Corns & calluses

What are they?

 

• Localised formations of thick, hardened skin on the feet

Aetiology?

 

• Combination of friction and intermittent pressure against the bony prominences of the feet

• Frequently caused by inappropriate footwear

• Pressure on nerve endings = pain

• Hard corns – top of the toes

• Soft corns – between the toes

• Calluses – Balls of the feet, heel and lower border  of the big toe

Clinical features of corns & calluses?

• Hard corns

  • Exhibit a central core of hard grey skin  surrounded by a painful, raised, yellow ring of  inflammatory skin

  • Rounded or crecent shape

  • Small as pin head - lentil size

  • Over joints, next to nails, between tails, under nails near end of toes

• Soft corns

  • Whitened appearance and remain soft due to  moisture being always present between the toes,  causing maceration of the corn

• Calluses

  • Depending on the cause and site involved, can  range in size from mm to cm

  • Appear as flattened, yellow-white and thickened  skin

Differential diagnosis?

• Site will determine the condition

• Rule out Bunions:

• Due to foot wear or conditions

• Look at bony prominent one

Treatment options?

• Epidermabration

  • Removal via physical processes by mechanical aid

• Hydrocolloid plasters

  • Swell in prescence of water

• Keratolytic agents

  • Rehydrates and soften harden skin

  • Corn/callus comes away after a week

• Correctly fitting footwear

• Padded inserts/shields around affected area

Practical measures?

• Do

  • wear thick, cushioned socks

  • wear wide, comfortable shoes with a low heel and soft sole that do not rub

  • use soft insoles or heel pads in shoes

  • soak corns and calluses in warm water to soften them

  • regularly use a pumice stone or foot file to remove hard skin

  • moisturise to help keep skin soft

• Don’t

  • do not try to cut off corns or calluses at home

  • do not walk long distances or stand for long periods

  • do not wear high heels or tight pointy shoes

  • do not go barefoot

When to refer?

• you have diabetes

• you have heart disease or problems with your circulation

• it bleeds, or has any pus or discharge

• it has not improved after treating it at home for 3 weeks

• the pain is severe or stopping you doing your normal activities