FOOT PAIN & PODIATRY ONLINE

FOOT PAIN - CORNS AND CALLUSES

WHAT ARE CORNS AND CALLUSES?
Corns and calluses are similar in their podiatry presentation in that extra skin forms in response to pressure on the skin causing foot pain.  In the case of corns, the extra skin forms between the toes. In the case of calluses, the extra skin forms on the outside of the foot. Corns are usually from the knuckle joints on one toe pressing on the knuckle joint on the adjacent toe. Usually, a seed or central nucleus is seen when examining the corn. Calluses occur due to many causes but the most common cause is incorrect padding in the shoes, flat feet, a bone spur and hammertoes. In rare instances, the painful callus is an abnormal sweat gland that has became impacted with hard skin.  The names given to corns and calluses by doctors are numerous depending on their location and presentation.

TREATMENT CONSIDERATIONS:
Treatment for corns has many remedies including many types of products at the store. These products rarely correct the underlying problem. Corn and callus pads continue to be the main home treatment. The best corn and callous pads are made of clear silicone. The excessive pressure to the skin that is causing the corn or callous must be addressed. Because so many women suffer with painful corns and calluses, many seek the help of a Podiatrist.

Using a callous file or rough stone does help but usually leaves a rough skin surface.  Using an electric burr such as a Dremel moto-tool to reduce the calluses and corns on a weekly basis is the easiest and most successful home treatment.  Using a battery type Dremel Drill with a medium grit sand paper attachment is the best choice and can be found at any hardware store.  A good kit for a reasonable price is from Footsmart for around $50. There are many other callous electrical kits around such as at Sharper Image but the Dremel Drill is a better unit for continuous use.  Acid plasters are also used in reducing calluses and corns but generally the corn patch only softens the callous and does not remove the excessive skin. In the patient with poor blood supply and/or if the person has diabetes, corn pads are dangerous because a hole can occur from the acid without any warning due to diminished skin sensitivity.

For generalized calluses to the ball of the foot, for lady's shoes, the silicone insoles are the thinnest and most comfortable of the pads you can buy. Avoid the foam types that quickly lose their cushioning characteristic after about a month of using the pad. Spenco is an excellent padding material but because it is neoprene (the same material that is used to make wetsuits) it can be hot to use in a shoe. During the winter, the use of Spenco is welcomed in colder climates.  When placing new pads in athletic shoes, it is important to make sure to remove the foam pad that came with the shoe. To remove the pad, just pull up under the arch part of the pad. If the pad will not come out, do not tear it out. Instead, place the new insert over the pad.

If there is a bone spur or a toe deformity such as a hammertoe, surgery may be warranted to correct the cause of the corn or callous.  Many times over years of pressuring the skin, the bone will from a spur and the spur grows with the amount of pressure on the skin.  Surgery for digital deformities and bone spurs has a high success rate. Typically, it will require a couple of months before the swelling leaves the toes.  The swelling in the toes after surgery is normal and is part of the healing process.  If a patient had to wear closed toed shoes due to cold weather, the swelling that is present after toe surgery may be a problem and should be explored prior to undergoing digital surgery.   In summery, corns and calluses is just the body's way of responding to pressure on the skin and the key to keeping calluses and corns in check is getting the pressure under control. Sometimes, a bony prominence or a toe deformity is the cause to the calluses and corns and needs to be surgically corrected.

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