NICE Guideline NG19

Callus is a key risk factor for Diabetic Foot Ulceration. Removing it can reduce the risk of ulceration 14 fold. 1

For patients with callus and another risk factor (neuropathy or PAD) NICE guideline NG19 requires the provision of skin care for the feet.

There is no evidence showing that non keratolytic emollients can remove callus.

A paper in The Diabetic Foot Journal by leading UK experts suggests the application of urea creams to treat callus 2. Patients with neuropathy have impaired sweat glands and should therefore continue to use Dermatonics Once Heel Balm to prevent recurrence of callus.

Click for NICE guideline NG19


Dermatonics has unparalleled published evidence of its efficacy in treating Callus in high risk patients with Diabetes in the UK. 3

In a trial at Whittington Hospital 96% of patients had their callus treated within 2 weeks.


Dermatonics offer savings v the competing 25% urea drug tariff product.




Dermatonics Once Heel Balm requires just one quarter of the application amount per day.

Dermatonics Once Heel Balm requires just a 1cm strip to be applied once a day, whereas competing products require a 2cm strip to be applied twice a day for all patients, for best results.

Please ensure that Dermatonics Once Heel Balm is applied around but not in any splits. Application in these splits risk stinging, as well as the introduction to pathogens. 


Health Economics

An ulceration costs the NHS almost £15000 to treat, whereas a years course of Dermatonics costs £28.32. There is 1 ulceration for every 20 high risk patients. At Ipswich Hospital the use of Dermatonics alongside a prevention protocol reduced ulcerations by 2/3rds. 4


In addition, Dermatonics Once Heel Balm has received just one written report of a (minor and transitory) sensitisation in 15 years on the Drug Tariff despite us having sold 2million tubes. In contrast, another heel balm manufacturer has received an addition to its list of adverse reactions, See below quote:
Alternative Heel Balm Manufacturer Prescribing Information:
"ADVERSE REACTIONS: Rarely, allergic reactions such as skin rash, blistering and skin peeling may occur. Blackening of treated skin on the sole of the foot may occur very rarely. If you notice these or any other side effects, stop use and speak to your doctor or pharmacist, they will tell you what to do.”


    1. 1. Leese GP1. Stratification of Foot Ulcer Risk in Patients with Diabetes: A Population-based Study. International Journal of Clinical Practice. Int J Clin Pract. 2006 May; 60(5):541-5.

      2. Bowen G, Bristow I, Chadwick P et al (2021) Optimal emollient treatment and prevention of diabetic foot complications. The Diabetic Foot Journal 24(1): 40–5

      3. Jones S, Lunn D. A Clinical Review of Dermatonics Once Heel Balm 2020. Diabetic Foot Journal, March 2020

      4. Diabetic foot care in England: An Economic Study. Marion Kerr, Insight Health Economics, for Diabetes UK, January 2017

For more information on ulcerations and diabetic foot screenings, please visit the online version of 'A Pictorial Guide to Diabetic Foot Screening' below