Corns and Calluses

Corns are small areas of very thick skin. They are roughly round in shape. Hard corns commonly occur on the top of the smaller toes or on the outer side of the little toe. Soft corns sometimes form in between the toes. These are softer because of the sweaty skin between the toes. Soft corns sometimes become infected. Corns press into the deeper layers of skin and can be painful. Calluses are larger, broader and have less well defined edges than corns. These tend to form on the underside of the foot (the sole). Commonly they form over the bony area just behind the toes. This area takes much weight when walking. They may be painless but can become painful.

What causes corns and calluses?

The small bones of the toes and feet are broader and more lumpy near to the small joints of the toes. If there is extra rubbing or pressure on the skin overlying a small rough area of bone, this will cause the skin to thicken. The common reasons for this to happen are tight or poor fitting shoes and too much walking or running. If a thickened area of skin forms, this will cause even further pressure and rubbing in a tight fitting shoe. This may lead to corns or calluses forming.

Treatments

Paring and trimming of painful corns and calluses by a chiropodist or podiatrist is a common treatment. The pain is usually reduced as the corn is pared down and the pressure on the underlying tissues eased. Sometimes repeated or regular trimming sessions are needed. Once a corn or callus is trimmed down, it may not return if good footwear is used. If the skin seems to be thickening up again, a weekly rub with a pumice stone or emery paper may prevent a recurrence. Some people can do this themselves. It is best to soak the foot in warm water for 20 minutes to soften the thick skin before using a pumice stone or emery paper. A moisturiser cream used regularly on a trimmed corn or callus will keep the skin softened and easier to trim. Corn pads and plasters are available from pharmacies. They provide some protection to the corn. In addition they commonly have an acid chemical in the plaster. This helps by causing mild 'burns' to the top layers of skin of the corn which may then be shed. They may be a useful addition to soften up a corn before being pared or trimmed or rubbed with a pumice stone.

Shoes and footwear. Tight or poor fitting shoes are the main cause of most corns and calluses. The aim is to reduce pressure on the toes and forefeet. Shoes should have plenty of room for the toes, have soft uppers and low heels. In addition, extra width is needed if corns develop on the outer side of the little toe. Extra height is needed if corns develop on the top of abnormal toes such as 'hammer' or 'claw' toes. Sometimes a sharp rough seam or stitching in a shoe may be rubbing enough to cause a corn. Correcting poor footwear will reduce rubbing, friction etc and may allow a corn or callus to heal. Going barefoot when not outdoors will also help.

Footpads and toe protection. Depending on the site of a corn or callus, a cushioning pad or shoe insole may be of benefit. For example, for a callus under the foot, a soft shoe inlay may cushion the skin and help the callus to heal. If there is a corn between the toes, a special sleeve worn around the toe may ease the pressure. A special toe splint may also help to keep toes apart to allow a corn between toes to heal. A special shoe may be needed for people with toe or feet abnormalities which lead to corns or calluses forming. (Surgery. If there is a foot or toe abnormality causing recurring problems, an operation may be advised.)

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