Chapter II.

Review of Related Literature

Cracked heel is a common foot problem it is the

development of dry, hard, thickened skin around the rim of the heels

which is particular for some diabetic patients. (Ngan, 2006)

According to this article cracked heel is unattractive to look and is

merely a nuisance and when not treated immediately might cause it

to infection. Cracked heels are common to people whose footwears

are exposed in spending a long time standing. Dry skin occurs on

multiple areas of the body and is a common foot problem secondary

to an underlying health issue. Sometimes only our feet are affected

and this results to cracked skin in our heels on in our soles of the

feet. Dry skin or also known as xerosis, this can simply be a cosmetic

problem or it may lead us to symptoms such as itchiness, a skin

rash, or even pain and secondary infection. (Moyer, 2018) Dryness

of skin also causes cracked heels. Prolonged standing – standing for

a long time on a hard surface contributes and develops crack heels,

Eczema – an Italy condition and increase the dryness of skin

especially the heels, Psoriasis- dry scaly and flaking skins is also

caused by this, in some cases peeling skins may also occur.

Palmoplantar – thickening of the skin on palms keratoderma and

sole of the feet is caused by this condition and lastly, Inappropriate

footwear – this can cause or worsen cracked heels as there is little

to keep the fatty pad in the heel of the foot place when pressure is

exerted on it. (Fields, 2019) These are conditions that triggers

cracked heels.

There are several potential causes of cracked heels. Some of

the most common causes of cracked heels are pressure, aging skin

exposing footwear pressure in spending a long time standing at work

or school can stress the skin on your heels. Aging skin, if you have a

thick, dry, scalp skin loses its elasticity with age, and as such cracks

can name higher incidence as you become older. Third is exposing

footwear is if you are wearing open-back sandals or shoes this allows

fat under the heel to expand sideways and increase the possibility of

cracks on your heels. (Amope, 2017) The best form of treatment for

cracked heels is to prevent cracks from occurring in the first place. You

can simply moisturize your skin or to avoid doing what causes cracked

heels. Also, there are tips for boosting foot hygiene.

There are also home remedies that can help you cure cracked

heels. Ripe bananas are one of the best natural remedies to heal

cracked heels because of its moisturizing properties and also avocado

is rich in essential nutrients that has an ability to help heal dry skin.

Here are five tips to cure cracked heels. First, wash and wipe your feet

thoroughly, wash one ripe banana and half avocado into a smooth

paste and apply in the affected areas. Second, let it dry for about 10-
15 minutes to let it soak in some moisture. Third, wash your feet with

warm water then soak in a tub with cold water. Fourth, wipe any with

a clean cloth then lastly, do this daily for a few days. (D’Costa, 2017)

Avocados were widely cultivated in tropical America as

individual seedling trees before the Spanish conquest but did not

receive serious horticultural attention until about 1900. It is a fast-

growing plant and reaching a height of 20m with age whilst grafted

trees are usually 18-10m tall. It is also a dense polymorphic broad-

leaved aromatic evergreen tree species of the genus Persea classified in

the division Magnoliophyta. (Bergh. et al, 1990) The “genus persea” or

most commonly known as avocado is a fast-growing tree. Growth is in

frequent flushes during warm weather in warmer regions with only one

long flush per year in cooler areas. Avocado leaves are alternate, glossy,

elliptic,10-30cm long 4-10cm wide, leathery, upper surface dark green,

lower surface glaucous and sparsely hairy. Although the trees produce

on abundance of flowers, usually 0.1% of the flowers set fruit and most

of these fruits abcise within 6 weeeks from full bloom. Accordingly,

avocados differ in such significant ways as length of the time from

bloom to fruit maturity, thickness of skin, tolerance of cold, etc.

According to Borges, et al. 2014, Avocado is considered one

of the main tropical fruits- it contains fat-soluble vitamins which are

less common in other fruits. It contains vitamin A and B, and median

levels of vitamin D and E. Avocados provide substantial number of

vitamins, mineral and other nutrients with relatively few calories and

is the only fruits that contains monosaturated fat – good fat.

