickened tissue is cleaned without causing tissue damage with the help of cutters. Thanks to the mechanical cleaning provided by the cutters used, the desired normal tissue level can be easily reached without creating tissue injury. After the procedure, mild peeling can be applied if your doctor deems it necessary. Afterwards, the necessary care suggestions are made and the treatment is completed.