Corns and Calluses

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What Are Calluses and Corns?

A callus (tyloma) is an area of skin that thickens after exposure to repetitive frictional forces in order to protect the skin. A corn is a smaller type of callus that commonly develops on top of, and between, toes. Corns are separated into soft and hard corns. Both calluses and corns may or may not be painful. When it becomes painful, treatment is required. However, people who suffer from diabetes, poor blood circulation, or loss of sensation (neuropathy) should seek professional treatment even if there is no associated pain.

What Is the Difference Between a Corn and a Callus?

When a callus develops a mass of dead cells in its center (keratinocytes), it becomes a corn (heloma). Corns generally occur on top of, and between, toes. A hard corn is typically associated with toe deformities such as hammertoes. These deformities cause pressure points at toe joints, which rub against closed-toe shoes. The most common area is on the pinky toe. Soft corns commonly occur in between toes from excessive rubbing of toe bones to each other. These corns remain soft due to the moisture from sweat. Calluses occur on the feet, hands, and any other part of the skin where friction is present. It is more common to develop calluses at the bottom of the feet (the sole).

What Causes and Risk Factors of Corns and Calluses?

  • External factors (outside the body) that can cause calluses and corns from friction and mechanical stress
    • Ill-fitting shoes or socks
    • Bunching of socks or socks with seams by the toes
    • Manual labor
    • Not wearing shoes
    • Activities that increase frictional stress applied to the skin of the hands and feet, such as athletic events
    • Activities involving repetitive motion on the same parts of body, such as callus forming on hand/finger from playing the guitar
  • Internal factors (within the body) that may lead to the formation of corns and calluses
    • Bony prominences or structural deformities, such as hammertoes and bunions
    • Corns and callus formation at the bottom of foot, big toe, and ball of foot are most likely due to abnormal foot mechanics.
    • Faulty foot function such as overpronation or oversupination
    • Damaged sweat glands, scars, and warts (plantar verruca)
    • Frequent wear of open-heel shoes such as flip flops and sandals can cause callus to form around the heel in a horseshoe pattern

What Are Signs and Symptoms of Calluses and Corns?

  • Calluses
    • Thickening of skin without distinct borders
    • Most commonly on feet and hands over bony prominences
    • Vary in color from white to gray-yellow, brown, or red
    • May be painless or tender
    • May throb or burn
    • May form cracks (fissures) that are often painful
  • Corns
    • Texture varies from dry, waxy, transparent to a horny mass
    • Distinct borders
    • Most common on toes
    • May be hard or soft
    • Often painful
    • Many different types

When Should One Seek Medical Care for Corns and Calluses?

If home remedies fail to eliminate the corns and calluses and they continue to be painful or bothersome, consult your doctor. Anyone with diabetes, loss of sensation, or poor circulation should not attempt to get rid of his/her own corns and/or calluses and seek medical attention earlier because of a higher risk for infection. A medical specialist who treats skin disorders (a dermatologist) can trim calluses and corns in office, usually without any anesthesia. A medical specialist who treats foot and ankle disorders (a podiatrist) can also perform the same treatment. In addition, a podiatrist can also perform surgeries and prescribe orthotics to eliminate mechanical friction.

Normally, corns and calluses do not require emergency attention. These conditions, however, would need a visit to the hospital's emergency department or doctor's office:

  • Spreading redness around the sore
  • Any drainage from or around the sore
  • Increasing pain and swelling or streaking
  • Fever
  • Change in color of fingers or toes
  • Signs of gangrene (tissue decay)

Common Foot Pain Problems

Corns and Calluses

Friction and pressure cause corns and calluses. Corns are calluses impacted into the skin and are often small, round, and painful to pressure. Calluses typically appear at the ball of the foot and heel. Ill-fitting shoes or foot deformities such as hammertoes and bunions can cause corns and calluses. Pads can help relieve a painful corn or callus as well as periodic trimming by a podiatrist. In some cases, it's necessary for the patient to get custom shoe inserts (functional orthotics) or surgery to correct the underlying deformity causing the corn or callus.

How Do Health-Care Professionals Diagnose Corns and Calluses?

Diagnosis is often made by looking at the corn or callus. A biopsy with microscopic evaluation can be done, but is seldom necessary. The doctor also may take X-rays of your feet or hands to look at underlying bony structures that may be the cause of the corns and calluses. The doctor may also look at the way you walk and examine your shoes.

Sometimes, a wart (a skin infection caused by virus) can have similar appearance to a callus. Therefore, it is important to have an evaluation by a medical professional if home remedies do not improve the symptoms.

What Are Home Remedies for Calluses and Corns?

  • Place protective covering or pads over the sore to decrease friction and/or pressure on the skin until the sore heals.
  • Apply moisturizing agents such as lotions to dry calluses and corns. Agents with 10%/20% urea can soften the sores and make them easier to remove.
  • Rub sandpaper disks or pumice stone over hard thickened regions.
  • Avoid friction to hands or feet by using gloves or changing shoes or socks.
  • Soak feet or hands in warm soapy water to soften corns and calluses.
  • Avoid going barefoot and wearing flip flop sandals for prolonged periods.
  • Avoid using a shaver or blades to remove the sore, as this may cause laceration and cuts.

What Are Treatments for Corns and Calluses?

  • Periodic shaving or cutting off the hardened area on the skin (debridement) by surgical means or with medicines that break up hardened areas of skin such as 40% urea (keratolytic agents)
  • Salicylic acid is another common chemical agent that can break down the thick layer of skin. Many wart-removal products also contain salicylic acid. It is important to use these products as directed.
  • Accommodating pressure areas with shoe inserts (custom orthotics)
  • Antibiotics with possible incision and drainage for any infected corn or callus
  • Surgically removing areas of protruding bone where corns and calluses form and/or correcting the underlying deformity

Is Follow-up Necessary After Treatment of Corns and Calluses?

Follow-up is needed for ongoing corns and calluses that don't go away with treatment as well as for signs of infection or increased pain. Anyone with medical conditions such as diabetes, skin disorders, loss of sensation (neuropathy), or poor blood circulation should be evaluated by a medical professional prior to attempting any home remedies, even if there is no pain.

How Can One Prevent Corns and Calluses?

  • Wear gloves to protect hands.
  • Make sure shoes and socks fit properly and do not rub. Have the shoe store measure the feet for accurate length and width.
  • Wear felt pads over bony points where there is increased friction to the skin.
  • Use toe silicone sleeves and felt pads for soft and hard corns.
  • Surgically correct bony abnormalities.
  • Keep hands and feet moisturized.
  • Wear proper shoes with custom inserts (orthotics) if necessary.

What Is the Prognosis of Calluses and Corns?

Once the corns and calluses are eliminated, a complete cure is possible if the factors causing them have been eliminated. Permanently getting rid of calluses and corns typically requires modification of activities and footwear or surgical correction of deformity.

Reviewed on 11/21/2017
Sources: References

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