How to treat cracked heels with diabetes

Diabetes can lead to skin changes on the feet, including cracked heels. Without treatment, infections and other complications can arise. Tips for protecting the feet include regular checking, moisturizing, and wearing appropriate footwear.

Diabetes describes several conditions that affect how the body processes and maintains its blood sugar level. If a person has a difficult time keeping their blood sugar within a stable range, they may experience complications that can include foot problems, such as cracked heels.

Cracked heels, also known as heel fissures, refer to hard, dry skin forming over the heels of the feet. This can cause discomfort and may lead to health complications, such as slow-healing wounds and infections.

In this article, we discuss how diabetes affects the feet, how to treat cracked heels, and how to manage other common foot health concerns that may occur with diabetes.

An unstable blood sugar level can lead to nerve damage and a circulation decrease.

Nerve damage can result in a person losing sensation in their feet. This may make it harder for a person to notice wounds, such as blisters, on their feet. As such, a person may not treat some wounds, so these cuts and sores may have a higher infection risk.

Damage to the nerves can also impact how the body keeps its natural oils and moisture in the feet. This may make it more difficult for a person to feel the formation of hard, thick sections of skin. Therefore, a person with diabetes may be more likely to develop dry and cracked skin.

Usually, a healthy blood flow delivers sufficient nutrients and immune cells to a wound, which encourages healing and prevents infections. However, as diabetes can affect circulation, it causes blood to move more slowly, which means the body may have difficulty healing the wound or stopping an infection.

Additionally, a decrease in circulation can result in changes to the skin of the feet and lead to the formation of calluses.

The American Academy of Dermatology Association (AADA) recommends the following options to help treat cracked heels at home and prevent them from coming back. These suggestions include:

• Taking shorter baths and showers: Bathing for too long can make skin dry out, which can worsen cracked heals. It is also advisable to gently blot the skin dry using a towel.
• Using a gentle cleanser: This can help the skin on the heels retain their natural oils and prevent dry skin.
• Moisturizing after bathing: Applying a moisturizer to the heels immediately after bathing, when the skin is still damp, can lock in moisture. People may consider using moisturizers that contain urea, alpha hydroxy acid, or salicylic acid.
• Applying petroleum jelly before bed: Applying a layer of plain petroleum jelly and wearing socks before bed can help heels maintain moisture.
• Protecting the heels: People may consider using a liquid bandage during the day to create a protective barrier over the heel. This can help reduce pain, speed up healing, and prevent pathogens from entering the skin.
• Wearing proper footwear: Wearing appropriate footwear can provide the feet with suitable support and reduce pressure on the heel. As such, people may want to avoid open-heeled shoes, such as flip flops.

In more severe cases, or if a person notices no improvement, it is advisable for them to contact a podiatrist. This term refers to an individual who specializes in the medical care and treatment of the foot.

A podiatrist can provide advice on looking after the feet and can offer more effective treatment options, which may include debridement or stronger softening or debriding agents.

Learn more about treating cracked heels.

Foot health complications that a person with diabetes may experience include:

• Neuropathy: This refers to a potential complication of diabetes that results in nerve damage. This can lead to a person losing sensation in their feet, making it difficult to feel cuts or sores that can worsen and result in further complications.
• Circulation decrease: A decrease in blood flow to the feet can cause injuries to heal slowly or not heal at all, making it harder for the feet to clear infections.
• Foot ulcers: This refers to slow-healing wounds that commonly affect the feet of people living with diabetes. Without proper management, an ulcer can undergo necrosis and become gangrenous.
• Amputation: In severe cases, when wounds do not heal on the foot, a doctor may need to surgically remove the limb.

The Centers for Disease Control and Prevention (CDC) provides tips to keep feet healthy, including:

• Checking feet regularly: By checking the feet every day for any cuts, discoloration, sores, or other changes to the feet, a person can appropriately treat the health concern before it gets worse.
• Washing feet: It is important to wash, dry, and moisturize the feet to keep them clean and hydrate them.
• Avoiding going barefoot: To help prevent potential injuries to the feet, it is advisable to always wear footwear, such as shoes, socks, and slippers.
• Wearing well-fitting shoes: By wearing comfortable shoes that provide appropriate support, people can avoid injuries to their feet, such as blisters.
• Trimming nails carefully: It is advisable that people trim toenails straight across and keep them short. Rounded nails can grow inward, leading to infection.
• Caring for corns and calluses: It is important to treat corns and calluses carefully because if a person attempts to remove them themselves, this could cause injury.
• Regular foot exams: In addition to regularly connecting with other members of the diabetes healthcare team, a person may want to consider attending podiatry appointments so that a doctor can check their feet.
• Regular physical activity: Keeping physically active supports adequate blood flow to the feet, which can help avoid foot health concerns. A person can consider feet-friendly activities, such as walking, biking, or swimming.

