Corns & Calluses
Corns and calluses are areas of thick skin that result from excessive pressure or friction over a bony prominence. When these areas develop on the bottom of the foot they are called calluses. When they occur on the top of the toes they are called corns. These lesions can also occur between the toes, the back of the heels and the top of the foot. Thickening of the skin is a normal body response to pressure or friction. Often, corns and calluses are associated with a projection of bone called a bone spur. Not all areas of thickened skin are corns or calluses. Plantar warts, inclusion cysts and porokeratoses also cause a discreet thickening of the skin that resemble these lesions.
Corns are areas of thick skin that most commonly occur on top of the toes. Generally, there is an associated hammertoe deformity, which causes the top of the toe to rub on the shoe. A corn can also occur on the side of the little toe next to the toenail. Soft corns are areas of white, moist skin between the toes. This type of corn is due to an irregularity in the shape of the bone between the toes. Soft corns most commonly occur between the fourth and fifth toes. The condition can be very painful and if not treated can cause small ulcerations or sinus tracts to form that can become infected.
The most common area for the formation of a callus is on the ball of the foot. This is a weight bearing area where the metatarsals, the long bones behind the toes, bear the greatest amount of weight and pressure. If one or more of these metatarsals is out of alignment, then excessive pressure is generated in the area, producing a callus. The callused area can be very discreet and have a “core” or can be more dispersed covering a larger area. These areas can become quite painful as the skin thickens. People who have diabetes are at risk of these areas breaking down producing sores or ulcerations that can become infected.
What we can do to help you solve this problem
If you have a painful corn or callus, we would recommend that we see you as a patient. There are many over-the-counter treatments for corns and calluses, but most of these medications contain acids that can cause a chemical burn if used incorrectly. It is important to determine the cause of corns and calluses so the proper treatment can be performed.
Initially, we will perform a thorough examination to find the exact cause of the corn or callus formation. This is important as it will help to guide the appropriate treatment for your condition. We will also perform a biomechanical examination to see what role your gait may play in the formation of the skin thickening. Digital x-rays are often needed to assess the position of the bones of your foot.
We will reduce or debride the corn or callus on your first visit. This often produces instantaneous relief from your pain. Our goal, however, is to determine the cause of the problem and to develop a plan to prevent the return of the corn or callus. Many corns and calluses can be treated with simple measures such as accommodative pads, shoe modification and various soft inserts to wear in the shoes. We also carry prescription-strength urea cream in our office which is very helpful for softening calluses particularly around the heel.
If it is determined that your corn or callus formation has a biomechanical cause, it is often very helpful to use a pre-made arch support or a custom-made orthotic to control the abnormal flattening of your arch and to stabilize your gait. We carry arch supports in our office that are typically much better than what you will find in the store. These may be helpful for mild cases. For more severe cases, a special shoe insert called a functional orthotic may be needed. This is a custom-made arch support that is made from a plaster impression or digital scan of your foot and arch. Unlike pre-made arch supports, however, an orthotic completely controls the abnormal flattening of the arch and most effectively stabilizes the feet. Learn more about custom orthotics.
Surgery is sometimes needed to permanently stop the corn or callus formation. Various procedures can be performed including removing small spur formation, straightening a hammertoe (arthrodesis), or a metatarsal osteotomy to re-position the bone. Many of these surgeries can be performed easily in our office using just a local anesthetic.
If you have corn or callus formation, it is important that we see you in our office to help you determine the right treatment for your problem. The doctors at Council Bluffs Foot & Ankle Care are experts in the treatment of corns and calluses. We will work with you to help you solve this problem.