Cracked heels are caused when the skin becomes too dry; this combined with the forces acting on the heel as a result of walking and standing cause the skin to crack and split, producing what are known as fissures (think of what would happen if you pushed down on a tomato that was no longer ripe; the skin would split much in the same way as the skin on the heel). Fissures are deep cracks that are typically found on the heel border.

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Some people are more prone to developing heel fissures than others, they include:

• People who stand for long periods of time

• People who wear open back footwear

• People who are overweight

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Autonomic neuropathy is another cause of dry skin and heel fissures. Autonomic neuropathy occurs as a result of damage to the peripheral nervous system, in the foot this may result in a reduction in sweat production, leading to dry skin. Examples of conditions that can lead to autonomic neuropathy include:

• Diabetic neuropathy

• Alcoholic neuropathy

• Parkinsons disease

• Guillain Barr Syndrome

• Sclerosis

• Use of anticholinergic medications

• Chronic idiopathic anhidrosis

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People with certain medical conditions, for example; diabetes, hypothyroidism, psoriasis and eczema