What Are Skin Fissures?

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

Skin fissures are the result of very dry skin, also known as xerosis. Fissures begin as small cracks and can deepen, becoming more painful. You may notice a callus form, especially if you experience fissures on your heels. The thick callus may appear yellow or dark brown.

Because skin fissures are small skin wounds, they put you at risk of developing an infection in the skin. If the fissures are not treated, they can worsen and turn into skin ulcers. This results in an open wound and is especially risky for people with diabetes since it raises their risk for infection. 

The best way to treat skin fissures is to prevent them in the first place. Good moisturizers are the first step in preventing dry skin that could lead to skin fissures.

Why Do I Have Cracked Skin?

Cracked skin always begins as dry skin. As the skin becomes thick and calloused over time, it loses elasticity, and tiny cracks form. Left untreated, these 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 where skin fissures form. Pressure on the pads of the feet can lead to the feet expanding sideways, stretching the skin and causing cracks. 

You may be more at risk for heel cracks and fissures if you spend prolonged periods of time barefoot or wearing high-heeled shoes. Further, chronic conditions like diabetes, psoriasis, and eczema can change the hydration of your skin and increase your risk of fissures.

Eczema, combined with overwashing of your hands, can also lead to cracked skin.

Environmental Causes

Environmental causes of skin fissures include:

• Weather: Living in a cold, dry climate can be drying to 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 becoming 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 experiencing eczema and cracking. A 2020 study of healthcare workers found that 70% reported dry skin on their hands and 39% had skin fissures as well. 
• Nutritional deficiencies: Vitamin deficiencies can lead to dry, itchy skin that does not heal as quickly as healthy skin. Talk with your primary care doctor if you are concerned that you are experiencing any type of nutritional deficiency. 

Medical Causes

Medical causes of skin fissures include:

• Diabetes: People with diabetes are at higher risk of developing skin fissures because they are more likely to experience dry skin. If you have been diagnosed with nerve damage in your feet due to diabetes, then you may be more likely to experience skin dryness and heel cracks that could lead to fissures. 
• Psoriasis: Psoriasis is an autoimmune condition that leads to thick plaques of dead skin cells. These plaques are very dry and can lead to cracking and fissures. 
• Eczema: Eczema causes itchy, dry patches of skin that may become inflamed as well. 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 appears yellow or dark brown and feels thick and calloused. 

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

Home Remedies 

To promote healthy heels and prevent skin fissures, moisturizing regularly is a must. Keeping your skin soft and moisturized is the best way to prevent skin fissures. Look for 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 the skin’s surface into deeper layers of skin. They also help the skin shed dead skin cells and appear 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 lanolin and propylene glycol linoleate act as lubricants that fill in the crevices between skin cells. They improve skin hydration and smoothness. 

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

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

When to See a Dermatologist 

Many skin fissures can be treated at home, especially when they are caught and treated early. It’s time to see a dermatologist when home remedies don’t work.

If you do not notice any improvement after consistently moisturizing your skin twice daily, make an appointment. You may require a prescription ointment to moisturize and heal your skin. 

It’s also time to see a doctor if you develop any complications of skin fissures like bleeding or an infection. If your skin fissures have become so deep that your skin is bleeding or you have open sores, see your doctor for a prescription treatment.

Any sign of infection—such as redness, swelling, and pus coming from the fissures—should be evaluated by a dermatologist as well. 

Summary

Skin fissures are dry and 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 may be at higher risk of developing 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 moisturizing your skin regularly. However, if your skin fissures do not improve or you notice signs of an infection, see a doctor right away.

A Word From Verywell

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.

Frequently Asked Questions 

Where do skin fissures happen?

Skin fissures happen on areas of the body that are under stress. This stress could come from weightbearing, as is the case for your heels and feet. Any area of the body that is exposed to water regularly is at risk of dry skin and cracking. This is common on the hands due to handwashing. 

How painful are skin fissures? 

Skin fissures usually start out as small cracks in the skin. If the cracks worsen and deepen, they can become quite painful. As soon as you notice an area of very dry skin, start moisturizing twice daily. If that doesn’t help, see a dermatologist for help.

Does eczema cause skin fissures?

Eczema does not directly cause skin fissures, but it may raise your risk of having them. Eczema causes dry, itchy skin. If the skin becomes overly dry, you may develop tiny cracks that lead to skin fissures. Moisturizing twice daily with a quality, unscented moisturizer can help hydrate your skin and lower your risk of developing fissures.