Cracked Skin

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Introduction

What is cracked skin?

Cracked skin is a classic symptom of dry skin, but it can also occur in response to scratches or other trauma, or infection. When the skin dries, it can become rough and flaky, with small tears that can lead to deeper cracks called fissures, which can extend into the deeper layers of the skin.

Cracked skin is often accompanied by other symptoms of dry skin, with one symptom often leading to another. For instance, dryness can lead to scaling, scaling can cause itchiness, itching can lead to scratching, scratching can cause inflammation and small tears that can develop into fissures (cracks), and these can lead to further irritation. Treating dry, injured or cracked skin promptly and diligently can help break this cycle.

Causes of dry skin include diet, dry or cold weather, dermatitis, hormonal imbalance, allergic reactions, and other disorders. Other causes of cracked skin include exposure to chemicals such as alcohol, as well as a variety of skin disorders such as eczema (a term for several different types of skin swelling), psoriasis (a skin disease that causes itchy or sore patches of thick, red skin with silvery scales), fungal infections, ichthyosis (dry, scaly skin present from birth), Sjogren’s syndrome (a disease affecting the production of sweat, saliva and tears), and a variety of other disorders that cause damage to the skin.

In cases of deep fissures, cracked skin can lead to infections. In rare cases, if left untreated, skin infections can become systemic and lead to sepsis (a life-threatening bacterial blood infection).

A break in the skin must always be treated to avoid potentially serious infections. Seek prompt medical care for a fissure or deep crack in the skin, especially if it is accompanied by redness, heat, throbbing, swelling and pain. Seek immediate medical care (call 911) if you believe your infection, or that of someone you are with, is spreading and you are seeing signs of sepsis (a life-threatening bacterial blood infection), including high fever (higher than 101 degrees Fahrenheit); a change in your level of consciousness or alertness, such as passing out or unresponsiveness; and a change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions.

Symptoms

What other symptoms might occur with cracked skin?

Cracked skin may accompany other symptoms affecting the skin which vary depending on the underlying disease, disorder or condition. Symptoms that most frequently accompany cracks in the skin are scaling and itchiness, as well as redness and dryness of the surrounding skin.

Skin symptoms that may occur along with cracked skin

Depending on the disorder, cracked skin may accompany other symptoms that affect the skin including:

  • Bleeding from raw, cracked skin

  • Blisters

  • Burning feeling

  • Crumbling nails

  • Crusting sores

  • Itchy skin

  • Rash

  • Redness, warmth or swelling

  • Scaly skin

  • Silver or white plaques

Other symptoms that may occur along with cracked skin

Cracked skin may accompany symptoms related to other body systems including:

  • Excessive sweating

  • Joint pain

  • Loss of feeling in the feet and other symptoms of diabetes (a chronic disease that affects your body’s ability to use sugar for energy)

  • Loss of sweating (anhidrosis)

Serious symptoms that might indicate a life-threatening condition

In some cases, cracked skin, if left untreated or if occurring with other symptoms, may indicate a serious condition that should be immediately evaluated in an emergency setting. Seek prompt medical care if you develop pus or the skin cracks deepen (forming fissures); if the skin in the affected area is red or feels warm, tender, throbbing or swollen; if the area is oozing; if you have cracks or deep fissures in your foot and you have diabetes; or if the skin on your lower legs becomes very scaly or develops a thick, rough texture. Seek immediate medical care (call 911)if you, or someone you are with, have cracked skin along with other serious symptoms that could indicate sepsis (a life-threatening bacterial blood infection) including:

  • Change in your level of consciousness or alertness, such as passing out or unresponsiveness

  • Chills with shaking

  • Confusion or loss of consciousness, even for a brief moment

  • Fainting or change in level of consciousness or lethargy

  • High fever (higher than 101 degrees Fahrenheit)

  • Severe pain

Causes

What causes cracked skin?

You can get cracked skin from environmental factors such as dry air, particularly during cold winter months. Certain medical disorders can also contribute to dry, cracked skin—especially disorders that cause nerve damage, reduced sweating, or dehydration—as well as other skin conditions.

Medical causes of cracked skin

Cracked skin may be caused by a number of medical conditions including:

  • Anhidrosis (reduced or loss of sweating) in diabetes, a chronic disease that affects your body’s ability to use sugar for energy

  • Atopy (allergic skin reaction)

  • Dermatitis (a skin inflammation which has many causes)

  • Diabetic neuropathy (nerve damage caused by high blood sugar levels associated with diabetes)

  • Eczema (itchy, scaly skin)

  • Excess body weight (extra pressure on the heels can cause the skin to crack)

  • Hypothyroidism (underactive thyroid)

  • Ichthyosis (a hereditary disease characterized by scaly skin)

  • Inadequate moisture content to skin

  • Psoriasis (a skin disease that causes itchy or sore patches of thick, red skin with silvery scales)

Nonmedical causes of cracked skin

You can also get cracked skin from excessive exposure to external factors including:

  • Abrupt change in temperatures (hot to cold, cold to hot)

  • Cold weather

  • Excessive exposure to hot water, detergents, or harsh chemicals

  • Forced-air heat

  • Prolonged standing (causing pressure on the skin of the heels)

  • Sandals, sling-back, or open-backed shoes (causing heel expansion on the sides that can crack the skin)

  • Walking barefoot

Serious or life-threatening causes of cracked skin

In some cases, cracked skin may be a symptom of a serious or life-threatening condition that should be evaluated by your healthcare provider. These include:

  • Diabetes (a chronic disease that affects your body’s ability to use sugar for energy)

  • Exposure to toxic chemicals

  • Hormonal imbalance

  • Hypothyroidism (underactive thyroid)

  • Malnutrition

  • Nondiabetic neuropathy (nerve damage)

  • Sjogren’s syndrome (an autoimmune disease affecting the glands that produce sweat, tears and saliva)

Questions for diagnosing the cause of cracked skin

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your cracked skin such as:

  • How long have you had cracked skin?

  • Have you had cracked skin in other parts of your body?

  • Have you had redness, scaling or itching?

  • Do you feel warmth near the site?

  • Has there been any bleeding at or near the affected site?

  • Have you had a rash recently or do you have a rash now?

  • Have you had any blistering, oozing or pus near your cracked skin?

  • Have you had a fever?

  • Do you have any allergies?

  • Have you had any insect bites?

What are the potential complications of cracked skin?

In you have deep fissures, cracked skin can lead to infections. In rare cases, if left untreated, these skin infections can become systemic and lead to sepsis, a life-threatening bacterial blood infection. It is important that you treat any crack or opening in your skin to avoid complications. Also, because cracked skin can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Deepening fissures

  • Deep-tissue skin infections

  • Scarring and disfigurement

  • Sepsis (life-threatening bacterial blood infection)

  • Spreading skin infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 28
  1. Winter dry skin. University of Iowa Children’s Hospital. http://www.uichildrens.org/Adam/?/HIE%20Multimedia/1/003250.
  2. Dry skin. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003250.htm.
  3. Langan SM, Williams HC. What causes worsening of eczema? A systematic review. Br J Dermatol 2006; 155:504.
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