According to Elumeze, 2017 avocados contains vitamin B, C, E and

K, riboflavin, niacin, folate, pantothenic acid, magnesium, potassium,

lutein, Beta-carotene, omega 3 fatty acids and anti-aging antioxidants

that is beneficial to the hair and skin. As previously mentioned,

avocados have excellent moisturizing properties that can soften, sooth

and quench the driest skin that ever existed. An example of a home-

made moisturizer. We can do with Persea Americana is avocado and

coconut oil moisturizer for the body and contains antioxidants which

are widely known for their anti-aging properties. Avocados contain

vitamins that are good for keeping the skin healthy. Avocado are a

good source of vitamin E, which is an important anti-oxidant that

helps protect your skin from oxidative damage caused by the sun and

the environment. (Jones, 2018)

Avocado tree also has a high fruit yield, it can produce

138kg at 7years after planting- it also has intense growth and

development differently from other fruit species. It has major changes

in metabolism and higher respiratory, and thus high production of

ethylene. In addition, it is widely used in pharmaceutical and

cosmetic industries. While most fruit consists primarily of

carbohydrate, avocado is high in healthy fats. Avocado is the fruit of

the avocado tree, scientifically known as Persea Americana. This fruit

is prized for its high nutrient value and is incredibly popular food

among health-conscious individuals. It’s often referred to as a

superfood, which is not surprising given its health properties. The

most popular variety is the Hass Avocado. The avocado fruits are very

nutritious and contains a wide variety of nutrients, including 20

different vitamins and minerals. Avocados do not contain any

cholesterol or sodium and are low in saturated fats. This is why they

are favored by some experts. (Gunnars, 2018) Avocado is a green fruit

and we all know that green fruits are rich in vitamins, protein, copper,

fiber and monounsaturated fats that does the body good. Avocados

are a superfood but aside of this all, avocados also have the beauty

benefit. (Oliver, 2019) Accordingly, avocados also have ways to

incorporate into our beauty regimen such as it moisturizes our skin

because it has a natural oil that can penetrate deep into our skin that

helps soften and hydrate dry and flaky patches. Antioxidants are

abundant in fruits and vegetables. Some common antioxidants

include beta-carotene, lutein, lycopene, selenium and vitamins A, C,

and E. Avocados contain many of these antioxidants which are helpful

in keeping the skin healthy.

According to overstock, the skin is largest organ of our body,

so it is very important to take care of it. In order to protect the skin

antioxidant must be present in our body because it limits the

production of free radicals that can damage skin cells. It is an anti-

inflammatory, reducing inflammation can help keeping acne and

wrinkles and it promotes more even skin stone. Another benefit of

antioxidant is skin firming- it moisturizes the skin and may actually

reverse the effects of aging. It also reduces appearance of aging. It also

reduces the appearance of wrinkles, treats the scar and repair sun

damage. Avocados are rich in anti-oxidant which is very useful for our

research. Avocado is rich in monounsaturated fatty acids a diverse

array of carotenoids, fiber, folate, glutathione, and phytosterol. It also

includes the powerful oleic acid also found in olive oil and flavonoids,

which are the pigments found in plants that is certainly a wealth and

health benefit. Research also establishes that avocado’s unique

nutrient profile promotes joint, eye, and skin health and it also helps

prevent cancer, cardiovascular disease, metabolic syndrome and

obesity. (Downey, 2014)

According to Marks, D. though the fruit avocado has various

health benefits, eating it or applying it to the skin can cause adverse

reactions. A rash that develops after your skin comes into direct

contact with avocado by-products is most lively needed to allergic

contact dermatitis-a localized allergic reaction that occurs minutes

after you touch the product that contains avocado. It causes skin

redness, inflammation, swelling, itching and general irritation. These

symptoms may appear immediately or several hours later in some

cases. Treating the affected area by washing with soap & water and

applying creams is the best first line treatment. Even though avocado

has a lot of good benefits there are also negative effects to you.

In the late 19th Century, Lacatan was first described as

Musa Paradisiaca by the Spanish botanist Francesco Manuel Blanco

in his book Flora Filipinas. A molecular and cytological analysis of

the lakatan accessions at the ICT places the cultivar (an organism

and especially one of an agricultural or horticultural variety or strain

originating and persistent under cultivation) in the AAA genome (one

haploid sets of chromosomes with the genes they contain broadly the

genetic material of an organism) group. The letter C was eventually

changed to K to differentiate it from “lacatan”, the American name for

the tall cavendish cultivar known as “bangulan” in the Philippines.

