A callus or corn is an area of thickened skin that forms at pressure points over bony prominences.
They are one of the most common problems seen by Podiatrists and can occur on any part of the foot and vary in symptoms. A corn or callus is caused by one thing – too much pressure, usually in combination with some friction. In the foot, the skin will thicken up to protect itself where there are areas of high pressure. Corns and calluses do not have roots.
Too much pressure can be caused by:
- Footwear that is too tight
- Toe deformities, such as hammertoes
- Bony prominences
- Biomechanical or gait abnormalities
A corn or callus is a symptom of an underlying cause that needs to be assessed by your Podiatrist. A corn is a cone-shaped mass pointing down into the skin. A callus is a dispersed area of thickening that does not have the focal point of a corn. There are two main types of corn:
- Hard corns which are concentrated areas of dry and hardened skin. They are the most common and often found on your fifth toe. They are sometimes called digital corns, and
- Soft corns which are white and rubbery. They can be extremely painful and tend to develop between your toes.
Infection and ulceration of corns of the toe may occur. This can be a serious complication for those with poor circulation, peripheral neuropathy and the need for diabetes foot care.
Corns and callus that are not treated will become painful. They will not come right on their own unless the pressure that caused them is taken away.
Prevention is better than a cure
Corns and callus are easy to prevent – just take away the cause. That cause is excessive pressure. Correct fitting of footwear around the toes, the use of pads to relieve pressure, surgical management of a bony prominence and regular podiatric care are the best options for prevention of corns and callus.
You should never try to cut out a corn yourself, however, there are other things you can do to help relieve the symptoms:
- Use a pumice stone or a foot file to rub away the thickened skin, a little at a time (not if you’re a diabetic) – do this after you have soaked your foot in the bath for about 20 minutes so that your skin is softer
- If the corn is between your toes, you can buy foam/silicone wedges that may help to relieve the pressure
- Wear supportive shoes with a wide toe box and a low heel
The use of corn plasters in those who are at risk or have frail skin or poor circulation, are very likely to cause an ulcer (a breakdown of the skin), which could become infected.
Avoid remedies such as corn paint, cure or plasters as these will only treat the symptom of the corn and not the problem that causes it. In some cases, particularly for people with other health issues, some treatments can make the problem worse.
When to see a Podiatrist
Podiatric management of corns and callus includes a proper assessment to determine the cause of the corn or callus and an implementation of a management plan. It is especially important that those with diabetes or poor circulation see a Podiatrist for the management of corns and callus.
A management plan is likely to take into account several options:
- regular maintenance to keep the corn and callus reduced, this is usually painless
- padding to prevent the pressure
- advice about the fitting of footwear
- the use of foot orthotics to relieve the pressure under the foot
- surgical correction of the bony prominence that may be causing the high pressure area
Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.