Corns & Calluses

What is it? / What causes the problem?

When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker to withstand the pressure. When this pressure becomes excessive, some areas of skin thicken in the form of corns and callus, as a protective response to the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground. 

Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type. Elderly people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot.

Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core which may cause pain if it presses on a nerve. There are five different types of corns, the most common of which are ‘hard’ and ‘soft’ corns:

• Hard corns – these are the most common and appear as a small area of concentrated hard skin up to the size of a small pea usually within a wider area of thickened skin or callus. This may be a symptom of the feet or toes not functioning properly.
• Soft corns – these develop in a similar way to hard corns but they are whitish and rubbery in texture and appear between toes where the skin is moist from sweat or from inadequate drying.
• Seed corns – these are tiny corns that tend to occur either singly or in clusters on the bottom of the foot and are usually painless.
• Vascular corns – these can be very painful and can bleed profusely if cut.
• Fibrous corns – these arise when corns have been present for a long time and are more firmly attached to the deeper tissues than any other type of corn. They may also be painful.

How are corns and calluses treated?

The most important part of treating painful corns and calluses is prevention. Choosing the appropriate footwear in correct shape and size is perhaps the most important rule of prevention. 

It is best not to cut corns yourself, especially if you are elderly or diabetic. A podiatrist will be able to reduce the bulk of the corn and apply astringents to cut down on sweat retention between the toes.

You should be careful about using corn plasters, as they contain acids than can burn the healthy skin around the corn and this can lead to serious problems such as infection.  You should always consult a podiatrist for advice before using corn plasters.  Home remedies, like lambswool around toes, are potentially dangerous. Commercially available ‘cures’ should be used only following professional advice.

If you are unsure of what to do or need special attention, consult a registered podiatrist who will be able to remove corns painlessly, apply padding or insoles to relieve pressure or fit corrective appliances for long-term relief.  For callus, your podiatrist will also be able to remove hard skin, relieve pain and redistribute pressure with soft padding, strapping or corrective appliances which fit easily into your shoes. The skin should then return to its normal state.

The elderly can benefit from padding to the ball of the foot, to compensate for any loss of natural padding. Emollient creams delay callus building up and help improve the skin’s natural elasticity. Your podiatrist will be able to advise you on the most appropriate skin preparations for your needs.

General tips in order to avoid and prevent corns and calluses

1. Choose comfortable shoes in the right size and made of soft material. Never buy tight shoes thinking that they "will stretch open".
2. Avoid, whenever possible, narrow high heeled shoes. They do not properly distribute the pressure on the feet and may create calluses more easily.
3. Use products that relieve pressure and friction of shoes from your feet (silicone wedges, special insoles etc.).
4. Use a pumice stone on dry heels and feet to remove any skin hardening.
5. Have a five to ten minute foot bath in lukewarm water.
6. Moisturize your feet daily with special foot care products that soften and maintain the natural elasticity of skin.

Caution for Diabetic people

1. Do not attempt to remove calluses yourself. You need to see a professional podiatrist to safely remove corns and calluses. The use of incorrect and non-sterile instruments (e.g. scissors) can cause serious problems in people with diabetes or other vulnerable groups.
2. Do not neglect and do not refrain from treatment of hard skin by a specialist for a long time. The concentration of pressure at specific points may cause ulceration below the callus, which is a very dangerous situation for a person with diabetes.
3. Use of caustic liquids is strictly prohibited for people with diabetes (e.g. corn caps with salicylic acid) as they can cause ulcers which can get infected easily and delayed in healing in people with diabetes.
4. Consult your podiatrist or pharmacist regarding available products that are suitable for diabetics. Always read the information shown on each product.
5. In advanced situations and when necessary, your podiatrist may recommend gait analysis in order to prescribe an orthotic insole which will balance the pressures on your feet.

CAUTION: People with diabetes have extremely sensitive and fragile skin. This makes the skin more susceptible to cracks and wounds, which can be caused by excessive pressures on the feet. Calluses and hard skin may cover an ulcer, a very dangerous complication for people with diabetes. Failure to treat an ulcer may sometimes lead to amputation. Visit your podiatrist for prompt treatment of hard skin and remember to do your annual diabetic foot check.

(Reference: https://www.scpod.org/foot-health/common-foot-problems/corns-callus/ & http://podiatry.org.cy/index.php/en/corns-and-calluses )

(tags: podiatros, podologos, paralimni, ποδίατρος, ποδολόγος, παραλίμνι)