Corns and Calluses
and calluses are just your body's response to increased friction or pressure
against the skin. When a particular area of your foot rubs-up against the inside
of your shoe(s), the affected area of skin tries to 'protect' itself by increasing
the thickness of the skin.
and calluses normally occur over boney prominences in your feet. These prominences
create the increased pressure and friction that leads to formation of this extra
corns and calluses are just normal build-up of hyperkeratotic (dead cornified
layers of skin) tissue. In many cases, this build-up of tissue may look bad,
or unsightly; but are not harmful or painful. However, more severe cases of corns
and calluses can cause pain with shoe gear and ambulation, develop into ulcerations
(openings to deeper tissues), and can cause serious infections.
associated with the feet are no different than those associated with the hands.
They occur in areas of increased pressure and/or friction. The most common type
(and place) for calluses to form on the foot are on the bottom.beneath the metatarsal
bones. These are the long bones which bear much of the weight which is distributed
through your feet when you walk.
calluses may be very mild (and frequently quite dispersive) but cause no problems
whatsoever. However, if the callus tissue is very thick and concentrated in a
specific area (usually under one the metatarsal bones), severe pain can result.
This type of callus is called an IPK, or Intractable Plantar Keratosis. This
type of callus can develop into ulcerations which can become secondarily infected.
typical corn, or helloma dura, is a special type of callus that forms in particular
areas of the toes. Most notable on the top of the lesser toes and are associated
with hammer toes, mallet toes, and claw toes.
more information regarding these common digital problems, please see Hammer
corns associated with hammer/mallet/and claw toes, occur over the bony prominences
created by the buckling of individual joints in the toes-either the proximal
interphalangeal joint, the distal interphalangeal joint, or both. The corns can
also form at the tips of the toes due to increased pressure. There are varying
degrees of hyperkeratosis which occurs with individual corns..from very superficial
and mild to very deep and severe. In many cases, the corns can become so thick,
that ulcerations develop under the overlying callus tissue. This can be a very
dangerous situation as bacteria can enter through the opening within the ulcer
and lead to skin and/or bone infections.
type of specialized corn that commonly occurs in the foot, is referred to as
a helloma molle. This is a 'soft corn' that occurs in-between the toes of the
feet. They take-on a whitish color due to the constant perspiration that occurs
between the toes. They are commonly mistaken by non-foot specialists as an athlete's
foot infection. This can be very problematic, as the application of OTC and/or
prescription anti-fungal medications only serves to increase the maceration (fluid-filled
tissue) at the site of the corn. Additionally, the lapse in appropriate treatment
time while using these medications, normally worsens the condition and frequently
the area can become infected by neighboring bacteria.
treatment for calluses and corns depends on the severity of each individual condition.
asymptomatic (pain free) calluses and corns, in most instances, require no treatment
whatsoever. Most callus or corn tissue is just a normal tissue response to areas
of pressure and friction. These types of calluses or corns are usually more of
a cosmetic problem for many patients due to the unsightly build-up of callus
tissue. This is more problematic for darker skinned individuals due to pigment
changes that often accompany corns. Treatment of this type of condition with
trimming and/or the use of topical medications can many times cause the condition
to worsen and ultimately become painful.
symptomatic calluses or corns can be treated with OTC corn medications, pumice
stones, callus files, and the use of topical moisturizers and keralytic creams.
Also, the use of various types of pads (moleskin) can be used to relieve pressure
with particularly bothersome shoes.
for more progressive, severe, calluses and corns, are primarily treated by the
routine debridement (trimming) of the exogenous callus formation. This should
be performed by a medical (foot) specialist with training to perform this procedure
properly. Other treatments include the use of both oral and injectible anti-inflammatory
medications, shoe inserts, and various types of padding or molded appliances.
Surgery is indicated for the treatment of calluses and corns, only after failure
of the above noted treatments.
For more information regarding
the surgical treatment of calluses and corns, please see Hammer