Corns and Calluses
The buildup of hard thick skin is extremely common on the feet and toes, and is a major cause of pain and disability when the buildup gets too thick or causes pressure on sensitive parts of the foot. Hard skin can occur on any part of the foot and toes, and has many causes. The most common reason hard thick skin develops is pressure from shoes or the ground on the foot.
When hard skin occurs on the bottom of the foot that is due to pressure, it is called a CALLUS or a TYLOMA (medical term). When it occurs on or between the toes, it is called a CORN or CLAVUS (medical term). There are two medical terms used to distinguish between the corns that occur on the top and end of the toe, from corns that occur between the toes. HELOMA DURUM (hard corn) occurs on the top and end of the toe, and HELOMA MOLLE (soft corn) occurs between the toes.
Common locations for calluses under the foot are under the metatarsal heads in the forefoot. Calluses also form around and under the heel, and rarely in the arch since no weight is borne by that part of the foot except in extreme deformities.
Common locations for hard corns on the toes are at the first toe joint (PROXIMAL INTERPHALANGEAL JOINT) and at the end of the toe. Both of these types of corns occur in those who have CROOKED TOES, and wear shoes that do not fit properly.
Soft corns can occur between any of the toes and are a result of having a shoe that is too tight in the forefoot. Soft corns are seen more often in those that wear shoes with tapered toeboxes, which force the normal roundness of the forefoot into an unnatural triangular shape. An unusually shaped corn often occurs on the bottom of the fourth and sometimes fifth toe that is flat and is the result of wearing a shoe with a tight toebox that pinches the toe skin between the adjacent toe and the shoe.
Treatment of corns and calluses is directed at obtaining a properly fitted pair of shoes and manual attempts at reduction of the thick skin. This is best carried out using a pumice stone after the feet have been bathed or soaked. Over the counter acid plasters should be used with extreme caution as they contain acid that is capable of damaging normal tissue surrounding the corn or callus. People with diabetes, nerve related conditions and poor circulation should not use acid plasters, as they may be unable to feel if the acid is damaging their skin or infection has set in. Further, they may be unable to heal the tissue damage that has occurred as a result of using the acid preparation.
If manual reduction of the skin buildup and attention to proper shoe fit has not relieved the corn or callus, see a podiatrist for treatment.
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