Corns and Calluses

A corn is simply an area of hard, thickened skin that can occur on the top, between, or on the tip of the toes. A callus is similar in nature, but is larger and usually occurs across the ball of the foot, on the heel, or on the outer side of the great toe. Corns and calluses are often mistakenly considered a "skin" condition. They are actually the visible sign of an underlying "bone" problem.

Treatment

First, your doctor will conduct a thorough inspection of these areas. He/she may gently trim some of the thickened skin away, in order to rule out a wart (caused by a viral infection of the skin) as the culprit. X-rays will often be taken to identify the specific bone problem that is causing the corn or callus. The doctor may place a small marker on the corn before taking the x-ray, to make it's location visible on the x-ray. The finished x-ray will then show the location of the corn and the bone spur underneath that caused it.

HOW DID THIS HAPPEN?

Corns and calluses form due bodys way of protecting itself from repeated friction and ecess pressure. This is usually as a result of shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure, in order to protect the area from developing an open sore or blister. Small amounts of friction or pressure over long periods of time cause a corn or callus. Corns can be due to a buckled or contracted toe position called a hammer toe. Corns and calluses on the bottom of the foot are often caused by a plantar flexion of the metatarsal. This caused the metatarsal head (the long bone that forms the ball of the foot) to carry more than its fair share of the body weight causing excess pressure. A poor choice of shoes can aggravate corns and calluses, but often it is not the only cause. REMEMBER A BAD FOOT CAN NOT BE FIXED BY A GOOD SHOE, BUT A GOOD FOOT CAN BE RUINED BY A BAD SHOE.

TREATMENT

Trimming of this thick skin can relieve the pressure for a short time. You should never consider doing this yourself if you are diabetic or have poor circulation. If you cut yourself, you may cause an infection. Corn pads and callus removers often have harsh acids that peel this excess skin away after repeated application, but they can cause a severe chemical burn BUT WILL NOT CORRECT THE UNDERLYINBG CAUSE OF THE CORNS. This might lead to infection and greater pain than the original foot condition....so do not use any "corn removers". A pumice stone, buff bar or emery board can be used to "file" this thickened skin. This should be done gradually, a bit at time, ideally after each shower or bath. Attempting to file off the entire thickness of a corn or callus can result in a burn or abrasion. Applying a good moisturizer to the hardened areas should keep them softer and relieve pain. Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can be purchased to protect corns and calluses, but should be removed carefully, so you do not tear the skin, and should only be worn for a day at a time.

TREATMENT

After an initial history and physical exam of your feet, x-rays will be needed to tell the whole story and determine why corns and calluses are developing. Your doctor is the expert in trimming down these areas of thick skin and will often apply comfortable padding to these painful corns and calluses. Changes in shoe wear may be recommended. A prescription custom-made device called an orthotic might be made to wear inside your shoes, to redistribute pressure more evenly across the ball of your foot. A pad placed in your shoes (called a metatarsal pad) may help reduce your contracted hammer toes and relieve pressure on the ball of the foot as well. Often corns and calluses will have to be trimmed on a regular basis to prevent them from hurting. Eventually, you may desire corrective foot surgery by your podiatrist to straighten curled or contracted toes for corns or elevate and shorten metatarsals for calluses. Often such surgery represents a short term inconvenience to your lifestyle, but will not require any lengthy period of rest or inactivity. Many satisfied patients have remarked that surgery to remove the bone beneath the corn hurts less the very next day than on a painful day walking in their shoes with the corn present.

PREVENTION

Often changing your style or size of shoes may help. Carefully review the shoes in your closet. Check their fit and discard any that have seams and stitching over painful corns or have worn out innersoles that offer too little protection for calluses on the ball and heel of your foot.