Additionally, it is important for a person to try to manage their blood sugar and keep it within a stable range. A person can reduce the risk of foot health complications from diabetes by:

• checking blood glucose levels regularly
• taking diabetes medication
• maintaining a moderate weight

Potential complications of diabetes can include a circulation decrease and slow wound healing. This means a person living with diabetes may be at a higher risk of foot health concerns, such as cracked heels. Without appropriate treatment, cracked heels can become painful and develop infection.

Therefore, to prevent cracked heels and potential complications, it is important for a person with diabetes to try following foot care tips, such as checking their feet regularly, moisturizing, and wearing well-fitting shoes.

How to treat cracked heels with diabetes

Diabetes can lead to skin changes on the feet, including cracked heels. Without treatment, infections and other complications can arise. Tips for protecting the feet include regular checking, moisturizing, and wearing appropriate footwear.

Diabetes describes several conditions that affect how the body processes and maintains its blood sugar level. If a person has a difficult time keeping their blood sugar within a stable range, they may experience complications that can include foot problems, such as cracked heels.

Cracked heels, also known as heel fissures, refer to hard, dry skin forming over the heels of the feet. This can cause discomfort and may lead to health complications, such as slow-healing wounds and infections.

In this article, we discuss how diabetes affects the feet, how to treat cracked heels, and how to manage other common foot health concerns that may occur with diabetes.

An unstable blood sugar level can lead to nerve damage and a circulation decrease.

Nerve damage can result in a person losing sensation in their feet. This may make it harder for a person to notice wounds, such as blisters, on their feet. As such, a person may not treat some wounds, so these cuts and sores may have a higher infection risk.

Damage to the nerves can also impact how the body keeps its natural oils and moisture in the feet. This may make it more difficult for a person to feel the formation of hard, thick sections of skin. Therefore, a person with diabetes may be more likely to develop dry and cracked skin.

Usually, a healthy blood flow delivers sufficient nutrients and immune cells to a wound, which encourages healing and prevents infections. However, as diabetes can affect circulation, it causes blood to move more slowly, which means the body may have difficulty healing the wound or stopping an infection.

Additionally, a decrease in circulation can result in changes to the skin of the feet and lead to the formation of calluses.

The American Academy of Dermatology Association (AADA) recommends the following options to help treat cracked heels at home and prevent them from coming back. These suggestions include:

• Taking shorter baths and showers: Bathing for too long can make skin dry out, which can worsen cracked heals. It is also advisable to gently blot the skin dry using a towel.
• Using a gentle cleanser: This can help the skin on the heels retain their natural oils and prevent dry skin.
• Moisturizing after bathing: Applying a moisturizer to the heels immediately after bathing, when the skin is still damp, can lock in moisture. People may consider using moisturizers that contain urea, alpha hydroxy acid, or salicylic acid.
• Applying petroleum jelly before bed: Applying a layer of plain petroleum jelly and wearing socks before bed can help heels maintain moisture.
• Protecting the heels: People may consider using a liquid bandage during the day to create a protective barrier over the heel. This can help reduce pain, speed up healing, and prevent pathogens from entering the skin.
• Wearing proper footwear: Wearing appropriate footwear can provide the feet with suitable support and reduce pressure on the heel. As such, people may want to avoid open-heeled shoes, such as flip flops.

In more severe cases, or if a person notices no improvement, it is advisable for them to contact a podiatrist. This term refers to an individual who specializes in the medical care and treatment of the foot.

A podiatrist can provide advice on looking after the feet and can offer more effective treatment options, which may include debridement or stronger softening or debriding agents.

Learn more about treating cracked heels.

Foot health complications that a person with diabetes may experience include:

• Neuropathy: This refers to a potential complication of diabetes that results in nerve damage. This can lead to a person losing sensation in their feet, making it difficult to feel cuts or sores that can worsen and result in further complications.
• Circulation decrease: A decrease in blood flow to the feet can cause injuries to heal slowly or not heal at all, making it harder for the feet to clear infections.
• Foot ulcers: This refers to slow-healing wounds that commonly affect the feet of people living with diabetes. Without proper management, an ulcer can undergo necrosis and become gangrenous.
• Amputation: In severe cases, when wounds do not heal on the foot, a doctor may need to surgically remove the limb.

