Cracked Skin: Causes and How to Heal It

Why skin cracks

The outer layer of skin acts as a flexible barrier held together by natural oils and fats. When it loses water and oil, it becomes stiff and brittle. Areas that stretch or bear weight, such as finger joints and heels, then split. Thickened skin cracks even more easily because it cannot flex. Cracks hurt because they reach the deeper, nerve-rich layer, and deep ones may bleed.

Common causes of cracked skin

Dry skin (xerosis)

Dry skin is the most common cause. Triggers include cold, windy weather, low indoor humidity from heating, long hot showers, harsh soaps and aging, as the skin produces less oil after about age 60.

Hand eczema

Hand eczema (hand dermatitis) causes red, dry, itchy, scaly skin that cracks over knuckles and fingertips. It is very common in people whose hands are often wet or exposed to irritants: healthcare workers, cleaners, hairdressers, cooks, mechanics and parents of young children. It may be:

• Irritant: from repeated water, soap, detergents and solvents
• Allergic: from rubber, nickel, fragrances, preservatives or hair dyes. See contact dermatitis
• Atopic: in people with a history of eczema, asthma or hay fever

Cracked heels

Heel skin is naturally thick. Dryness, standing for long periods, open-backed shoes, obesity and walking barefoot cause a build-up of hard skin (callus) around the heel rim that splits. Deep heel fissures can bleed and become infected.

Psoriasis

Psoriasis on the palms and soles causes thick, well-defined, scaly plaques that crack painfully. Look for psoriasis elsewhere, nail pitting and a family history.

Fungal infections

Athlete's foot causes cracked, peeling, itchy skin between the toes or a dry, scaly "moccasin" pattern on the soles that can crack at the heels.

Other causes

• Angular cheilitis: cracked corners of the mouth from saliva and yeast. See angular cheilitis.
• Thick-skin conditions: inherited keratoderma and ichthyosis.
• Underactive thyroid: hypothyroidism makes skin dry and rough.
• Diabetes: nerve damage reduces sweating on the feet, leaving them dry and cracked.
• Nutritional deficiencies: rarely, low zinc, essential fatty acids or B vitamins.
• Medicines: retinoids and some cancer treatments dry the skin.

Cracked skin by location

When to see a doctor

See a doctor if cracked skin does not improve after 2 weeks of regular moisturizing, keeps returning, is affecting your work, or shows signs of infection. People with diabetes should get any foot crack or sore checked promptly.

How it is diagnosed

The diagnosis is usually made by examining the skin. Your doctor may scrape scales to test for fungus, arrange patch testing to find an allergy causing hand eczema, or check thyroid function and blood sugar if dryness is widespread.

How to heal cracked skin

Moisturize properly

• Use a thick, fragrance-free ointment (such as petroleum jelly) or a heavy cream rather than a thin lotion.
• Apply within 3 minutes of washing, while skin is still slightly damp, to lock in water.
• Reapply after every hand wash and at bedtime.
• For heels and hands, products with urea (10% to 25%) or lactic acid soften thick skin.
• At night, apply a thick layer and wear cotton gloves or socks.

Protect your skin

• Wash with lukewarm water and a soap-free cleanser.
• Wear cotton-lined rubber gloves for wet work and cleaning, and warm gloves outdoors.
• Use a humidifier in dry, heated rooms.
• Wear closed-back, cushioned shoes if your heels crack.

Treat deep cracks

• Liquid skin bandage or skin glue can seal painful fingertip cracks and help them heal.
• Gently file thick heel skin with a pumice stone after soaking, a few times a week. Do not cut hard skin with blades.
• Keep cracks clean and covered if they bleed.

Treat the cause

• Eczema: a short course of steroid ointment prescribed or recommended by a doctor or pharmacist.
• Psoriasis: prescription creams, light therapy or tablets.
• Athlete's foot: antifungal cream or spray for 2 to 4 weeks.
• Allergy: avoid the trigger found on patch testing.

Frequently asked questions

Why is my skin cracking?

Skin cracks when it becomes too dry or thick to stretch. The most common causes are cold weather, frequent washing, harsh soaps, hand eczema, thick heel skin, psoriasis and fungal infections. Diabetes and an underactive thyroid can also cause very dry, cracked skin.

How do you heal cracked skin fast?

Apply a thick ointment such as petroleum jelly or a urea cream several times a day, especially after washing and at bedtime under cotton gloves or socks. Seal painful cracks with liquid bandage. Avoid harsh soaps and hot water, and protect hands with gloves.

What deficiency causes cracked skin?

Most cracked skin is caused by dryness, not a deficiency. Rarely, low zinc, essential fatty acids, vitamin A or B vitamins cause dry, cracked skin, usually with other symptoms such as rashes, hair loss or sores at the mouth corners. A doctor can check if this is suspected.

Why do my fingertips crack in winter?

Cold outdoor air and indoor heating both lower humidity, drawing moisture from the skin. Frequent handwashing strips natural oils. Fingertips flex constantly, so dry skin there splits easily. Moisturizing after each wash and wearing gloves outdoors usually prevents it.

When are cracked heels a problem?

Cracked heels need medical attention if they bleed, become red, warm or swollen, or if you have diabetes or poor circulation, because infection and ulcers can develop. Thick cracked heels that do not improve with urea cream and filing may need a podiatrist.