Corns and calluses are caused by an accumulation of dead skin cells that harden and thicken on an area of skin as the body’s way of protecting it against excessive pressure and friction in order to avoid creating a wound.
A corn will have a cone-shaped core with an inward point that can press on a nerve below the skin, making it very painful. Corns are usually found on the tops, sides and/or tips of the toes. There are two types of corns: soft corns, and hard corns.
Usually soft corns are found in between the toes. They are created when the bony prominences of the toes rub together, creating pressure. Due to perspiration, this area often stays moist, not allowing the dead skin to dry out and harden – resulting in a softer tissue corn. When the foot is in a shoe, the darkness and moisture caused by perspiration also can set the stage for fungal infections as well.
In contrast, hard corns are more common on the tops and tips of the toes. These corns are dryer, usually thicker, and are more commonly due to a deformity in the toe, causing pressure to the area. A hammertoe may develop a corn on the top of the proximal interphalangeal (PIP) joint or the middle joint of the toe. A claw toe is more likely to result in a corn on the very tip of the toe due to the nature of the deformity itself. Also, these areas can have callus formations that are usually a precursor to the development of a corn.
Calluses are more common on other areas of the foot, such as on the outside and bottom of a bunion or bunionette; the ball of the foot, causing metatarsalgia; the heel, creating heel pain; and any other area of the foot where undue pressure occurs. Some calluses have a deep-seated core known as a nucleation that can be especially painful. This type of callusing is usually on the plantar side, or the bottom, of the foot and is known as intractable plantar keratosis or a pressure callus. This type of callus should never be self treated.
Common root causes of corns and calluses are:
- Improper biomechanics of the foot causing pressure;
- Bunions and bunionettes;
- High-heeled dress shoes, which put the foot in a less-than-ideal position for walking, sometimes causing metatarsalgia;
- Shoes and/or hosiery that are fitted too small or too big;
- Pes planus feet, more commonly know as overpronation or flat feet;
- Pes cavus feet, more commonly know as high-arched feet;
- Deformities such as hammertoes and claw toes; and
- The loss of the fat pad on the bottom of the foot.
Many people try to alleviate the problem of corns and calluses by self treating. For callus formations, the best self treatment is the daily use of a pumice stone. Never cut the dead skin tissue due to the risk of injury and infection. Over-the-counter preparations for the removal of corns and calluses are not a good idea as these preparation usually don’t work and can cause more irritation. If your corns and calluses become inflamed; create severe pain; develop open sores; or bleed, you must consult your doctor for proper treatment. Left untreated, these complications may lead to infection which can result in the loss of toes or worse. If you have diabetes and suffer from the pain of corn and/or callus formations, NEVER self treat and ALWAYS consult a physician since the risk of infection is too great, leading to the possibility of amputation.
Consult the Shoe Fitting Reference Guide for proper guidelines on how to best fit your shoes. Even if you are correctly fitting your shoes and wearing shoes designed for your specific activity, the use of an ezWalker® Custom Performance Orthotic can be the best approach to reduce existing corn and callus formations, as well as a way to proactively avoid these painful conditions altogether. The ezWalker® Custom Orthotic will redistribute weight, create balance, give stability, and, in general, reduce fatigue – making it easier to walk.
If you follow these guidelines and your problems persist, seek the counsel of a physician for proper diagnosis and treatment.