The morphological (relating to the form or structure of things)

characters of the plant lacatan weights 2.7-2.8m the color of its

bracts is purple- brown lavender and orange – red on the inside,

fading towards the base. The bracts roll it before falling (revolute).

(Vezina, 2019) Among the banana varieties, the lakatan type has a

higher vitamin content. It has much more vitamin A and vitamin C.

Based on these nutritional values, banana is natural multivitamin. It

also has 10 benefits including protection against heartburn, it has

high fiber and vitamins, it is also good for the heart, it reduces stroke,

it counters stress and insomnia, it may moderate diabetes, it fights

fatigue and anemia, it also prevents leukemia, prevents childhood

asthma and lastly it is cheap. (Ong, 2008)

Fruits and vegetables are an important part of a healthy

diet. Fruits like banana offers great benefits. Bananas help retain the

calcium, nitrogen, and phosphorus, all of which helps regenerate and

build healthy tissues in the body. Bananas are very helpful for

intestinal disorders like ulcer. The role of bananas is to neutralize the

acidity of gastric juices, that by reducing the ulcer irritation by

coating the lining of the stomach. Additionally, the fruit is also used

for the treatment of wounds and burns. For an immediate pain relief,

beat a ripe banana into a paste and spread over a wound or burn.

Banana has great nutritional value. It has a rare combination of

energy value, tissue-building element, proteins, vitamins and

minerals. It’s a good source since it is rich in solids and low in water

content as compared to any other foods and so they are invaluable to

those with compromised immune system. Furthermore, banana don’t

contain amounts of fats, cholesterol, or sodium which makes it a

healthy food option. There are several types of bananas which are

classified according to their task and color of their skin. Red bananas

have red peel and the flesh is light pink in color. Apple bananas are

smaller than the usual varieties of bananas and yellow in color. The

baby banana is of one of the smallest varieties and they are yellow in
color. Ripe banana’s benefits are very varied and so it also helps

fortify the skin and prevents wrinkles. (Bhowmik, Duraivel, 2012)

Banana is the common name for herbaceous plants of the

genus musa and for the fruit they produce. It is one of the oldest

cultivated plants. All parts of the banana plant have medicinal

applications: the flowers in bronchitis and dysentery and on ulcers;

cook flowers are given to diabetics; the astringent plant sap incases

of hysteria, epilepsy, leprosy, fevers, hemorrhages, acute dysentery

and diarrhea. It is applied on hemorrhoids, insect and other stings

and bites. Young leaves are placed as poultices on burry and other

skin affliction. The astringent ashes of the unripe peel and of the

leaves are taken in dysentery and diarrhea and used for treating

malignant ulcers. The roots are administered in digestive disorders,

dysentery and other ailments. Banana seed mucilage is given in cases

of diarrhea in India. Anti-fungal and antibiotic principle are found in

the peel and pulp of fully ripped bananas. The antibiotics acts against

mycobacteria, a fungicide in the peel and pulp of green fruits is active

against a fungus disease of tomato plants. Norepinephrine, dopamine,

and serotonin are also present in the ripe peel and pulp. The first two

elevate blood pressure; serotonin inhibits gastric secretion and

stimulates the smooth muscle of the intestines.

 According to Sadhwani, 2018, banana is a very healthy

fruit, but it also has its negative effects. It may cause allergies to some

people, specially to those who also has allergy to pollen. This allergy

should be treated immediately because it can range to from mild to

life threatening. Having a banana allergy is linked to a latex allergy.

The proteins present in the rubber tree, which produce latex are main

cause of allergy. These proteins are similar to the proteins found in

certain fruits, such as banana. This allergy is triggered by the

hypertensive reaction to proteins present in banana when eaten. Also,

in some cases, allergy to bananas arises when an individual comes

in contact with the fresh fruit. Banana is a frequent cause of food

allergy particularly to latex-sensitive persons. You’ll suffer from this

allergy when you eat banana not when you apply it on your skin.

