innovative skincare solutions
HEELS Heel Balm
Introduction
Heel balms have become very popular and are frequently prescribed by Podiatrists and Dermatologists.
Heel balms are utilized to soften the thickened stratum corneum of the heel. If not properly looked after thickened heels may fissure leading to pain, difficulty walking, increased susceptibility to infection (especially amongst diabetics) and more frivolous complaints such as wear and tear on socks and laddering of stockings.
In order to soften the stratum corneum, a number of keratolytic chemicals can be used. These include hydroxy acids, such as lactic acid and glycolic acid. These are usually used in concentrations of about 5% in hydrophilic bases. It is only moderately effective, and is found to be an irritant in some individuals even at this low concentration.
Salicylic acid has been used for decades and is used in ointments, oils or in combination with other topical agents. Propylene Glycol in concentrations of 40% - 60% under occlusion also has a softening effect.
Urea is one of the more popular choices. It accelerates the digestion of fibrin at 15% concentrations, and is proteolytic at 40%. In order to reduce build up of keratin, a 25% concentration has been found to be most effective.
One of the problems of compounding an effective heel balm is to achieve efficacy but at the same time to make them cosmetically acceptable. R.E.D Skincare have recently created such a product.
HEELS contains 25% urea in a non greasy base. In addition, 2% tea tree oil was added as it has powerful antiseptic properties, has been shown to have anti fungal and antibacterial effects and improves healing of wounds. In addition it has a pleasant fragrance and has natural preservative qualities.
Case Study
There are a number of creams on the market, and in order to assess the acceptability of R.E.D Skincare's new HEELS Heel Balm formula, a two phase simple trial was devised.
In the first trial 10 volunteers all of whom complained of dry and cracked heels were asked to apply the active cream to one heel, and a neutral, urea free base cream to the other. The ages of the volunteers ranged from 32-89 years and included both males and females.
The trial was double blinded in that neither the investigator a Dermatologist, nor the volunteers were aware of the nature of the creams being applied. Creams were applied at night after bathing the foot in warm water. 5ml of cream was applied to each heel before retiring in the evening. No occlusion was used.
The feet were examined prior to use of the creams and given a score on a scale of 1-5 for the following parameters:
• Dryness
• Fissuring
• Thickness
After two weeks, the feet were examined by the same investigator and rescored. The code was then opened and the two creams assessed. There was an improvement in both groups, but the active cream scored better in all parameters, especially the fissuring.
A second open trial was undertaken to compare the cream with another well known and popular brand on the market. This was an open two week trial, using one brand on the right foot and the HEELS Heel Balm with tea tree oil on the left. After two weeks, volunteers were asked to subjectively assess both preparations for effectiveness and cosmetic acceptability.
Although these were simple trials, they served to confirm that the HEELS Heel Balm cream was both effective and aesthetically pleasing.
Both creams conferred 25% urea, one in a super-fatted base, the other (R.E.D Skincare Heel balm) in a non greasy petrolatum base with 2% tea tree oil added. Both creams were regarded as being equally effective in reducing the cracking and dryness, but the HEELS Heel balm was easier to use and more cosmetically acceptable.
The tea tree additive was also preferred as there was a perception that it had healing properties and prevented athlete’s foot.
In Summary
HEELS Heel Balm has been used widely by dermatologists and Podiatrists in South Africa, UK and the Middle East for the last year. More recently it has been exported to Australia where it is rapidly gaining popularity. It has been well accepted and is popular with doctors and patients alike.
It has been prescribed to patients with a number of conditions including dry and cracked heels, calluses, corns and stucco keratoses. In addition, it is particularly useful in the management of diabetic feet to prevent fissuring and potential infection. It can also be used for other areas where thick skin is a problem such as elbows, knees, hands and rough cuticles with good results.
In summary, HEELS heel balm is a useful adjunct to management of a number of dry skin disorders of the feet.
The HEELS Heel Balm has been well formulated and has been found to be effective in clinical usage. It is aesthetically pleasing and is popular amongst both health care professionals and the public.
