Corns and callus

Corns are a minor problem—on somebody else’s feet. On one’s own feet, they can be very painful and get in the way of our daily activities. But they don’t have to be.

Causes

When skin is exposed to pressure and friction over a period of time, its outer layer thickens forming the common callus. This is a way the body has of protecting itself from injury. But sometimes it produces too much callus. The callus itself becomes a source of pressure and pain.

A corn is the same as a callus except that it is more focal and deeper. Patients describe the pain as similar to having a pebble glued to the foot with the sharp point facing inward.

While corns may be deep, the idea that they have a “root” is a myth. They are composed of dead, compressed skin cells and do not bleed when cut.

Problems on the toes

Corns and callus often develop on toes. Toes should be straight but in many people they are hammered (crooked). Corns and callus develop where the deformed toe hits the shoe.Corns and Callus

Protective pads around the irritated skin provide temporary relief. Having the toes straightened solves the problem. This is usually done as an outpatient procedure in the hospital. A local anesthetic and IV sedation are used.

Soft corns, softened by moisture, often develop between the toes. This occurs when the bones of one toe exert pressure against the bones of its neighbor. A small boney spur is often the culprit. Here too padding offers temporary relief. Permanent relief is obtained by removing the spur.

Problems on the bottom of the feet

An abnormal foot structure is the most common cause of excessive pressure. For example, if one of the long bones (metatarsals) in the foot is excessively long or is lower than its neighbors, a pressure point develops.

The callus or corn that develops on the overlying skin is usually what the patient complains of. But the callus or corn is only a symptom. Cutting it will give immediate, but only temporary relief. More definitive treatment may include the fabrication of an in-shoe orthotic to disperse the weight better. The best types are made from plaster impressions or computerized scans of the feet. Some devices may also be made from a foam impression of the foot held in a particular manner to allow for corrections. Corrections are then built into the orthotics. They are worn in normal, everyday shoes.

If the problem is severe and resists conservative care, surgery may be performed to correct an underlying boney problem.

Other treatments

For small corns or callus, the use of a pumice stone after a shower or bath when the skin is softest is helpful. But don’t cut corns or callus with a razor blade! Such bathroom surgery often leads to serious cuts and infections.

Over-the-counter chemicals are risky too. Skin burns and infections frequently occur when these acids are used incorrectly. Diabetics and those with poor circulation must be especially careful and should seek professional help.

Finally—and most importantly, is the need to select shoes more carefully. High heels put more weight on the front of the foot for longer periods of time in the gait cycle. Tight shoes also cause corns and callus, especially on the smaller toes. Compromises between comfort and fashion do sometimes need to be made.

The causes of corns and callus are numerous. Treatment is always best when tailored to the needs of the individual.