The Centers for Disease Control and Prevention (CDC) provides tips to keep feet healthy, including:

• Checking feet regularly: By checking the feet every day for any cuts, discoloration, sores, or other changes to the feet, a person can appropriately treat the health concern before it gets worse.
• Washing feet: It is important to wash, dry, and moisturize the feet to keep them clean and hydrate them.
• Avoiding going barefoot: To help prevent potential injuries to the feet, it is advisable to always wear footwear, such as shoes, socks, and slippers.
• Wearing well-fitting shoes: By wearing comfortable shoes that provide appropriate support, people can avoid injuries to their feet, such as blisters.
• Trimming nails carefully: It is advisable that people trim toenails straight across and keep them short. Rounded nails can grow inward, leading to infection.
• Caring for corns and calluses: It is important to treat corns and calluses carefully because if a person attempts to remove them themselves, this could cause injury.
• Regular foot exams: In addition to regularly connecting with other members of the diabetes healthcare team, a person may want to consider attending podiatry appointments so that a doctor can check their feet.
• Regular physical activity: Keeping physically active supports adequate blood flow to the feet, which can help avoid foot health concerns. A person can consider feet-friendly activities, such as walking, biking, or swimming.

Additionally, it is important for a person to try to manage their blood sugar and keep it within a stable range. A person can reduce the risk of foot health complications from diabetes by:

• checking blood glucose levels regularly
• taking diabetes medication
• maintaining a moderate weight

Potential complications of diabetes can include a circulation decrease and slow wound healing. This means a person living with diabetes may be at a higher risk of foot health concerns, such as cracked heels. Without appropriate treatment, cracked heels can become painful and develop infection.

Therefore, to prevent cracked heels and potential complications, it is important for a person with diabetes to try following foot care tips, such as checking their feet regularly, moisturizing, and wearing well-fitting shoes.

Skin lesions in diabetes

Home / Articles / Skin lesions in diabetes

Diabetes is a chronic disease that has a negative impact on the entire human body. Often the life of people living with diabetes is complicated not only by the need to constantly monitor the level of sugar (glucose) in the blood, damage to the eyes, kidneys, cardiovascular system, but also by various skin disorders. With a severe course of the disease, it becomes rough to the touch, its turgor decreases, significant peeling develops, especially of the scalp. Hair loses its shine. Calluses and cracks appear on the soles and palms. Often develops a pronounced yellowish coloration of the skin. Nails are deformed and thickened.

Some dermatological manifestations can act as “signals” of an undiagnosed diabetes mellitus. As a rule, the disease is indicated by skin itching, dryness of the mucous membranes and skin, recurrent skin infections (candidiasis, pyoderma), diffuse hair loss.

The etiology of skin lesions in diabetes is certainly associated with disorders of carbohydrate metabolism. To prevent the development of complications, patients need to constantly monitor their blood sugar levels. The closer this indicator is to “non-diabetic”, the less likely the occurrence and development of complications.

Diabetic dry skin

When blood sugar (glucose) is elevated, the body of a diabetic produces excess urine and loses fluid. This means that the skin is also dehydrated: the skin becomes dry and flaky. The work of the sebaceous and sweat glands is disrupted. Unpleasant itching occurs, cracks form, and the risk of developing skin infections increases.

Good skin hygiene helps prevent skin lesions. But conventional cosmetics, such as toilet soap, are not suitable for diseased skin: it lowers the acidity of the skin, reducing its resistance to microbes. Therefore, wash, wash hands and feet should be pH-neutral soap. And the face is generally better to clean with water lotions or cosmetic milk.

Great attention should be paid to the skin of the hands and feet. Maintaining the cleanliness of the skin, the use of special moisturizing and softening cosmetics is a necessary daily procedure for diabetics. The most effective are cosmetic products containing urea.

Diabetic hyperkeratosis

Hyperkeratosis (excessive callus formation) is one of the main causes of diabetic ulcers. When wearing tight shoes, constant pressure on a certain spot can cause calluses to form. They usually occur on the sole (corns), on the upper surface of the finger, sometimes on the lateral side and in the interdigital space. The resulting callus presses on the skin, causing a hemorrhage under it, which can subsequently lead to the formation of a trophic ulcer. Dryness of the skin of the heel area leads to its keratinization, the appearance of cracks, which cause a lot of inconvenience when walking and can also become infected.

