Corns and calluses

corns-calluses

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.

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.

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.

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.

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.

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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