Cracked Callused Heels in Individuals with HEDS

Living with Hypermobile Ehlers-Danlos Syndrome (HEDS) often means managing a variety of symptoms that affect the skin, joints, and connective tissues. One common concern for many with HEDS is the development of cracked heels and thick, dry calloused skin on their feet. These issues can cause discomfort and sometimes pain, impacting daily activities and quality of life. Understanding why these skin problems occur and how to care for them can help individuals with HEDS maintain healthier feet and reduce complications.

Why Do Heels Crack and Develop Thick Calluses in HEDS?

People with HEDS have connective tissue that is more fragile and elastic than usual. This affects the skin’s ability to stay strong and resilient. The skin on the heels is naturally thicker because it needs to withstand pressure and friction from walking and standing. In HEDS, this skin can become even more prone to damage for several reasons:

• Reduced skin elasticity and strength: The collagen abnormalities in HEDS make the skin less able to stretch and recover. This leads to cracks when the skin is under pressure.

• Dry skin: HEDS often causes the skin to be drier than normal. Dry skin loses moisture and flexibility, increasing the chance of cracking.

• Abnormal foot mechanics: Joint hypermobility can change how weight is distributed on the feet. This uneven pressure causes certain areas, like the heels, to develop thick calluses as a protective response.

• Delayed wound healing: Skin injuries, including cracks, may take longer to

  heal in HEDS, making the problem persist or worsen.

• Increased friction and pressure: Wearing shoes that do not fit well or standing for long periods can worsen calluses and cracks.

  
  

How Thick Calluses Form on Heels

Calluses are areas of thickened skin that develop as a natural defense against repeated friction or pressure. In people with HEDS, the skin’s fragility and altered foot structure can cause calluses to form more easily and become thicker. The body tries to protect the underlying tissues by producing extra layers of skin, but this can lead to discomfort and cracking if the callus becomes too hard or dry.

Common Symptoms and Risks

Cracked heels and thick calluses can cause several issues, including:

• Pain and discomfort when walking or standing

• Bleeding or deep cracks that may become infected

• Increased risk of skin infections due to open wounds

• Difficulty wearing shoes comfortably

• Reduced mobility if pain limits activity

  
  

Recognizing these symptoms early and taking steps to manage them is important to prevent complications.

Practical Tips for Managing Cracked Heels and Calluses in HEDS

Taking care of your feet regularly can help reduce the severity of cracked heels and thick calluses. Here are some practical steps:

1. Keep Feet Moisturized

Dry skin is a major factor in heel cracking. Use a thick, emollient-rich moisturizer daily, especially after bathing. Look for products containing:

• Urea or lactic acid to soften thick skin

• Glycerin or shea butter for hydration

  
  

Apply moisturizer generously to the heels and surrounding areas.

2. Gentle Exfoliation

Removing dead skin can prevent calluses from becoming too thick. Use a pumice stone or gentle foot file on wet skin, but avoid aggressive scrubbing which can cause damage. Limit exfoliation to 1-2 times per week.

3. Wear Supportive Footwear

Choose shoes that fit well and provide cushioning to reduce pressure on the heels. Avoid open-backed shoes or sandals that allow the heel skin to dry out and crack.

4. Use Protective Padding

If certain areas of the heel are prone to pressure, consider using gel pads or cushioned insoles to distribute weight more evenly.

5. Stay Hydrated and Maintain Skin Health

Drinking enough water and eating a balanced diet supports overall skin health. Vitamins like A, C, and E play a role in skin repair.

6. Avoid Prolonged Standing or Walking on Hard Surfaces

When possible, reduce time spent standing or walking on hard floors to lessen heel stress.

7. Seek Professional Care

If calluses become very thick or cracks are deep and painful, a podiatrist or dermatologist can provide treatment. This may include:

• Professional debridement (removal of thick skin)

• Prescription creams to promote healing

• Advice on orthotics or specialized footwear

  
  

When to See a Doctor

Because HEDS can affect healing and increase infection risk, it is important to consult a healthcare provider if you notice:

• Deep or bleeding cracks that do not heal

• Signs of infection such as redness, swelling, warmth, or pus

• Severe pain that limits walking

• Changes in skin color or texture around the heel

  
  

Early treatment can prevent complications and improve comfort.

Summary

Cracked heels and thick callused skin are common problems for people with HEDS due to fragile, dry skin and altered foot mechanics. These issues can cause pain and increase the risk of infection if not managed properly. Regular moisturizing, gentle exfoliation, supportive footwear, and professional care when needed can help maintain healthy feet. Paying attention to foot health is an important part of living well with HEDS.

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