Corns and Calluses




What are Corns and Calluses

Most people have at some time during their life developed a callus. Corns and calluses are the body's normal response to repeated levels of friction and / or pressure. This friction can irritate the skin; rather than tear open, sometimes the body's natural defences will cause the formation of additional skin in the affected area. This additional skin typically takes the form of a hard, thick layer.

Differences Between a Corn and A Callus

corns and callusesCorns and calluses are not radically different in nature, but they take on distinct appearances that cause them to go by two different names. A callus is generally a flat area of hardened skin, while a corn extends more from the foot, almost resembling a single kernel of corn sticking out from the surface of the foot. Despite these two presentations and other differences, the term "corns and calluses" is generally employed whenever discussing this health issue.

Corns and calluses share some similar characteristics and are often grouped together for purposes of discussion, such as in this article, but they are not two words for the same thing.

callus pictureCalluses occur most frequently on the soles of the feet, particularly in the heel or ball area. (They also commonly occur on knees and palms, but this article is restricted to the specific consideration of foot calluses exclusively.) Calluses are almost always pain free, even when pushed or manipulated. Their size and shape varies according to the area of skin being placed under undue pressure and friction.

Corns, on the other hand, tend to be small and have a characteristic appearance: a hard center much like a nodule surrounded by an expanse of irritated skin, sometimes red. Corns are most commonly found on the sides and tops of toes, areas which are not weight bearing but which can still end picture of a cornup rubbing uncomfortably against the inside surfaces of shoes. Although not the most common presentation, corns can also form between the toes. Corns are not usually painful on their own, but when they are pressed they can cause considerable pain.

Although corns and calluses can be unpleasant because they are not attractive to look at, they do not usually cause any additional problems. In most cases, corn and calluses do not even require treatment. To make them slowly vanish over time, the patient needs merely to get rid of the causes of friction or pressure that caused them to develop in the first place.

Symptoms Associated with Corns and Calluses

The most common symptoms of a corn or callus include the following:

  • a thickened or rough area of skin, particularly in an area that has been rubbing against a surface, such as the inside of a shoe. (This is a callus.)
  • a bump raised off the surface of the skin, very hard to the touch. (This is a corn.)
  • skin areas that appear to be dry and flaky
  • skin areas that appear to be waxy
  • pain or tenderness. These sensation will be localized underneath the corn or callus, not inside it. Corns and calluses do not have nerves running through them and so are impervious to sensation.

Risk Factors for Development of Corns and Calluses

If shoes that don't fit well or other causes have led to other serious foot problems, you could be at greater risk of also developing corns and calluses. Some of the common health problems in feet that can be contributing factors include:

  • bone spurs
  • other foot deformities that lead to the foot rubbing the inside of the shoe
  • bunions (bony bumps at the base of the big toe, located on the joint there)
  • hammer toe (a condition in which the toe curls downward much like the shape of a hammer)

Another risk factor is improper footwear, but as that is so heavily associated with the formation of corns and calluses, it is detailed in the next section, which covers causation.

What Causes Corns and Calluses

The root cause of corn and callus formation is friction, sometimes accompanied by pressure. These, however, can arise from a variety of underlying causes. The most common reason why feet are subjected to excessive levels of friction and pressure involved the patient's choice of footwear. As with many foot conditions, shoes that do not fit properly are often to blame. Very tight shoes and those with high heels are common culprits.

corn on small toeThe problem with ill fitting shoes is that as we walk, stand, and go about our daily activities, the shoe will be loose enough so that our feet can slide around inside them. This causes repeated friction due to the rubbing action involved.

However, even well fitting shoes can present a problem if their interior surfaces are badly placed for your particular feet. An interior seam or other obstruction that rubs against your foot during normal activities can also lead to corns and calluses.

Less commonly understood as a cause is a patient's decision to wear shoes without socks. This increases the amount of friction a foot will be subjected to, as socks tend to provide a cushioning environment for the foot. Even sandals worn without socks can lead to the development of corns and calluses, a fact which surprises many patients since wearing sandals without socks is the  norm in the United States. Another thing to keep aware of is that sock fit is important. Socks that slide around too much on the foot, possibly because they have lost their elasticity over time, can help to cause corns and calluses.

Diagnosis and Testing

Most of the time a physician can diagnose corns or calluses simply through a visual inspection of the affected area. In general, no formal tests will be needed.

When to Consult a Physician

However, if your corns or calluses are causing you more than minor discomfort, you should seek the advice and recommendations of a health care professional. In particular if you are experiencing high levels of pain or if your corn or callus shows signs of inflammation such as redness or swelling, consult a doctor.

