Corns and Callouses

 IMPORTANT: If you have diabetes, you should see your podiatric physician at the first sign of any problems with the skin of your feet or toes, no matter how minor you may think they are. Patients with diabetes who develop podiatric problems often require special attention.  The following precautions and steps may be recommended by your podiatric physician, but should not be undertaken without his/her supervision and consent.

What is it?
Corns and callouses are similar, and indeed, the terms are often used interchangeably, although they are not the exactly the same.  They do, however, share a common cause in that both are a thickening of the skin in an area that receives extra pressure.  They are actually an interesting example of the way our body protects itself; in this case, it builds up hard, dead skin to toughen up an area and prevent it from developing a blister, which can lead to infection. 

 What is the difference?
 Generally speaking, the location differentiates the two. The disorder is called a corn when it applies to a small, specific area of the foot.  Many corns form on the sides of toes, particularly where the knuckle joints of one toe press or rub against the knuckle joints of another. A podiatric physician will probably be able to examine a corn and show you where the center, (or “seed”) of it lies.

Callouses, on the other hand, can be caused by many things, but mostly by incorrectly fitting or improperly padded shoes, flat feet, bone spurs or hammer toes.  (Callouses may also be seen on the hands of anyone who works hard, or without gloves).  The bottom of the foot or the ball of the foot are common locations for callouses.

What to look for:
If you see a hardened area of skin, particularly in an area that receives pressure, such as the heel, ball of the foot, or areas on the sides or tops of toes, suspect corns and callouses.  The area may or may not be painful.  Corns and callouses generally look like other skin around them, but they may feel rough or somewhat less sensitive to the casual touch.

What it means to you:
Corns and callouses are can be annoying and sometimes painful, but they’re not life-threatening. That said, however, it is important to note that there are various lesions of the skin on the foot, including moles, warts - and even a few rare cancerous growths - that have similar or identical characteristics.  It’s best to have a podiatric physician examine any growth on your foot to ascertain that it is indeed a corn or callous.  Many corns and callouses can be addressed with over-the-counter treatments; however, it depends on the specific condition, the cause, the patient and how far the problem has progressed.

 What causes it?
As previously mentioned, you develop corns and callouses through continued, sustained pressure on a particular area (or areas) of your foot. They’re not contagious, and generally speaking, they’re not dangerous.  If, however, you have diabetes, have your feet checked by a doctor before you attempt any type of self-treatment, self-medication or home remedy.  An incorrectly treated problem can lead to infection with serious and lasting consequences.

 Some of the causes of corns and callouses include shoes that fit incorrectly, are incorrectly padded, or that have an area that rubs or irritates part of the foot continually. Flat feet, a bone spur or hammer toes are also contributing factors to some corns and/or callouses.  Occasionally, a blocked sweat gland on the foot can have symptoms that mimic a corn or callous.

What cures it?
Of all the podiatric problems out there, corns and callouses have given rise to a veritable cottage industry of home remedies, do-it-yourself fixes and all-natural cures.  Before you go trying your grandma’s favorite corn remover made out of who-knows-what that came out of the refrigerator, try the scientific approach.

A corn or callous is caused by constant pressure to a specific area. Your goal, logically, is to remove the pressure. If improperly fitted shoes are the source of the pressure, then obviously choosing properly fitted shoes will help.  At a minimum, shoes should have ½ inch of space between the toes and the end of the shoe, along with a large, square toe box.  It is equally important that the widest part of the foot fits in the widest part of the shoe. 

 Pads made of silicone, foam or cotton are available in the healthcare sections of many stores. These can be considered the first line of attack (or defense, as it were) in treatment.

Some patients report success with the use of a callous file or a pumice stone; however, this tends to leave a rough skin surface, and some patients tend to be overzealous and damage their skin while pursuing this course of action. Should the low-key, at-home forms of treatment not be successful in treating your disorder, a podiatric physician, has a greater array of tools at his or her disposal, and can treat the problem with greater precision and usually better results.

If the corn or callous is the offshoot of a bone spur or hammertoe condition, your podiatric physician may recommend further treatment. 

 How can corns and callouses be prevented?
Wearing properly fitted shoes and paying special attention to your feet is your best bet for avoiding corns and callouses.  Do not wear shoes that cause blisters, redness or sore spots on your feet; over time, your body develops corns and callouses to prevent further injury. Corns and callouses aren’t contagious (the way plantar warts are), but they can be hard to get rid of if the patient persists in wearing the shoes, or performing the activities, that cause injury to his or her feet.

 Outside of these precautions, follow commonsense rules regarding foot health. Do examine your feet (and indeed, all of your skin) regularly.  Note any unusual growths or lumps.  Pay special attention to the soles of your feet, the tops of feet or toes, and the skin between the toes.  Call anything unusual to the attention of your doctor immediately.

Do these symptoms always mean corns or callouses?
No - as mentioned before, several other problems, including plantar warts, blocked sweat glands and other lesions can have symptoms that appear to be those of corns and callouses.  Therefore, it’s essential to get a professional’s diagnosis of the problem.  If you assume that bump on your foot is a corn, and begin treatment with some kind of an over-the-counter medication - and it isn’t a corn after all - the true problem could get far worse because of the delay in getting the correct treatment - not to mention the additional trauma you have inflicted on the foot, particularly if an infection is already present.

Who can help me?
The American College of Foot & Ankle Orthopedics & Medicine (ACFAOM) stands ready to help you find a podiatric physician in your area. Simply click on our  foot-help-finder link to find the professional who can help you find the most effective treatment.