by Dr. S. Liam

Pruritus Calcaneus is a condition where a certain point of the heel is itching.

Following Symptoms are being associated with Deep Heel Itching (Pruritus Calcaneus):

  • Irresistible itch on the heel, mostly on one foot, sometimes both heels
  • Anti-Inflammatory creams, anti-fungal creams and anti-itching don’t help or provide only a temporary relief
  • Itching feels like it comes from inside the heel rather than on the surface
  • Doesn’t disappear and stays with the patient for 5, 10, 30 years and longer — sometimes rests for years and comes back
  • Patients feel the need to use callus remover or foot scrubber to peel off the callus round the heel to get closer to the itch
  • Often appears before sleep or during the night — sometimes causing sleep disorders due to pain or heavy itching
  • Feeling pulse sensation around the heel
  • Feeling heat sensation and sometimes pain on the surface of the heel
  • Rubbing the heel to a surface (warming it up) causes a temporary relief

If you associate yourself with one or more of these symptoms, you might have one of the rare but harmless conditions called Pruritus Calcaneus — a bacterial infection of the Calcaneus (heel bone), which is often described as to be impossible to detect since it is neither based on the surface of the skin, nor it’s neurologically related.

Pruritus Calcaneus is a harmless infection and causes no dangerous side effects, it’s not contagious, but it can be very annoying for those who have to endure it.

Since it’s hard to detect, it is also misdiagnosed. Below are some common misdiagnoses:


Deep Heel Itching is mistaken for other diseases since dermatologists can’t find any inflammation or other irritations on the surface or inside the skin of the heel. Due to no findings, the patient is sometimes being sent to a neurologist who mistakenly can diagnose a nerve damage or point the source to back issues. Below are typical diagnoses that are not associated and are the source of Deep Heel Itching:

  • Back Pain
    Patients suffering from back pain can mistakenly associate the deep heel itching with their back problems, because itching of the foot are often associated with nerve issues on the back.
  • Sciatic Nerve and Spine-Health related problems
    A very common mistake to make, because the nerve roots in the spine can lead to numbness, tingling, burning, and prickling sensation in the legs and the feet, known as Sciatica Symptoms.
    A variety of lower back problems can lead to pain that radiates along the sciatic nerve. Most often, sciatica pain is caused when the L5 or S1 nerve root in the lower spine is irritated by a herniated disc. The nerve roots that exit the spine to form the sciatic nerve are extremely sensitive, and the inner portion of the disc that may herniate or extrude contains proteins that are inflammatory and easily irritate the nerve.
  • Plantar Fasciitis
    Plantar Fasciitis is a band issue that connects the heel bone with the toes. It has nothing to do with patients who have itching problems on their heel or heels.
  • Athlete’s Foot
    Not only the heel is rarely infected by tinea pedis, patients with deep heel itching do not show any signs of a fungal infection, also antifungal medications provide no help or relief.
  • Tarsal Tunnel Syndrome
    Both, Tarsal Tunnel Syndrome (TTS) and Carpal Tunnel Syndrome are wrongly associated with Deep Heel Itching. Especially TTS (also known as posterior tibial neuralgia) since it’s foot related.
  • Bone Spur (Osteophyte)
    Osteophyte is the formation of the bone causing many problems, but very seldom the symptoms described above.
  • Multiple Sclerosis
    This is a very scary diagnosis; however deep heel itching has nothing to do with MS.
  • Neuropathic or Chronic Itch
    Since many patience experience the same symptoms on the exact same location, the source of the problem can’t be a chronic itch caused by a dysfunction of the itch-sending neurons causing a sensory hallucination of pruritogenic stimuli.


The deep heel itching is caused by a developed type of the bacteria Actinomyces. Since Actinomyces are not being expected to nest in the heel, it makes the diagnosis extremely difficult and almost impossible. Actinomyces are known to cause problems in ENT areas, and especially intestines, which explains why doctors are hesitant to associate deep heel itching with it, or do not see a connection.

Actinomyces species are anaerobic bacteria and they can flourish deep under body tissues such as under the heel, where even oxygen levels are very low. In case of deep heel itching, the bacteria rests on the Calcaneus (heel bone), close to the Subcalcaneal Bursa, which also makes it very difficult to detect.