Likewise, people who suffer from certain conditions that can affect the feet should treat the development of corns or calluses with suspicion. These conditions include diabetes as well as other health issues that may lead to poor circulation, particularly poor circulation to the feet. In these cases, corns and calluses can lead to other complications, some of which can be serious. To be on the safe side, consult a health care professional if you have one or more such conditions and you notice the onset of corns or calluses on your feet. It is no exaggeration to say that minor injuries to the feet can escalate into large problems for people with these underlying health conditions.

Common Treatments for Corns and Calluses

The most basic level of treatment involves eliminating the risk factors and causes that can be ascertained and modified. In most cases this involved a change in footwear; sometimes the footwear is further modified to provide patient comfort and help gradually reduce the incidence of corns and calluses. Self-care efforts include wearing shoes that fit properly and using protective pads and other inserts inside the shoe.

However, self-care is not always successful in the treatment of corns and calluses. Painful corns and calluses, as well as those that are inflamed, should definitely be seen by a health care professional. At this stage of treatment, many different options become available.

One of the most common initial treatments is to trim the callus or corn. This involves the doctor using a scalpel to gradually slice off layers of the hardened skin of a callus. When dealing with a corn, the entire growth may be sliced off at once with the exception of a small layer next to the skin.

Salicylic acid is sometimes used in combination with a trimming procedure. In most cases the acid is applied via a commercially prepared patch such as Dr. Scholl's Corn Removers. The patch is typically replaced at intervals to be specified by your doctor. Full removal of the corn or callus can take some time using this method, but the process can be accelerated through abrasion techniques used in between patch applications. The most common sources of abrasion are a nail file (metal so that it can be sterilized properly) or a pumice stone. These are used to gently slough away the skin cells killed by the acid in the patch. When calluses cover a large area, your physician may prefer you to use salicylic acid in topical form, sometimes in combination with sterile gauze pads.

It is not recommended that patients with diabetes or poor circulation undertake salicylic acid treatments without the advice of a physician. The acid can lead to infections in some cases and this can be a serious problem for patients with these health conditions.

With both trimming and salicylic acid patch treatments, your physician may recommend the use of an antibiotic ointment. This will help to decrease the likelihood of an infection setting in.

Trimming is not truly considered a surgical procedure. However, true surgery is sometimes called for in the treatment of corns and calluses. This is fairly unusual and generally occurs only when your health care professional has determined that the underlying problem leading to your corns or calluses involves an improper alignment of the bones in the feet.

A final option involves a higher level of orthotics than available over the counter. These are custom made and incorporate padding to conform to your foot. Custom orthotics are generally used only in cases where a foot deformity has been diagnosed as an underlying cause of corns and calluses.

Other Home Care Treatments Commonly Used

The following home based procedures can help alleviate the symptoms of corns and calluses:

  • regular use of a moisturizer. This will help to keep skin supple. However, do not use so much moisturizer on your feet that they begin to slide around inside your shoes, a situation that is counterproductive when it comes to corns and calluses.
  • Frequent soaking of the feet in warm water. Adding a tiny bit of liquid soap to the water can make this treatment even more effective at softening corns and calluses.
  • Use of a pumice stone to gradually wear away calluses. You should do this while bathing or immediately afterwards, while skin is still relatively soft. If a pumice stone causes discomfort, try abrading your corns and calluses with a wet washcloth. Though using a washcloth will slow progress considerably, it will in time make a difference in your condition.
  • The use of well fitting shoes and socks. Shoes should have adequate cushioning and socks should be made of a cotton-polyester blend. 100% cotton socks tend to retain moisture. Be vigilant about proper footwear until your corns and calluses have completely vanished. If not, they are likely to soon return.

An important note of caution: slicing away of corns or calluses should be done only by a properly licensed health care professional. It may seem tempting to attempt the procedure yourself, but the result could be an infection or worse, a cut that goes too deep. Some self help guides will recommend that shaving a corn or callus is a safe home procedure, but it is not. Do not attempt it -- seek the services of a physician qualified to assist you with foot issues. This injunction is true even for patients who do not have diabetes or poor circulation.

When shopping for corn and callus treatment products, you will frequently see on sale some that are designed specifically for cutting the callus away without consulting a physician. The use of these products should be avoided, whether they label themselves safety callus shavers or corn and callus razors. The only over the counter products that are truly self for home use are protective pads and cushions. Experts remain mixed on the advisability of home care salicylic acid products. 

Preventing Corns and Calluses

Wearing proper footwear is the most important thing you can do to prevent the formation of corns and calluses. Understanding the characteristics of proper footwear can be helpful. The shoes should be neither too tight nor too loose. Toes should have wiggle room, both side to side and up and down. Any portion of the shoe that pinches your foot or rubs against it should be stretched out -- a shoe repair shop can usually help you to correct the problem.

If you notice that your foot is rubbing and changing your shoe style is not feasible, as when your job requires you to wear a certain type of footwear, then the use of protective felt pads or bandages is advisable. Place them on your foot in areas that are in danger of forming corns or calluses.



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