Corns and Calluses

What are calluses and how are they created?

Calluses are the thickening and hardening of skin due to friction and pressure. When specific areas of our feet take up constant pressure, our body creates a harder surface of skin in response to protect itself. Corns and calluses can be caused by many things, such as:

1. Pathological conditions, such as arthritis.
2. Trauma and injuries.
3. Standing for long periods of time.
4. Unsuitable footwear, such as high-heeled, narrow and ill-fitting shoes.

Corns can appear on the bottom of your feet and on top of joints, too. They look like circular, hard bumps with yellowish appearance. They are quite painful because calluses put pressure on nerves crossing underneath the skin.

What are the different types of corns/calluses?

Some types of corns and calluses are:

1. Hard corns: Hard skin is usually created on the top side and tip of the toes, but also the bottom of the feet. These are created by pressure on specific points for a long time.
2. Soft corns: Hard skin usually created between the toes (interdigital spaces) due to friction. These corns are more white and soft because of humid conditions between the toes.
3. Vascular and neurovascular corns: These happen when blood vessels and/or nerves penetrate the calluses. They are quite painful and usually occur in cases where calluses remain untreated for a long time.

How are corns and calluses treated?

The most important part of treating painful corns and calluses is prevention. Choosing the appropriate footwear in correct shape and size is perhaps the most important rule of prevention.

Calluses are removed by professional podiatrists. This is a painless removal done with a clean surgical blade. A common misconception is that removal of calluses with a blade causes its deterioration, a statement which is not true since the hardening of the skin is caused by pressure and friction.

In order to eliminate calluses, however, the cause of their occurrence needs to be eliminated (e.g. unsuitable shoes, bony prominences), or otherwise calluses will re-appear every time.

If your podiatrist deems it necessary, he or she will advise you on use of orthotic insoles or silicone devices to reduce excessive pressure on sites that create hard skin.

General tips in order to avoid and prevent corns and calluses

1. Choose comfortable shoes in the right size and made of soft material. Never buy tight shoes thinking that they “will stretch open”.
2. Avoid, whenever possible, narrow high heeled shoes. They do not properly distribute the pressure on the feet and may create calluses more easily.
3. Use products that relieve pressure and friction of shoes from your feet (silicone wedges, special insoles etc.).
4. Use a pumice stone on dry heels and feet to remove any skin hardening.
5. Have a five to ten minute foot bath in lukewarm water.
6. Moisturize your feet daily with special foot care products that soften and maintain the natural elasticity of skin.

IF YOU HAVE DIABETES

1. Do not attempt to remove calluses yourself. You need to see a professional podiatrist to safely remove corns and calluses. The use of incorrect and non-sterile instruments (e.g. scissors) can cause serious problems in people with diabetes or other vulnerable groups.
2. Do not neglect and do not refrain from treatment of hard skin by a specialist for a long time. The concentration of pressure at specific points may cause ulceration below the callus, which is a very dangerous situation for a person with diabetes.
3. Use of caustic liquids is strictly prohibited for people with diabetes (e.g. corn caps with salicylic acid) as they can cause ulcers which can get infected easily and delayed in healing in people with diabetes.
4. Consult your podiatrist or pharmacist regarding available products that are suitable for diabetics. Always read the information shown on each product.
5. In advanced situations and when necessary, your podiatrist may recommend gait analysis in order to prescribe an orthotic insole which will balance the pressures on your feet.

 

CAUTION: People with diabetes have extremely sensitive and fragile skin. This makes the skin more susceptible to cracks and wounds, which can be caused by excessive pressures on the feet. Calluses and hard skin may cover an ulcer, a very dangerous complication for people with diabetes. Failure to treat an ulcer may sometimes lead to amputation. Visit your podiatrist for prompt treatment of hard skin and remember to do your annual diabetic foot check.