Once infected and nested, the bacteria usually don’t spread to other parts of the foot or body, as it seems that the heel provides exactly what the bacteria needs to settle down and live for even decades. Other than severe itching and sometimes pain, the infection is harmless.


Due to its strong persistence to short-time antibiotic treatments, Pruritus Calcaneus is hard to get rid of with antibiotics. A recent study in 2016 researched the resistance patterns of the Actinomyces species as former studies could not provide enough information on the antimicrobial resistance of the Actinomyces bacteria. However, these kinds of treatments are recommended for severe infections with Actinomyces such as in the intestines, face and mouth. It’s not recommended to treat Pruritus Calcaneus with antibiotics for 5 to 12 months as it seems unnecessary and excessive to expose oneself to the side effects of a long-term antibiotic treatment because of a harmless, nonetheless annoying itching sensation.

The way to get rid of the Actinomyces is in fact Melaleuca Alternifolia — I’ll explain why: Actinomyces is in fact a tropical bacterium and was often classified as fungus due to its very similar behavior and conduct on the human body. In my research could find a very close connection between Melaleuca Alternifolia and Actinomyces. Especially in tropical areas such as Australia, Melaleuca Alternifolia was used by indigenous people to treat many diseases long before bacterial research was conducted in modern societies. Melaleuca alternifolia is known for its very strong antimicrobial properties as it is composed of terpene hydrocarbons, sesquiterpenes, and alcohols which penetrates skin — and it can find its way into the blood stream and bone tissue where it can unfold its healing and antimicrobial properties.

The following treatment will get rid of the deep heel itching

The patient must use callus remover on the heel to get closer to the source of the bacteria. Melaleuca Alternifolia (known as Tea Tree Oil or TTO) must be applied 2 hours before sleep time around the itching area.

This is how it’s done:

Use silicon heel cups before going to bed, and apply 10 drops of TTO inside the cup (products displayed further down).

Deep Heel Itching Therapy

Repeat for 6 consecutive weeks.

What it does

The heel cup conserves the tea tree oil on the surface of the heel and helps to penetrate the skin or callus. Once in contact with the infected area, TTO will slowly kill the Actinomyces over the next weeks since Actinomyces is extremely sensitive to Monoterpenes which is the ingredient of TTO . It’s important that the treatment is not stopped and continued for 6 weeks, even when the patient feels relief, and it seems that symptoms such as pain, heat and itching on the heel have disappeared within days.

Below are the products tested:

Silicon Cup Heels

Heel Cups

Silcon based cup heels that keep the tree tea oil inside (Amazon Link)

Tee Tree Oil

Tea Tree OilWhen it comes to Tee Tree Oil, you want to make sure they have the highest amount of monoterpenes and alcohol. Not all Tree Tea Oils provide that, like the ones from Walmart, CVS. They come very cheap, but are not as effective (some have low concentration of progesterone — but you need a high concentration of progesterone to get rid of the cause of deep heel itching which are Actinomyces). Below are the products that have been tested:


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Heel Itching Are you suffering from Deep Heel Itching?

Is your heel itching and it drives you nuts? Anti-Fungal and Anti-Itching cremes don’t help, and dermatologists don’t have a solution? Cure your Deep Heel Itching with this method…

9 comments for “Deep Heel Itching: What Causes It and How to Heal It

  1. Mary S,
    March 20, 2019 at 12:36 pm

    Wow. I have never been able to find out what is wrong with my feet (heels)! I have been researching for a long time and this is the first article to explain it all. I have every single symptom listed. I have noticed that it sometimes goes away and then comes back as weather is changing (not sure why). Well, it’s back again and driving me crazy. Will definitely try this method. Thank you! Is there any way to reach Dr. Liam?

  2. Cris,
    April 9, 2019 at 6:58 am

    Omg finally!! Thank you for this article! I went to a foot doctor who has no clue what was causing my itchiness! And for 20 years, I have been dealing with this! I want to hug you!

  3. Melanie P,
    April 17, 2019 at 12:14 pm

    OMG!!!! The symptoms described is so me!! The itching just started a few days ago and I had no glue what was wrong with me. I have not yet gone to the doctor for it. I decided to google first. I’m so glad I came across this article. I will definitely give this treatment a try.

