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Corns & Calluses
What are corns and calluses?
Corns and calluses are hard, thickened layers of skin tissue that build up as a response to friction and pressure your toes experience in prolonged rubbing against another surface. Variations of hard corns are soft corns, which are more like open sores that develop on skin surfaces between the toes.
Although corns and calluses are similar in make-up, corns are generally small, often painful and usually found on the tops or sides of your toes. Calluses are usually larger, normally are not painful and generally are located on the soles of your feet (Calluses can also develop on your hands, usually on the palms).
While corns and calluses may be less than attractive to look at, they are harmless and do not need to be treated unless they cause pain or otherwise interfere with your ability to be active.
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How do the feet work?
Each of your feet has 26 bones, more than 30 muscles and numerous tendons and ligaments that work together to bear and propel your body weight during standing, walking and running. Bones provide support, ligaments provide stability and muscles and tendons provide movement.
The toes (as well as the fingers) are each made up of bones called phalanges, two in the big toes and three in the others. The bones at the ends are called the distal (meaning farthest away) phalanges, the ones in the middle (not present in the big toes) are called the middle phalanges, and the ones closest to the other bones of the feet are called the proximal (or nearest) phalanges. These join directly to the metatarsal bones, which lead to the bones that make up the ankles.
As you walk, the joints that connect these bones, held together by muscles, ligaments and tendons, flex each time you take a step. You place 1½ times your weight on your feet when you walk normally (and more when you run) and it's estimated that the average person walks for approximately 1,000 miles each year.
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What is the make-up of corns and calluses?
Corns develop when the friction of skin rubbing against a surface (such as shoe leather) over time causes the skin's surface layer to build up. While this thickened skin becomes dead tissue, the layer underneath can become irritated and painful. A typical corn will present itself as a small mound of dead skin with a painful spot in the middle.
While calluses involve the build-up of skin tissue, they generally escape the irritation of the skin below. They tend to develop on less sensitive areas of skin and develop more slowly over a longer period of time.
Most corns are small mounds of tissue less than a quarter-inch in diameter. Calluses tend to be larger and can vary in shape.
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What causes corns and calluses?
Wearing ill-fitting shoes is the number one cause of corns and calluses. The friction and irritation that leads to their development can be caused by:
- Shoes that are too tight and cause the toes to rub against their inside surfaces
- Shoes that are too loose and allow the foot to slide around and similarly rub against the shoe
- High-heel shoes that place the body weight on the front of the foot and jam the toes against the front of the shoes
- Stitches or seams within the shoe that create a source of friction for the skin
Problems such as hammertoe frequently have corns associated with them, since the tops of the affected toes tend to be jammed against the tops of the shoes' toe boxes.
In addition, ill-fitting socks that create irritation can lead to the development of corns.
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Do I need to see a doctor about my corns and calluses?
Based on their appearance, their "feel" and the pain you experience, your corns will be pretty self-evident. Your doctor can certainly confirm their nature and offer treatments for them.
However, since warts and plantar warts on the soles of your feet can resemble calluses, it may be wise to consult a physician about those issues.
More importantly, your doctor can help you find solutions for preventing future development of corns and calluses. And, if your corns are associated with a more serious condition such as hammertoe, you should consult a physician.
If you have diabetes, it is important that you consult a physician about any foot problem, including corns and calluses, since foot issues can become serious for diabetics and self-treatment is not advised. In fact, if you have diabetes, you should consult the accompanying article on diabetic foot care. You can do so by (clicking here).
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What can I do to treat corns and calluses?
If you can eliminate the source of irritation, your corns and calluses often will disappear over time.
Some steps you can take to assist this are:
- Pad your corns and calluses. You can use donut-shaped pads you can buy at the drugstore to protect the area where the corn is located while it reduces. Use nonmedicated pads: Pads that contain salicylic acid that are supposed to dissolve the tissue can cause irritation and infection. For soft corns — the corns that resemble open sores on the skin surfaces between toes — you can use lamb's wool for protective padding.
- Rub your corns and calluses to reduce them. After a shower or bath, rub your corns or calluses with a pumice stone or callus file to help eliminate the thickened skin.
Note: you should not attempt to cut or trim your corns or calluses with a knife or other instrument yourself. Doing so can lead to infections or injuries. If a corn or callus needs to be trimmed, it should be done by a professional healthcare provider.
- Wear roomier shoes. You should seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed. You should make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe. Make sure the ball of your foot fits comfortably in the widest part of the shoe. Feet normally swell during the course of the day, so shop for shoes at the end of the day, when your feet are at their largest. Don't be vain about your shoe size — sizes vary by brand, so concentrate on making certain your shoes are comfortable. Remember that your two feet are very likely to be different sizes so you should fit your shoe size to the larger foot.
- Wear low-heel shoes. High heels shift all your body weight onto the front of your foot and jam your toes into the front of your shoes, tremendously increasing the pressure on them and the joints associated with them. Instead, wear shoes with low (less than two inches) or flat heels that fit your foot comfortably.
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What treatments will a doctor provide for corns and calluses?
If you have a bothersome corn or callus that won't go away with padding, rubbing or a change in shoes, you should consult your physician. During your visit, your doctor may be able to reduce the size of your corns by using a scalpel to shave layers of dead skin off them.
If your corns are associated with a more serious condition such as hammertoe or bunions, he or she can help you deal with that through either medical or surgical treatment. If conservative treatments such as padding and use of orthotics don't help, Connecticut Surgical Group's podiatrists are skilled and experienced in surgical correction of hammertoes and other problems through realignment of bones to correct a deformity and various other surgical techniques.
In addition to dealing with the immediate problem of existing corns, your doctor can help you find ways to prevent future corns and calluses from developing. Among other possible methods, he or she may prescribe orthotics, inserts you can wear in your shoes to correct mechanical foot-motion problems that lead to the development of corns and calluses.
If you have diabetes, it is important that you consult a physician about any foot problem, including corns and calluses, since foot issues can become serious and self-treatment is not advised.
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What can I do to prevent corns and calluses from recurring?
If you go back to the same habits in terms of shoes, you are likely to develop your corns and calluses again. To avoid them:
Wear roomier shoes
- Seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed.
- Make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe.
- Make sure the ball of your foot fits comfortably in the widest part of the shoe.
- Since feet normally swell during the course of the day, shop for shoes at the end of the day, when your feet are at their largest.
- Don't be vain about your shoe size — sizes vary by brand, so concentrate on making certain your shoes are comfortable.
- Remember that your two feet are very likely to be different sizes and fit your shoe size to the larger foot.
Don't wear high-heel shoes
- Avoid high heels, which shift all your body weight onto your toes, increasing the pressure on your toes and their joints tremendously.
- Wear shoes with low (less than two inches) or flat heels that fit your foot comfortably.
Wear orthotics to correct mechanical movement problems
- Orthotics are shoe inserts that can help correct mechanical foot-motion problems to reduce pain and prevent worsening of your hammertoe.
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For additional information
You can find additional information about corns and calluses at web sites sponsored by government agencies, societies and healthcare institutions. It should perhaps be noted that the World Wide Web is open to many sources posting questionable information and promises, and you are encouraged to seek information from established, reputable organizations.
Likely sources include:
The American College of Foot and Ankle Surgeons
(www.acfas.org)
The American Podiatric Medical Association
(www.apma.org)
The American Orthopaedic Foot and Ankle Society
(www.aofas.org)
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