Dry skin may not be considered a serious condition, but it can be uncomfortable and associated with a feeling of tightness and itching. Skin can appear shrunken, rough, flaky, with scaling and peeling. There may be associated redness or deep fissures and in some cases bleeding. On the foot, the heel is a common area for excessive dryness and bleeding. The skin on the lower legs can also become excessively dry. Severe dry skin can represent an underlying medical condition, such as hypothyroidism or psoriasis. More commonly, weather, long showers, excessive water exposure, certain soaps and the sun will cause dry skin. Low humidity conditions, as commonly occurs during the winter months, in association with central heating and wood burning stoves contribute to dry skin. Soaking the feet or hands in water for long periods also dries out the skin. It’s common to think that the skin is being hydrated with exposure to water, but water is actually being pulled out of the skin with continued exposure. Hot baths, hot tubs and very hot water soaks can break down lipid barriers in the skin, contributing to dry skin. Sun exposure causes the collagen and elastin in the skin to breakdown and the skin becomes less effective at holding in moisture. Callus tissue can form at the heel due to abnormal biomechanics in the feet in combination with improper footgear. Callus tissue is a build up of dead tissue in response to pressure or friction and is quite different than dry skin. But, when dry skin and callus tissue appear on the heels, this contributes to deep fissures which can result in bleeding and pain.
Tips to help prevent dry skin:
Avoid soaking feet for more than 15 minutes at a time. Use warm water, not hot water.
Minimize time spent in the hot tub and frequency of use to 3 times a week for no more than 20 minutes.
Limit showers and baths to 15 minutes.
Apply a rich moisturizer after bathing. Creams are more hydrating than lotions.
Use sunscreen daily, even if it looks overcast or cloudy outside.
Avoid deodorant and perfumed soaps.
Avoid using fabric softeners and laundry detergents with fragrance.
Use a humidifier during the winter months.
For dry, callused heels, use a foot cream (not a lotion) twice a day. Place on the heel after bathing and at night before sleep. For severely dry heels, cut a square of saran wrap and place over the cream and then pull a sock on over the saran wrap. This will increase penetration of the cream and decrease the chances of the cream being soaked into the sock. Do not do this is you are diabetic without consulting with your doctor.
For dry, callused heels with have deep fissures, cracking or bleeding and for skin with large areas of dry skin, surrounding redness, silver plaques or bleeding, make an appointment with your physician.