Honey is a sweet substance that bees make by collecting

nectar juice and other sweet drinks that are found on living parts of

plants, enrich it by the substance of its body. Honey contains mostly

sugar, as well as a mix of amino acids, vitamins, minerals, iron, zinc

and antioxidants. Honey is used as an anti-inflammatory, antioxidants

and antibacterial agent. (Mayo Clinic Staff) Honey can treat some skin

conditions such as cracked heels and dry skin. It is composed of 76%

of sugar, 18% of water, and 6% other ingredients. Sugar is present in

honey but sugar in honey is not a single species, it contains three kinds

of sugar- fructose, glucose and sucrose. Minerals in honey raise the

value of honey and it has about 3.68%. Protein, Acids and Essential

oils are also present in honey. Vitamins in honey has a very modest

quantity. It has vitamins C and some B complex vitamins. (mmm.ba)

Honey contains many vitamins and other nutritious minerals that is

really good for our health, for our body and for treatment. It is a

therapeutic agent.

Honey is one of natures wonders. For long, honey has been

used as important source of carbohydrate and natural sweetener.

Honey contains sugar, organic acids, minerals, and proteins, enzymes

and vitamins in trace amounts. The simple sugars in honey are

responsible for its sweetness, hygroscopicity, energy value and other

physical properties. Honey’s use as medicine has been limited due to

lack of scientific report. In recent days, however, there is resurgence.

Its greatest medicinal potential is its application a topical agent to

wounds and skin infections. Honey has anti-inflammatory, immune

boosting property, and exhibits broad spectrum anti-bacterial activity,

which are attributed both to physical factors: acidity and osmolarity,

and chemical factors: hydrogen peroxide, volatiles, bees wax, nectar,

pollen and propolis. Its anti-oxidant activity is attributed to: glucose

oxidase, catalase, ascorbic acid, flavonoids, phenolic acids, carotenoid

derivatives, organic acids, mallard reaction products, amino acids, and

proteins. Honey prevents and treats gastrointestinal disorders such as

peptic ulcers, gastritis and gastroenteritis. It also poses prebiotic

effects and promotes health of gastrointestinal tract.

Problems with conventional treatment for a range of

dermatological disorder have led scientist to search for a new

compound of therapeutic (of or relating to the treatment of disease or

disorder by remedial agents or methods) value. Efforts have included

the evaluation of natural products such as honey. Manuka honey, for

example has been scientifically recognize for its anti-microbial and

wound healing properties and is now used clinically as a topical

treatment for wound infections. Nevertheless, positive effects have

been reported, for example, kanuka honey from New Zealand was

shown to have therapeutic value in the treatment of rosacea. (McLoone,

et al.) Honey has been linked to health benefits like heart health,

wound healing, skin treatment and blood antioxidant. It has many

types but it is generally high in calories and carbs and consuming too

much may cause adverse effect. (Link, 2019) Accordingly, honey has

been used as both a food and a medicine. It is very high in beneficial

plant compounds and offers several health benefits. Topical honey

treatment has been used to heal wounds and burns since Ancient

Egypt up to today. It was also said that it can help treat other skin

conditions. Honey is beneficial for our research topic because it can

help treat skin conditions such as callus or cracked heels. Also, honey

is a humectant which means that it traps and seals moisture.

(Gunnars, 2018) All honeys kill bacteria and help wounds to heal.

When the skin around our heels becomes thickened or dried out it

results and causes cracking.

Though it contains a lot of health benefits honey can also be

harmful to some people. Commonly, honey is used to help treat

allergies so as it having to cause the allergic reaction. When body

comes in contact with allergies, it can cause mild symptoms like skin

irritation, watery eyes or even sneezing.

Chelsea Silverman’s tutorial on how to make an avocado

paste, you need to have 2 avocado’s and 1 tablespoon of Olive-Oil. First,

you have to take the avocado flesh Second, put it inside the blender

and then put 1 tablespoon of olive oil and lastly blend. Accordingly,

avocado has a lot of health benefits. It is not only nutritious with the

number of protein & good calories in it, it is also cancer preventative,

high in vitamin E, full of enzymes and certain minerals. Additionally,

it is good for eye health, heart health and so much more.