You may notice some thick areas of skin on your feet, possibly even causing some pain. It could be a corn or callus, but what’s the difference between the two, and why are they important?
Getting its name from its resemblance to a corn kernel, a corn is a small, circular, thickened area found in the skin of the foot. This buildup of skin can be found on the top, side, or end of the toe, or between two toes. Corns are caused by constant friction against the shoe or too tight of shoes. They may be soft or hard with a center, depending upon their location.
People with foot deformities, such as hammertoes, often suffer from corns because the tops of the bent toes rub against the tops of shoes.
There are a number of treatment options for corns. When corns get hard enough to cause pain, a foot and ankle surgeon will recommend the treatment option most appropriate for you. However, if the underlying cause of the corn is not treated or removed, the corn may return. It is important to avoid trying to remove a corn at home or using medicated corn pads, as serious infection may occur.
Calluses, another type of skin buildup, are usually located on the bottom of the toe or on the ball of the foot. When your foot rubs repeatedly against your shoe or sock, the friction and pressure can cause the skin to produce a thick layer of protective skin called a callus. A callus can vary in size and does not have the hard center the corn has, so it may not be as painful as a corn.
There are a number of treatments for painful calluses. People who have calluses are cautioned against performing “bathroom surgery,” as this can lead to cuts and infection. A foot and ankle surgeon can evaluate the cause of the calluses and recommend the treatment most appropriate for your condition. However, if the underlying cause of the callus is not treated or removed, the callus may return.
They occur because the skin is trying to protect itself. For example, there is a bony deformity such as a hammertoe that creates a pressure point in the skin. Over time, a corn or callus can form. Some mistakenly believe that this protective mechanism is good and that corns or calluses should not be removed.
However, corns and calluses can be painful and make it difficult to find a comfortable shoe. These growths, often mistakenly called warts by many health care professionals, or bunions by patients, can also be dangerous. Learn more about warts.
The condition is cyclical. When the corn or callus forms, it provides more pressure on the underlying skin, causing further production. Eventually, if untreated, the pressure can damage the underlying skin causing sore and infections.
These sores and infections can lead to bone infection, systemic infection and loss of limb and life. Diabetes is a dangerous disease because the high amounts of sugars in the tissues and lead the bacteria to thrive and infections to spread. Other conditions that may be harmful include poor circulation, which makes it more difficult to heal wounds, and poor nerve sensation or neuropathy, which makes it so that you can’t feel it when the callus or corn is digging into the flesh and becoming a sore. Both of these are common in diabetes. Most insurances allow corns and calluses to be trimmed once a month for patients who are at risk with poor circulation or nerve sensation, or in pain. It is also important to identify the underlying cause that causes the skin to need to protect itself and produce the corns or calluses, such as bunions or hammertoes, and address these.
One of the most commonly asked questions is why do these need to be trimmed so frequently? First of all, there may be pain with recurrence, and trimming them reduces the pain. Secondly, by trimming the calluses, it breaks the cycle so that they do not form as fast, and may eventually stop forming altogether.
Another commonly asked question is can’t they just be cut out or burned out? There is usually an underlying bony deformity that causes the callus, and that must be evaluated. Procedures such as excising calluses or cauterizing them are invasive, not useful, and do not address the underlying deforming force.
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