Hyperkeratosis is a thickening of the skin. It can be caused by increased blood flow to an area resulting from persistent friction. This then simulates the germinal cells of the stratum basale meaning the frequency at which they multiply is increased. Friction resistant keratin cell production is increased. Desquamation is reduced so skin thickening increasing causing hard skin to form.
Fissures are the linear discontinuation of the epithelial lining of the skin of the heel. When they are deep, they can be painful when standing and may even bleed and become infected. They are caused by dry skin of the heel (some people naturally have drier skin). Prolonged standing, the overweight, poor footwear choices and certain medical conditions all increase the risk of fissures occurring. They can be treated at home through the use of a pumice stone to remove the hardened skin and an oil based moisturiser to hydrate and heal the skin.
Spilts and fissures occur as a result of dryness or reduced elasticity and are commonly seen on the rim of the heel. Treatment is the use of emollients. If splits occur between the toes then they are difficult to dry out. Astringents may be necessary.

