What causes thick, white dead skin on the heel, and how should it be treated?
Dec 01, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, thick white dead skin on the heel may result from prolonged friction and pressure, dry and dehydrated skin, athlete's foot (tinea pedis), palmoplantar keratoderma, ichthyosis, or other causes. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general measures, medications, or other treatments. Avoid using sharp tools to remove dead skin in daily care to prevent infection.
Generally, thick white dead skin on the heels may result from prolonged friction and pressure, dry and dehydrated skin, athlete's foot (tinea pedis), palmoplantar keratoderma, or ichthyosis. It is recommended to seek medical advice promptly to determine the underlying cause, then improve the condition under a doctor’s guidance through general care, medication, and other treatments. Specific causes are analyzed as follows:
1. Prolonged friction and pressure: Wearing hard-soled shoes or standing/walking for long periods can cause repeated friction on the heel skin, leading to thickening of the stratum corneum and formation of dead skin. Switch to loose, soft cotton socks and shock-absorbing, cushioned shoes. Soak feet in 40°C warm water for 15 minutes daily; after softening the skin, gently exfoliate dead skin with a dedicated foot file, avoiding excessive force that could damage the skin.
2. Dry and dehydrated skin: In dry climates or with insufficient fluid intake, moisture loss from the heel skin accelerates, causing the stratum corneum to become dry, rough, and thickened. Immediately apply urea vitamin E cream after soaking, wear socks to lock in moisture, drink 1500–2000 mL of water daily, and use a humidifier if indoor air is dry.
3. Athlete's foot (tinea pedis): A fungal infection damages the integrity of the heel's stratum corneum, resulting in thickened dead skin accompanied by itching and flaking. Follow medical advice to use antifungal medications such as bifonazole cream, terbinafine hydrochloride cream, or itraconazole capsules. Avoid sharing slippers and keep feet dry.
4. Palmoplantar keratoderma: A genetic condition causing excessive keratinization on palms and soles, leading to thick, hard, white dead skin on the heels, which may crack easily in winter. Use salicylic acid ointment, tretinoin cream, or urea ointment as directed by a physician. After application, cover the area with plastic wrap to enhance absorption, and avoid contact with irritating detergents.
5. Ichthyosis: Abnormal keratinization reduces sebum secretion, causing generalized dry skin, with more pronounced dead skin buildup on the heels. Follow medical advice to use compound lactic acid cream, tretinoin cream, or isotretinoin soft capsules. Include vitamin A-rich foods in the diet, such as carrots and animal liver.
Avoid using sharp tools to remove dead skin, which may lead to infection. Dry between toes thoroughly after washing feet, choose breathable shoes and socks, trim toenails regularly, and maintain proper foot care to improve heel skin health and reduce dead skin accumulation.
