What to Know About Skin Fissures

Skin fissures are areas of dried, cracked skin that thicken over time. They look like tiny cuts or cracks in the skin. The skin around the cracks is usually thickened and calloused. Skin fissures most often occur on dry areas of the skin like the heels, fingertips, and between the toes. 

Skin fissures are caused by very dry skin (xerosis). Fissures start out as small cracks and can get deeper, becoming more painful. You may notice a callus forming, especially if you have fissures on your heels. The thick callus may look yellow or dark brown.

This article will go over the causes of skin fissures and how they’re treated, including what you can do to treat a skin fissure at home. 

Causes of Skin Fissures

Cracked skin always starts as dry skin. As the skin gets thick and calloused over time, it loses elasticity, and tiny cracks form. Left untreated, the cracks can deepen and lead to bleeding and infection.

Skin fissures are often found on skin that is under stress. For example, the heel of the foot supports the weight of the body and is a common place for skin fissures to form. Pressure on the pads of the feet can lead to the feet expanding sideways, stretching the skin and causing cracks. 

You might be more at risk for heel cracks and fissures if you spend a lot of time barefoot or wearing high-heeled shoes. Chronic conditions like diabetes, psoriasis, and eczema can affect the hydration of your skin and increase your risk of fissures.

Environmental Causes

Environmental causes of skin fissures include:

• Weather. Living in a cold, dry climate can dry out your skin and raise your risk of skin fissures. You may also notice that your skin feels drier in the winter months.
• Overuse. Any area of skin that is continually used or washed is at a higher risk of getting too dry. For example, walking barefoot increases the stress on your feet and puts you at a higher risk of developing heel fissures. 
• Water exposure. Frequent exposure to water, such as handwashing, can dry out your skin and raise your risk of eczema and skin cracking. A 2020 study of healthcare workers found that 70% reported dry skin on their hands and 39% had skin fissures. 
• Nutritional deficiencies. Vitamin deficiencies can lead to dry, itchy skin that does not heal as quickly as healthy skin.

Medical Causes

Medical causes of skin fissures include:

• Fungal infections. Fungal infections can also lead to skin fissures. A common example is athlete's foot (tinea pedis), a fungal infection that starts between the toes. It can spread and cause the affected skin to crack and fissure.
• Diabetes. People with diabetes are at higher risk of developing skin fissures because they are more likely to have dry skin. If you have been diagnosed with nerve damage in your feet caused by diabetes, then you might be more likely to have skin dryness and heel cracks that could lead to fissures. 
• Psoriasis. Psoriasis is an autoimmune skin condition that leads to thick plaques of dead skin cells. The plaques are very dry and can lead to cracking and fissures. 
• Eczema. Eczema causes itchy, dry patches of skin that can get inflamed. These dry patches are at risk of cracking and developing fissures.

Symptoms of Skin Fissures 

Skin fissures look like small cuts or cracks in the skin. The skin often looks yellow or dark brown and feels thick and calloused. 

Symptoms of skin fissures include pain, itching, and bleeding. Early signs of skin fissures are redness and scaly, dry skin. When fissures are on your feet, they can make walking and bearing weight painful.

Skin fissures are wounds that can get infected. If the fissures are not treated, they can get worse and turn into open wounds called skin ulcers. The risk is especially high in people with diabetes.

Home Remedies 

You can do a few things at home to take care of your skin and prevent fissures from happening. One of the most important things to do is keep your skin hydrated, soft, and moisturized. Use a high-quality moisturizer that is free of artificial dyes and fragrances. 

Look for moisturizers with the following ingredients:

• Humectants like glycerin and urea attract water from the environment and your skin’s surface and help it get into the deeper layers of the skin. They also help your skin shed dead skin cells, which can make it look and feel healthier. 
• Occlusives like beeswax and mineral oil increase the water content of your skin by preventing water loss through evaporation. They are most effective when applied to damp skin, such as after toweling off following a shower. 
• Emollients like lactic acid fill in the crevices between skin cells. They improve your skin’s hydration and smoothness. 
• Exfoliating, or removing dead skin cells on your feet, with a pumice stone can help keep the skin healthy. While you do not want to rub the hard stone on sensitive or cracked areas of skin, they can help with tough callouses to prevent fissures.

Other home remedies that may help treat or even prevent skin fissures include: 

• Olive oil. Using olive oil on your skin may help reduce inflammation and promote wound healing. When applied to burns, olive oil may prevent infections and speed up tissue repair. 
• Coconut oil. Coconut oil has been found to be a safe and effective treatment for dry skin. It moisturizes your skin while improving the function of your skin’s natural barrier (the top layer of your skin that keeps bacteria and other threats away). 
• Avocado oil. Avocado oil can be applied directly to your skin to heal dry, damaged areas. Using avocado oil on your skin may also increase collagen production and speed up wound healing. Collagen is also helpful for preventing skin fissures because it improves the elasticity of your skin. 
• Oat oil. Using oat oil on your skin can add moisture and reduce inflammation. Oats have antioxidant properties that might promote wound healing.
• Almond oil. Almond oil helps heal skin fissures by improving the function of the skin barrier. The healthy fats in almonds can aid in preventing water loss in your skin.
• Honey. When applied to your skin, honey is naturally moisturizing and helps heal cracked skin. It also has antibacterial properties, which may help prevent skin infections.
• Aloe vera. Aloe vera is soothing to cracked skin and provides much-needed hydration. It also contains antioxidants, which may help to increase your skin’s collagen.

When to See a Dermatologist 

Many skin fissures can be treated at home, especially when they are caught early. If you do not notice any improvement after consistently moisturizing your skin twice a day, make an appointment to see a dermatologist.

You may need a prescription ointment to moisturize and heal your skin. Deep skin fissures might need specific medical treatments, like taking out any dead or damaged skin and cleaning the wound (debridement) or using skin glue or bandages to keep them closed.

It’s also time to see a provider if you have complications of skin fissures. If your fissures have gotten so deep that your skin is bleeding or you have open sores, see your provider for prescription treatment.

Any signs of infection—such as redness, swelling, and pus coming from the fissures—mean you should be seen by a dermatologist as well. If you get an infected skin fissure, your provider might want you to take antibiotics. 

Antifungal medications can help if athlete’s foot is causing fissures. You can get over-the-counter antifungal sprays or creams at a pharmacy. If it doesn't clear up in two weeks, your healthcare provider may suggest a prescription cream.

Summary

Skin fissures are dry, cracked patches of skin that thicken over time. They develop as dry skin loses elasticity and forms tiny cracks. You’ll usually find them on your heels and fingertips and between your toes. You might be at a higher risk of getting skin fissures if you spend a lot of time walking around barefoot or in high heels.

The best way to prevent and treat skin fissures is to moisturize your skin regularly. If you take these steps to care for your skin but your skin fissures do not improve or you notice signs of an infection, you should see a skin health specialist for treatment. 

Skin fissures can be a painful and frustrating problem, especially when they deepen and lead to bleeding of the skin. In addition to the physical pain, you may feel hesitant to wear sandals or allow the dry areas of your skin to show for fear of embarrassment.

Fortunately, many cases of skin fissures can be treated at home or even prevented in the first place. Invest in a high-quality moisturizer and use it twice daily on dry skin. If your skin fissures do not seem to be improving, see your dermatologist to obtain a prescription treatment and address any signs of infection.