Patients with diabetes should wear comfortable, ideally special orthopedic shoes to avoid foot deformity, blisters and abrasions. In no case should a callus that has already formed be cut off or steamed out in hot water. It is forbidden to use corn liquid and patches. The means of choice in such cases are special softening and moisturizing creams containing a large amount (about 10%) of urea. It is best to use them 2-3 times a day: apply to clean skin, preferably after pumice treatment, and make sure that the cream does not get into the area between the fingers.

Trophic ulcers in diabetes mellitus

Diabetic ulcers appear when infected wounds have not been properly treated. With the formed trophic ulcers, patients with diabetes mellitus are treated in the office of the “Diabetic foot”. The general principles of treatment are the use of modern dressings (alginates, polyurethane foam dressings, hydrogels, etc.), regular treatment of the wound with alcohol-free antibacterial agents and the competent use of antibiotics.

Infection of cuts and small skin lesions in diabetes mellitus

Patients with diabetes often develop skin infections at the sites of insulin injections and blood sampling. Small skin cuts when cutting nails can also become the entrance gate of infection. Due to impaired nerve conduction (diabetic neuropathy), diabetic patients have reduced pain sensitivity, and even serious skin damage can go unnoticed, which will eventually lead to infection. Therefore, patients with diabetes pay considerable attention to the condition of the skin, undergo special training under the program “Diabetic foot”.

For the treatment of small wounds, under no circumstances should the use of alcohol-containing solutions (iodine, brilliant green) or potassium permanganate solution be recommended. It is best to treat with hydrogen peroxide, furatsilin, chlorhexidine or apply special cosmetics containing antibacterial components. If signs of inflammation appear (its signs are redness, swelling, soreness), the patient should immediately see a doctor.

Fungal infection of nails and skin (mycosis) in diabetes mellitus

The source of fungal infection is the contact with the skin of pathogens of mycoses. The weakening of the immune defense in diabetic patients leads to the fact that the fungus begins to actively multiply. Fungal infections in patients with diabetes occur more than 2 times more often than in healthy people.

Mycosis of the nail plate (onychomycosis) is manifested by a change in the color of the nail, its thickening or delamination. The thickened toenail puts extra pressure on the toe in the shoe, which can result in a diabetic ulcer. To reduce the thickness of the nail, patients with diabetes regularly perform mechanical processing of the plate: polishing with a file or pumice stone.

Itching, irritation in the folds of the skin or in the space between the fingers indicate the presence of a fungal infection of the skin. To prevent the occurrence of skin mycoses, patients can be recommended to use daily cosmetic creams containing fungicidal and antibacterial complexes. Fungal infections are perfectly treated with modern drugs, both oral and topical, provided that they do not increase the moisture between the fingers.

Patients with diabetes are characterized by increased sweating, thermoregulation disorders, especially in the folds of the skin, resulting in diaper rash. To prevent the development of a fungal infection, places with diaper rash are recommended to be treated with talc or prophylactic creams containing zinc oxide.

Diabetic Foot Syndrome

It is common knowledge that people with diabetes are at a significantly higher risk of foot problems than other people. Diabetic foot syndrome (DFS), a complex of purulent-destructive lesions of the lower extremities in diabetes, is one of the serious complications of diabetes mellitus, often leading to leg amputation. Quite eloquently this is evidenced by at least the fact that the risk of developing foot gangrene in patients with diabetes is 10-15 times higher.

If the peripheral nerve endings are damaged, the skin of the legs will no longer feel pain, temperature changes, and touch. This poses a high risk of injury. The patient can step on a sharp object, get burned, rub his leg – and not feel it. Violations of capillary blood flow (microangiopathy) dramatically reduce the ability of the wound to heal.

The manifestations of SDS include: trophic ulcers; chronic, long non-healing purulent wounds; foot phlegmon; osteomyelitis of the bones of the foot; gangrene of one or more fingers, the entire foot or part of it. The treatment of a diabetic foot is very complex and costly, often patients come to the doctor already at such a stage of development of the complication that only amputation can save a life. Therefore, it is very important that patients know that early contact with a doctor, prevention of skin lesions and foot care are necessary measures to prevent disability.

Foot care for diabetics differs significantly from normal hygiene for people without diabetes. The main point in the treatment of diabetic foot is the correction of blood sugar levels, so the treatment is usually carried out by a surgeon together with an endrinologist. It is almost impossible to achieve good results in the treatment of infectious skin diseases without correction of carbohydrate metabolism.

Special rules for foot care have been developed for patients, and there are offices or departments of the “Diabetic Foot” in polyclinics.

