What are corns and calluses?

Callous_1A corn is a more focal area of thick skin which has caused a cone shaped plug of skin that presses down on to sensitive soft tissue underneath the skin. The thicker and bigger they get, the more painful they can become. Corns can also occur anywhere on the foot but are particularly common around bony prominences such as toe joints and the joints in the forefoot. They may be round, slightly raised and may too feel rough, but look slightly darker than the callus. They can also occur between the toes, where they may take on a more rubbery appearance due to excessive moisture between the toes.

According to one of the largest research studies in this area, nearly one in 5 employees in a workplace setting had corns or callouses under the forefoot [1].  Assessment of 1000 podiatry patients attending a university clinic found that forefoot corns and callouses were more common in women, were more often painful as people became older and were most common under the heads of the first metatarsal (21%), the second metatarsal (29.8%) and third metatarsal (12%). [1] In an Australian study of older adults, 60% had at least one callous or corn beneath their feet.[2]

It is important to determine if your skin problem is a corn or callus or if it could be a plantar wart, as the treatments will be different in each case.

What causes corns and calluses?

Callous_2Corns and calluses form usually in response to too much pressure, arising from prominent joints  or from too much rubbing or friction. This can be caused by

  • Poor fitting or non-cushioned footwear
  • foot deformities such as bunions, hammer toe and claw toes
  • pronated feet that move too much within shoes
  • high-arched feet with high forces at the forefoot and heel
  • older feet where the skin is less elastic and there is less fat pad to provide cushioning
  • excessive weight

Corns and calluses can also be due to conditions such as psoriasis and rheumatoid arthritis. Care must be taken if you develop corns and callus and also have diabetes as they can lead to development of serious complications such as foot ulcers. People with diabetes should have regular foot assessments by podiatrists.

At FootMotion, we use our extensive clinical experience and state-of the-art technology to properly diagnose your skin condition, carry out a thorough vascular and neurological examination to accurately assess your foot health and create an evidence-based treatment plan to effectively manage your condition.

How can corns and calluses be treated?

Treatment for corns and callus should be aimed at both relieving your symptoms by removing the thick skin as well as reducing the excessive pressure or friction causing them in the first place.

Removing your corns and callus involves careful debridement using a sterile scalpel to gently remove the thick skin. This process is normally quite painless as the tissue being removed has no sensation. The area would then be smoothed using a file or sanding instrument. In some cases, your podiatrist may use chemicals called caustics or keratolytics to help remove the thickened skin. You will also be given advice on self-care using appropriate creams, padding and filing, to help prevent or manage the thickening of the skin.

While ever there is still too much pressure or friction, the corns and calluses will likely continue. That’s why your treatment plan at Footmotion may include:

  • prescription of supportive, well-cushioned footwear that is fitting well
  • shoe padding to offload specific areas of high pressure
  • arch supports or prescription orthoses to improve function and reduce pressure and friction

In many cases these measures may stop the corns and calluses completely but sometimes the problems are severe enough that the goal is to slow down the process, reduce/remove the pain and lengthen the time between treatments.

References

  1. Springett KP, W.M., Marriott C, Epidemiology of plantar forefoot corns and callus, and the influence of dominant side. The Foot, 2003. 13(1): p. 5-9.
  2. Spink, M.J., H.B. Menz, and S.R. Lord, Distribution and correlates of plantar hyperkeratotic lesions in older people. Journal Of Foot And Ankle Research, 2009. 2: p. 8-8.