  4. Kathleen L.,
    April 24, 2019 at 8:29 pm

    Can this also happen along the lateral aspect of the feet? I have never had a rash, or flaking skin, but the sides of my feet itch and have been doing so for atleast 10 years. Sometimes it is on my heel too, but mostly on the sides of my feet. It is worse at night when I am in bed, when I’m standing in the shower, and when my feet get feel hot and sweaty. I have tried antifungal creams (they help a little, but never resolve the issue), domboro soaks and hydrocortisone cream, (they also help temporarily).

    Other than a fungal infection to one of my toenails (which I am treating with Jublia), I am a very healthy person.

    Just wondering if I should try this……

  5. Elizabeth Perez,
    August 18, 2019 at 1:01 am

    Hi, I’m curious of the treatment instructions. Should you sleep with the silicon cups on? Take them off in the morning? Would love any more specific instructions on the 6 week treatment. Thank You!

  6. Heels so Itchy,
    August 23, 2019 at 8:30 am

    The author has provided information about why other conditions in the differential that could be misdiagnoses. However, there is no information provided as to how a the bacteria is confirmed as being present in the heel apart from the fact that “they can flourish deep under body tissues such as under the heel”. Any test to confirm a diagnosis of actinomyces colonization before spending money on tea tree oil? Any published evidence about this approach being effective or indicated for heel itch?

    I have the problems, as described, and have suffered for years. Honestly, I’m going to still try this because I’m at wits end. However, I worry that the claims made by this article are baseless and this is a way to increase sales of the linked products in the article.

  7. Margarete,
    August 23, 2019 at 6:57 pm

    I had the same thoughts. The bacteria theory kind of sounds weird. My doctor told me it’s a long shot and he didn’t believe the bone bacteria theory. He’s still convinced it has to do something with the nerves. He said to go easy on the Tea Tree Oil — he said, it’s organic but still can cause burns and damages on the skin since the product advertised here is concentrated. I’m desperate, so I tried.

    This is my experience: For the Tea Tree Oil to work you need a callus remover — that thing that has a sharp razor on the top. I cut too deep at first and my heel started to hurt and burn because of the skin damage – be careful with that thing, don’t take too much skin from your heel. You have to use the Tea Tree Oil on that light skin on your heel after you have removed the callus.

    Next, the silicon cup heels dissipated, because the Tea Tree Oil has a corrosive effect on them. That didn’t workout as I have imagined, so I started to use duct tape on the silicon cups to hold them together. Using it the whole night thing didn’t workout for me, I started using them before I went to bed for a couple of hours.

    After around 2 weeks, the itching disappeared. I continued as described for another 4 weeks. The itching for now is gone and it has been 4 months since I had the itching sensation. The callus has grown back. But I have now itching on the side of my foot — but I don’t remember if I had that before or just ignored it because of the much stronger itching on my heel. I’m thinking now to try that Tea Tree Oil on the side, too.

    It’s unbelievable that nobody knows what this horror is. The Tea Tree Oil helps, I recommend it. However, I don’t know if it has really healed or the Tea Tree Oil just numbed all the nerves on the heal. If the Tea Tree Oil only numbs the nerves, it might a nerve issue after all. Since so many people have this problem, and no doctor seems to know (besides this article here claiming to know), this might be an anatomic problem that leads to nerve issues on the back.

    If I were to find out in this life, I will write about it. Until then, whatever works. So, Tea Tree Oil it is for now then. Numbing the nerves, bacteria or not, I live again with no itching sensation.

    Good luck!

  8. Ray,
    August 28, 2019 at 11:49 pm

    Have had itching in the left heel for quite a while, doesn’t hurt but has been very annoying. Checked the internet, came across this article and decided to give it a try. Took far too long to get the tea tree oil from Herb Pharm, but it finally arrived yesterday, followed the instructions and much to my surprise have had no itching today! Will continue for six weeks as the article suggests, but this is a great way to start.

  9. Joanne,
    October 7, 2019 at 6:02 pm

    Wow!! Came across this article the other day, I have been desperate to find a diagnosis for this problem I’ve been experiencing for years, I’ve even been to the doctor and they couldn’t detect anything. I have tried all different bacterial creams and nothing has worked. This is now my third night of using this method and I can honestly say I have felt an immediate relief. I’ve even managed to sleep without the irritating itch waking me up. I will definitely keep it up for the 6 weeks it recommends, hopefully it will be a long term relief.

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