Effective Relief for Cracked Heel; A Review of Poly Herbal Crack Heel Gel

There is no upper age limit for heel cracks, and anyone can have them regardless of gender, race, or place of origin. Cracks are typically occupational, such as in farming or among those whose jobs require constant standing. Common causes include advanced age, excessive uneven surface walking, extended hard floor standing, uncomfortable, ill-fitting, or open-back footwear, an unhealthy diet, obesity, diabetes, psoriasis, and other skin allergies, as well as unsanitary foot conditions or high foot exposure to dust, dirt, germs, etc. [1] Females frequently have cracked

heels as a result of performing household tasks carelessly, such as working barefoot in unsanitary

areas or as field workers and laborers. People with cracked heels can be seen in all socioeconomic levels and higher social groupings. Seasonal fluctuations may contribute to its frequent occurrence. The main prerequisite for having a beautiful and appealing personality is having healthy skin. Any flaw or violation of skin beauty results in severe disability or social disgrace. It could make someone less confident.[2]

People who walk a lot, wear inappropriate shoes, or walk barefoot, are exposed to cold water, or even unsanitary conditions like dust, germs, and dirt can develop symptoms like dry feet, cracks, flaring patches, itchy skin, and pain in the palms and soles. This is comparable to heel fissures or fractured heels. Deep fissures bleed and hurt, and they may eventually become infected. It makes feet less beautiful. Principles of numerous treatments are taught, including exterior applications, internal drug delivery, padabh yanga (foot massage), and more.[3]

Fig 1

1.1HISTORY 

This is a longer version of the section about the origins of crack heels: With a lengthy history spanning millennia, crack heel is a frequent and painful ailment. Crack heel was treated with a variety of natural medicines in ancient societies. Herbal treatments for dry, cracked skin, including plant extracts and oils, were listed in the Ebers Papyrus, an ancient Egyptian medical treatise written around 1550 BCE.[4] Similar to this, the Charaka Samhita (400 CE) and Sushruta Samhita (600 CE) of Ayurvedic medicine explained how to treat crack heels using natural remedies like neem, turmeric, and aloe vera. European doctors employed a variety of remedies, such as poultices and ointments, to cure ailments during the Middle Ages. The invention of protective lotions and moisturizers in the 19th century signaled a dramatic change in.  Additional developments occurred in the 20th century, when studies concentrated on the use of antibacterial and anti-inflammatory drugs to treat crack heels. These days, crack heel is commonly treated with polyherbal gels and lotions that combine natural components with cutting-edge technology. To offer extreme moisturization and protection, these products frequently include urea, hyaluronic acid, and glycerin. In order to encourage healthy skin renewal, advanced formulations also address underlying problems including bacterial or fungal infections. Important turning points in the development of crack heel therapy: Ayurvedic medicine (400–600 CE): Natural compounds used to heal broken heels - Ancient Egypt (1550 BCE): Herbal medicines recorded in Ebers Papyrus European use of ointments and poultices during the Middle Ages The introduction of moisturizers and protective lotions in the 19th century; research on antimicrobial and anti-inflammatory drugs in the 20th century.[5]

1.2Why need gel preparation

Humectants like glycerin and urea, which attract and hold onto moisture in the skin, are typically abundant in gel compositions. Additionally, they contain emollients, which form a barrier that retains moisture and stops additional cracking.[6] Additionally, gel's cooling properties offer immediate pain relief and inflammation reduction around the cracks. Salicylic acid and lactic acid are common constituents in these formulations because they gently exfoliate dead skin cells, leaving the skin smoother and more sensitive to moisture. Gels are suitable for frequent usage because they are easy to use, non-greasy, and hydrating. They can be worn all day without leaving a greasy residue because to their lightweight texture, which guarantees rapid absorption. Gel treatments are the perfect way to treat and avoid cracked heels because they combine protection, exfoliation, and hydration.[7]

1.3Advantages of gel dosage form

1) There are numerous benefits to local action, including.

 a. quick and long-lasting action (direct at the site).

 b. less adverse effects.

 c. avoiding GI administration issues such poor taste, potential interactions with other medications, foods, or HCl, and liver or other organ metabolism.

2) Easy Use (non-invasive application or use) leads to high patient compliance.

3) In contrast to other dosage forms, it is simple to formulate.

 4) Gels are often elegant and non-greasy compositions.

5) Patients who are unconscious, have stomach issues, are young or elderly, or are taking a lot of medications can all benefit from this dosage type, Skin Conditions f. Bitter-tasting salts.

1.4Disadvantages of gel dosage form

1) Reduced precision of dosage .

2) Drugs with large molecular sizes cannot be administered in gel form because they are unable to be by the skin.

3) Less stable than types of solid dosage.

4) Increased potential for contamination during use.

5) May be oily and unpopular with patients due to cleaning issues, clothing stains, etc.

6) May irritate or trigger an allergy in patients .

7) Generally more expensive and requiring more storage space than solid dose forms.

