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Corns And Calluses

Usually located on areas of repeated trauma (most often the feet), corns and calluses are acquired skin conditions marked by hyperkeratosis of the stratum corneum. The prognosis is good with proper foot care.

Causes

The small bones of the toes and feet are broader and more lumpy near to the small joints of the toes. If there is extra rubbing (friction) or pressure on the skin overlying a small rough area of bone, this will cause the skin to thicken. This may lead to corns or calluses forming.

The common causes of rubbing and pressure are tight or poor fitting shoes (which tend to cause corns on the top of the toes and side of the little toe) and too much walking or running (which tends to cause callus on the sole of the feet.) Corns and calluses are more likely to develop in people who have very prominent bony toes, thin skin, or deformities of the toes or feet which cause the skin to rub more easily inside shoes.

Signs and symptoms

Both corns and calluses cause pain through pressure on underlying tissue by localized thickened skin.

Corns

Containing a central keratinous core, corns are smaller and more clearly defined than calluses and are usually more painful. The pain they cause may be dull and constant or sharp when pressure is applied.

Soft corns are caused by the pressure of a bony prominence. They appear as whitish thickenings and are commonly found between the toes, most often in the fourth interdigital web. Hard corns are sharply delineated and conical and appear most frequently over the dorsolateral aspect of the fifth toe.

Calluses

Diagnosis

Corns can be recognized on sight. A family physician or podiatrist may scrape skin off what seems to be a callus, but may actually be a wart. If the lesion is a wart, it will bleed. A callus will not bleed, but will reveal another layer of dead skin.

Treatment

Surgical debridement may be performed to remove the nucleus of a corn, usually under a local anesthetic.

In intermittent debridement, keratolytics - usually 40% salicylic acid plasters - are applied to affected areas. Injections of corticosteroids beneath the corn may be necessary to relieve pain.

However, the simplest and best treatment is essentially preventive avoidance of trauma. Corns and calluses disappear after the source of trauma has been removed. Metatarsal pads may redistribute the weight-bearing areas of the foot; corn pads may prevent painful pressure.

Patients with persistent corns or calluses require referral to a podiatrist or dermatologist; those with corns or calluses caused by a bony malformation, as in arthritis, require orthopedic consultation.

Home remedies for Corns and Calluses

• Apply moisturizing agents such as lotions to dry calluses and corns.
• One teaspoon of lemon juice mixed with one teaspoon of dried chamomile ( Martricaria recutita ) tea and one crushed garlic clove dissolves thickened skin.
• Soak feet or hands in warm soapy water to soften corns and calluses.
• Aloe cream is an effective skin softener, and two or three daily applications of calendula salve can soften skin and prevent inflammation.
• Stick to loosefitting, cushioned shoes until your corn or callus disappears.

Prevention

Eliminating sources of friction or pressure should help you prevent corns and calluses from developing. These approaches may help:

• Wear shoes that give your toes plenty of room. If you can't wiggle your toes, your shoes are too tight. Have your shoe shop stretch your shoes at any point that rubs or pinches.
• Wear padded gloves when using hand tools. Or try padding your tool handles with cloth tape or covers. Warn the patient against removing corns or calluses with a sharp instrument, such as a razor blade.
• Advise the patient to wear properly fitted shoes. Suggest the use of metatarsal or corn pads to relieve pressure. Refer the patient to a podiatrist, dermatologist, or orthopedist, if necessary.
• Keep hands and feet moisturized.