Today, diabetics can find everything they need for special skin care in pharmacies. A sufficient choice of expensive imported and effective, but affordable Russian products will help make thorough skin care for diabetes a good habit, improve the quality of life of patients and avoid the development of a number of serious complications

Diabetic foot, treatment and symptoms – (Di Center clinics)

Diabetic foot is a foot tissue lesion in a diabetic patient. Untimely treatment of a diabetic foot entails formidable complications that entail serious consequences: from high amputation of the lower limb to the death of the patient.

Diabetes mellitus is currently one of the most important problems of modern medicine. Everywhere there is a tendency to increase the number of patients with diabetic foot syndrome, whose share in Russia is 4-10% and in the USA 3-8% of all patients with diabetes mellitus.

The combination of purulent-necrotic lesions with critical ischemia of the lower limb leaves practically no chance of saving the latter. The number of patients with neuroischemic lesions is constantly growing and has already reached 40% in the structure of the diabetic foot syndrome. As a rule, these patients are burdened with severe comorbidities that dramatically increase the risk of surgical treatment and cast doubt on the possibility of anesthesia.

Symptoms and mechanisms of development.

The following signs of diabetic foot syndrome may be observed:

• numbness, decreased sensitivity;
• change in the shape and color of the foot;
• thickening and deformity of the nails;
• deformity of the joints of the foot;
• difficulty and pain when walking;
• edema;
• itching, dryness and flaking;
• fever in combination with a wound.

The mechanism of development of diabetic foot always has the same clinical pattern:

• Nerve damage. Sensitivity in the limbs decreases, and a person discovers wounds and injuries late, starts therapy late.
• Circulatory disorders. Due to poor blood flow, tissues are slowly restored, even small wounds and sores heal with difficulty.
• Inclusion in the picture of the joints. It is a problem in itself, and also deforms the outline of the legs and interferes with normal movement, increasing the risk of injury and the appearance of calluses.
• Fungal and bacterial infections. A weakened person is generally less protected from them. Pathogenic microorganisms easily penetrate into violation of the integrity of the skin, significantly complicating healing and increasing the susceptibility to general infection.

Non-healing wound areas lead to diffuse purulent inflammation, destruction and death of deeper tissue structures. If the situation goes this far, then there is a risk of amputation.

Amputation? No!

The above factors over a long period of time determined the dominance of amputations of the lower extremities in this category of patients. The prevailing fear of surgeons about organ-preserving operations on the foot with critical ischemia, and even against the background of diabetes mellitus, is quite natural, since the proportion of unsatisfactory results was very high.

The lack of modern possibilities at the previous stages of the development of surgery and the restrained attitude of surgeons to the use of available methods of vascular surgery in patients were also of significant importance. It was believed that in diabetes mellitus, reconstructive vascular operations are not indicated, since in this disease damage to small vessels or the microvasculature predominates. However, according to a number of studies, patients with diabetes can successfully perform operations to restore the patency of the arteries of the lower extremities, and their effectiveness is much higher and long-term results are better than with drug treatment.
In addition, surgical reconstruction of the arteries in a patient with a foot ulcer of ischemic origin significantly increases the likelihood of healing. Successful implementation of intravascular coronary operations opened up opportunities for surgical correction of another life-threatening manifestation of atherosclerosis, critical ischemia of the lower extremities. In recent years, there have been reports of a good therapeutic effect of percutaneous balloon plasty in critical ischemia of the lower limb in patients with diabetes mellitus.

Treatment of diabetic foot with balloon plasty

An innovative method of treating diabetic foot with balloon plastic surgery in Saratov and Engels can be performed at the Medical Di Center. This operation is performed under local anesthesia and eliminates the blockage of the vessels of the foot. The artery puncture site is treated with an antiseptic and a local anesthetic is injected under the skin. Then the doctor inserts a catheter with a balloon into the vessel.
As soon as the balloon reaches the site of stenosis, it is inflated under pressure, as a result of which the sclerotic plaques straighten out and are pressed into the walls of the vessel. After that, the balloon is removed. Thus, vascular patency is restored and blood flow is normalized. A pressure bandage is applied to the puncture site to prevent bleeding.

Advantages of this technique:

• performed under local anesthesia and no general anesthesia,
• less traumatic (sparing) procedure, no incision required,
• the opportunity to return to the normal rhythm of life in a few days.

Balloon plastic surgery is indicated in cases where there is no clinical improvement despite ongoing therapy and lifestyle changes.

After surgery

The most common question asked by patients is, can the vessel clog again? It is not excluded, but given this, the operation can be performed repeatedly (unlike shunting).