Why Heel Ulcers Are Common in Diabetes and How to Protect the Skin Before It Breaks
For people living with diabetes, even a small wound on the heel can become a serious problem if left unnoticed
Diabetes affects much more than blood sugar. Over time, it can also affect how the skin heals, how nerves sense pain, and how blood moves through the body. These changes make the feet, especially the heels, more vulnerable to injury.
A tiny blister or patch of dry skin might seem harmless, but for someone with diabetes, it can turn into a slow-healing wound called a diabetic foot ulcer. With the right care, daily checks, and gentle protection, most of these ulcers can be prevented before they ever appear.
Understanding Why Heel Ulcers Are Common in Diabetes
Heel ulcers are not random. They happen because diabetes slowly changes the body in ways that make the skin fragile and slow to recover.
1. Nerve damage (neuropathy)
High blood sugar over time can damage the nerves, especially in the feet. This condition is called diabetic neuropathy. It reduces the ability to feel pain, heat, or pressure. A patient may not notice when their heel rubs against a shoe, when the bed surface feels rough, or when a small blister forms. Without that warning pain, minor injuries can grow silently into ulcers.
2. Poor blood circulation
Diabetes can also narrow and stiffen blood vessels. When blood flow decreases, the skin and tissues receive less oxygen and fewer nutrients. This makes healing much slower and increases the risk of infection once a wound appears.
3. Dry skin and moisture imbalance
Nerve damage can affect sweat glands, leaving the skin dry and cracked. Cracks around the heel give bacteria a way to enter. At the same time, excessive moisture from sweat or poor foot hygiene can soften the skin, making it more likely to break.
According to the World Health Organization (2023), more than half of all diabetic foot ulcers begin with small injuries that were not noticed early. The heel, being a pressure-bearing area, is often one of the first places affected.
Early Signs Caregivers Should Look For
Catching the problem early can make all the difference. Check the heels daily for:
- Redness or dark spots that do not fade after pressure is relieved
- Hard or shiny patches of skin
- Small cracks or peeling
- Areas that feel unusually cool or warm
- Drainage on socks or bedding
If any of these appear, relieve pressure immediately and seek medical advice. It is always better to act early than to wait for pain or infection.
Daily Heel Care for People with Diabetes
Good heel care is simple but must be done consistently.
1. Daily inspection
Check both heels every day. If the patient cannot see the soles of their feet, use a mirror or ask for help.
2. Keep the skin clean and moisturised
Wash gently with mild soap and warm water, then pat dry. Apply a thin layer of diabetic-safe moisturiser, but avoid the spaces between the toes to prevent excess moisture.
3. Control pressure and friction
Use soft socks and avoid shoes that rub the heel. When in bed, place a pillow under the calves to lift the heels slightly off the mattress.
4. Balance moisture
Keep bedding and footwear dry. Excess moisture weakens skin and increases the risk of infection.
5. Use protective silicone foam dressings
Silicone foam dressings can protect the heel from friction and pressure while keeping the skin environment balanced. They act as a soft cushion that prevents rubbing and absorbs small amounts of moisture. For people with diabetic skin, which is often thin and sensitive, silicone foam offers gentle protection without irritation.
How Silicone Foam Dressings Help
Silicone foam dressings are made to maintain the right moisture level while protecting the skin from shear and friction. They are breathable, flexible, and comfortable to wear for several days.
They help prevent ulcers by:
- Reducing mechanical pressure on the heel
- Preventing rubbing between skin and bedding
- Managing moisture buildup
- Allowing gentle removal without damaging fragile skin
The European Pressure Ulcer Advisory Panel (2023) recognises silicone foam dressings as a safe and effective option for both prevention and management of early-stage ulcers.
For diabetic patients, these dressings can be used proactively on heels that show redness or tenderness, long before an ulcer develops.
Josephlister Versafit Silicone Foam Dressing: Gentle Protection That Lasts
Josephlister Versafit Silicone Foam Dressing helps protect high-risk areas like the heel and ankle, where ulcers often start. It combines softness, cushioning, and breathability for safer healing at home.
Key benefits:
- Gentle silicone layer: Adheres softly to the skin and removes without pain or trauma.
- Even pressure distribution: Cushions the heel to reduce friction and rubbing.
- Moisture balance: Absorbs fluid while keeping the skin comfortably hydrated.
- Long wear time: Can stay in place for several days with minimal dressing changes.
- Ideal for prevention: Suitable for fragile diabetic skin showing early redness or pressure marks.
Versafit offers quiet protection that supports healing, comfort, and confidence in everyday care.
A Simple Prevention Routine for Diabetic Heel Care
- Check heels every morning and evening.
- Keep feet clean and moisturised, avoiding excess moisture.
- Reposition the legs and lift the heels off the mattress when resting.
- Use a ripple mattress or soft cushioning for added comfort.
- Apply silicone foam dressing to protect high-risk areas.
This daily routine takes less than ten minutes but can prevent months of pain and recovery.
Protecting the Skin Before It Break
Diabetic foot ulcers can be serious, but they are not inevitable. With daily attention and gentle prevention, caregivers and patients can keep skin strong and healthy.
Every small act of care — checking the heel, keeping it dry, or placing a soft protective dressing — can stop a wound before it begins.
Empower healing at home with solutions made for gentle care.
References
- World Health Organization. (2023). Global report on diabetes and lower limb complications.
- European Pressure Ulcer Advisory Panel. (2023). Best Practice Recommendations.
- National Health Service. (2022). Foot care for people with diabetes.
