What is a corn and callous, and can you stop them

What are calluses and corns?

Calluses and corns are areas of thick skin caused by pressure or friction. It is a normal reaction by the body to produce thick skin when pressure is applied, in order to prevent itself from breaking down. However, this thickness can cause secondary pain by applying pressure on the soft skin around it. Corns and callouses are made of keratin, just like our hair and nails, so they dont actually have feeling. There is no nerve or blood supply to these lesions. The pain is caused by the pressure they apply to the soft skin.

Callouses are usually a patch of thickened skin which will be yellow in colour. They are caused by sheer forces on the skin.

Corns can be soft (between the toes) or hard (top of toes or sole of foot). A corn will usually appear as small seed size patch of hard skin. It occurs when there is torsional forces on the skin, which is why it becomes like cone shaped lesion. It hurts when direct pressure is applied.

What causes callouses and corns?

Callouses and corns are caused by repeated pressure or friction on an area of skin. The pressure causes the skin to die and form a hard, protective surface. A soft corn is formed in the same way, except that when sweat is trapped where the corn develops, the hard core softens. This typically occurs between toes. Calluses and corns are not caused by a virus and are not contagious.

Callouses and corns on the toes are often caused by pressure from footwear whereas on the sole of the feet, it is often caused by the way you walk. Walking barefoot also causes callouses which can be harmless.

Callouses and corns on the feet may also be caused by repeated pressure due to sports (such as a callus on the bottom of a runner’s foot), an odd way of walking (abnormal gait), or a bone structure, such as flat feet or bone spurs (small, bony growths that form along joints).

How are callouses and corns diagnosed?

Your podiatrist will look at the callouses or corns that are causing problems for you. He or she may also ask you questions about your work, your hobbies, or the types of shoes you wear. An Xray of the foot may be done if the podiatrist suspects a problem with the bones.

How are they treated?

Callouses and corns on the toes usually cause pain. If they do cause pain, you can ease the pain by:

  • Wearing shoes that fit well and are roomy, with wide and deep toe boxes (the area that surrounds the toes).
    • A wider toe box keeps the toes from pressing against each other, relieving pressure on soft corns.
    • A deeper toe box keeps the toes from pressing against the top of the shoe, relieving pressure on hard corns.
  • Using protective padding while your foot heals, such as: Moleskin, Felt padding, Gel toe protection.
  • Do not use medicated corn pads (active ingredient is salicylic acid) dressing on your toes, as it often is too strong for the thin skin on the toes, causing a mild burn reaction and secondary infection. And never use salicylic acid if you have diabetes or other conditions that cause circulatory problems or numbness.

Other things you can try include:

  • Reducing the size of the callous or corn by soaking your feet warm water and then using a pumice stone to lightly wear away the dead skin. Never cut the corn or callus yourself, especially if you have diabetes or other conditions that cause circulatory problems or numbness.
  • Having your podiatrist pare (trim) the callous or corn with a scalpel blade provides immediate relief.

If you keep having problems with callouses or corns, or your problem is severe, you may be fitted for orthotic inserts  for your shoes to distribute your weight more evenly over the ball of your foot. Athletes who run a lot may wear orthotic shoe inserts for the same purpose.

Surgery is rarely used to treat calluses or corns. But if a bone structure (such as a hammer toe or bunion) is causing a callous or corn, surgery can be used to change or remove the bone structure. This is used only if other treatment has failed.

If you have diabetes, neuropathy, arterial disease, poor ciculation or other conditions that cause circulatory problems or numbness, talk to your podiatrist before you try any treatment for calluses or corns.

How can callouses and corns be prevented?

Calluses and corns can be prevented by reducing or eliminating pressure on the skin.

Corns on your toes can usually be prevented by wearing shoes that have a wider toe box. Your podiatrist can discuss and educate you on your current footwear and the changes you need to make.

The way you walk can be affected by the bones in your feet or even tight calf muscles. If so, a podiatrist may be able to help you make changes that can prevent foot problems like callouses and corns.

Dr. Vanessa Hadchiti (Podiatrist)