2.Disease

Heel fissures, another name for cracked heels, are a frequent foot ailment in which the skin of the heels becomes thick, dry, and cracked. The main cause of this problem is a decrease in the skin's elasticity and moisture content, which results in rough, hardened skin that breaks under pressure. Since the cracks may widen and result in pain, bleeding, and even infection if treatment is not received, cracked heels can be a medical and cosmetic problem. Prolonged standing, barefoot walking, wearing open-heeled shoes, and exposure to dry or cold weather—which can worsen skin dehydration—are the main causes of cracked heels.[8] Additional contributing factors could include medical disorders like diabetes, psoriasis, and eczema, which can affect skin health and hydration, or obesity, which puts additional pressure on the heels. Another factor may be nutritional inadequacies, particularly in vitamins and minerals like zinc and vitamin E. Thickened skin around the heel, dryness, itching, and obvious cracks—which can be small or deep and severe fissures—are all signs of cracked heels. In extreme situations, there may be bleeding or infection of the skin surrounding the fissures, resulting in redness, swelling, and discomfort when standing or walking. In order to soften and hydrate the skin, thick creams or balms containing urea, salicylic acid, or lactic acid are commonly used to treat cracked heels. Dead skin cells can be removed using a pumice stone exfoliation, but to prevent more skin injury, delicate care is required.Cotton socks and closed shoes can help keep moisture in and lessen friction.[9] It is necessary to consult a doctor for appropriate treatment and care in cases where cracked heels are associated with underlying medical disorders in order to prevent complications.

2.1Clinical Name: Heel Fissures, Heel Cracks, or Xerosis

 Description: Deep, excruciating cracks or fissures on the heel of the foot are the hallmark of this prevalent skin disorder. It happens when the heel's skin gets dry, thick, and hard, which causes cracks and fissures.Signs and symptoms:

1. The heel has deep cracks or fissures.

2. Skin that is scaly, rough, and dry.

3. Pain or discomfort during standing or walking.

4. Inflammation or bleeding around the cracks.

5. A burning or itching feeling.

6. Discoloration around the cracks that is yellow or brownish .[10]

2.2Reasons: 1. Xerosis, or dry skin.

2. Too much water exposure.

3. Using harsh cleaners or soaps.

4. Unsanitary feet .

5. Health issues (such as diabetes, psoriasis, and eczema).

6. Growing older.

7. Being overweight.[11]

2.3Layer of injured skin

1 Outer layer: Made up of cells that create keratin, the epidermis is the skin's outermost layer. Because of their close proximity, the coenocytes isolate themselves from the surrounding air. The epidermal layer regenerates itself continuously. The lowermost layer of the epidermis is where the new cells are produced. The epidermal layer constantly renews itself to replace the cells that are lost and fall off as tiny skin flaks. The epidermis's thickness varies depending on the location. It is 0.3 mm thick on the elbows and knees, and 4 mm thick on other body parts including the palms of your hands and the soles of your feet.[12,13]

2: Middle layer: The dermis, which is composed of a dense network of elastic collagen fibers, lies beneath the epidermis. The dermis is what gives the skin its strength, elasticity, and durability. Additionally, the dermis is made up of tiny blood vessels and a network of nerve fibers. Through the capillaries, nutrients and oxygen are delivered. Additionally, it aids in body cooling.[14] The hypodermis and subcutaneous layer, the deepest layer, are made up of connective tissues and fat. Storage tissues are found in the tiny spaces that exist between the dermal folds. In addition to providing insulation, the hollow serves as a shock absorber and protects the bones and joints. One hormone found in skin is vitamin D.

Fig 2

Gel was developed with the goal of creating a material that doesn't flow like a liquid in a static state but still has some liquid properties so that a solid (medication) can be dissolved in it and applied easily to any surface (affected part), where it can be absorbed and act locally to provide quick action with the least amount of waste and adverse effects. "Jellies" is another term for gels . Some gel systems are turbid, while others are as transparent as water, depending on what's in them. [15]

5.1Properties of gels

1.The system is colloidal, consisting of a solid dispersion medium and a liquid dispersed phase.

2. It is immobile and semi-solid.

3. The structure resembles a honeycomb.

4. Most gels experience swelling as a result of fluid absorption.

5. Elastic gels are composed of organic materials that, when heated, produce elastic solids; when water is added, the gel form can be recovered. (lyophilic & reversible).

 6. Non-Elastic (Rigid) Gels are composed of inorganic materials that, when heated, produce a powder that is irreversible and lyophobic, meaning that it cannot be reconstituted into gel by adding water.

7. Gels have the potential to inflate, absorbing more liquid and becoming larger.

8. A phenomenon called syneresis, which happens when elastic tensions produced during gel setup relax, causes many gel systems to contract when left standing.

9. Gradual aggregation is typical in colloidal systems, including gels, and is called "ageing."

10. The network created by the interlinking of gelling agent particles makes some gels stiff.

5.2Components of gels

Fig 3

1.Thermal Changes: A solution is heated to solubilize polymers because many of them are more soluble in hot water than in cold, and when this solution cools, gel is created. For instance, cellulose derivatives, agar, gelatin, and guar gum.[16,17]

2. Flocculation: This process involves adding a small amount of salt to create a gel-like precipitate, but not enough to create full-solid precipitates. Quick mixing is necessary in this procedure to prevent solid formation and high concentrations in some areas. For instance, ethyl cellulose and polystyrene in benzene can be quickly mixed with appropriate proportions of a non-solvent, like petroleum ether, to gel the solution.[18]

3. Chemical Reaction: Gels are created when certain solutes and solvents interact chemically. An aluminum hydroxide gel, for instance, can be created by mixing sodium carbonate and aluminum salt in an aqueous solution, then raising the reactant concentration to create a gel structure.[19]

5.4Evoluation of gels [20]

1.PH

2.Drug content

3.Viscosity

4.Spreadability

5.Grittiness

6.Extrudability

7.Homogeneity

8.Skin irritation

9.Stability

5.5Application of gel [21]

1.Delivery systems for topical drug application.

2.Binder in tablet granulation..

3.protective colloids in suspensions

4.Thickness in oral liquid suppository bases.

5.In cosmetics like shampoos ,fragrance product, dentifrices, skin hair care preparation.