Corns and Calluses – Causes, Prevention & Treatment

What are corns and calluses?

Corns are small circular thickened lesions in the skin epidermis (usually the feet). They appear as a result of prolonged friction or constant, uneven pressure and rubbing on specific areas of the body.

These are the areas where the skin is above the bone padding and there is not enough body fat – palms, heels, feet, toes.

Friction and pressure on the tissue provoke the reaction with well expressed clinical and histological process called plantar keratosis (a focused, painful lesion that commonly takes the form of a discrete, focused callus, usually about 1 cm, on the plantar aspect of the forefoot).

In response to the continuous irritation of the cells in the stratum corneum (the outermost layer of the skin, consisting of keratinized cells), they start to reproduce relatively faster, and the skin becomes coarser and the callus appears.

Foot Callus
Fig1: Measurement landmarks used for plantar calluses, plantar corns, heel fissures, and xerotic plantar heel skin.
Source: https://openi.nlm.nih.gov

The areas which are most commonly affected by corns are the soles and palms, as they are sufficiently associated with prolonged mechanical friction and pressure.

Calluses occur on the feet, hands, and any other part of the skin where friction is present. It is more common to develop calluses at the bottom of the feet (the sole).

There is a big chance that some of the corns or calloused areas will disappear on their own, if you change your shoes with soft and comfortable ones, and thus eliminate the pressure and friction.

Corns can occur on the upper surface of the toes and between them, which is most often associated with wearing too tight and uncomfortable shoes.

The most common place where calluses may appear in the surface of the small toe.

Calluses and corns on the skin can be very irritating and unpleasant but they, in fact, represent a protective response of your skin against the pressure and friction in certain areas.

Fig2: Marking of the centre of plantar forefoot callus. The line drawn on this diagram is used to describe how the centre of the callus was identified. During testing a single dot or small cross was marked on the area to indicate the centre of the callus
Source: https://openi.nlm.nih.gov

There are lots of people affected by corns. According to Illinois Podiatric Medical Association, over 5% of the U.S. population has problems related to corns and calluses development at any given time. It is also important to note that different races can be affected by this unpleasant phenomenon.

In women, toes are more prone to corns and calluses development because of tight and uncomfortable shoes, high heels, tight socks, and tights. People of any age can be affected by this problem, but most individuals suffering from corns and calluses are adults.

Calluses can become a big problem for weightlifters, which is caused by not wearing gloves when you’re lifting weights. The friction between the hand and the bar caused by the movement and weight is the factor for getting a callus.

A very easy way to remove such skin formations is using pumice stones. They can be used to remove the dead skin from a callus or corn. Reducing the size of the callus or corn may result in less pressure or friction and less pain on the problem area.

Apply liberally to spots making sure not to miss any spots. Allow to sit for one to two days and then presto you should see that your calluses have regressed or disappeared completely.

What is the difference between a corn and a callus?

While they both have a tendency to cause pain, there are a few general differences between calluses and corns:

Calluses are flat areas of tough, thickened skin caused by repeated pressure or rubbing against your foot. They are your body’s way of protecting the inner layers of your skin by turning the outer surface hard and tough.

Corns are rounded bumps that often appear dry or discolored. Like calluses, they are caused by excessive, repeated pressure on the foot. Unlike calluses, corns have a core that points inward.

Corn on the middle toe of the left foot
Source

Causes

Usually, the cause for the appearance of both corns and calluses turns out to be incorrect gait or too tight and uncomfortable shoes. The most common reason for such formations is actually wearing high heels.

They exert enormous pressure on the toes and therefore women are four times more prone to such problems than men. Other risk factors can include various deformities of the feet deriving from wearing shoes without socks or wearing wrong shoe sizes.

Figure 1: Pressure patterns of each age-group.
Significant differences were found for each parameter between almost every age group.
The most significant differences were observed for the new-walkers. Regarding the heel significantly lower pressure patterns were seen in the new-walkers.
This is based on the fat pad, a lower body-weight to foot CA ratio and the non-existing initial heel contact in many new-walkers.
Source: https://openi.nlm.nih.gov

Practically, one of the main causes for the occurrence of foot problems is poor-fitting shoes. Three out of four people over the age of 65 wear shoes that are too small.

Narrow or high-heeled shoes, shoes with slippery soles, or ones that offer no protection or support may cause serious injury and pain, and increase your chance of a fall.

Prevention

Most foot problems can be treated effectively. A trained healthcare professional who specializes in the feet—also known as a podiatrist or chiropodist—can diagnose your condition and choose the most appropriate personal treatment.

Often a change in footwear will be perfectly enough. You do not have to suffer needlessly so you can arrange an appointment with a podiatrist as soon as you notice the corn or callus’ development.
It is not advisable to try to cut calluses or manipulate at home.

There is a severe risk of injury or even infection which can lead to serious health problems.

This is extremely important for people with diabetes [4] or circulatory disorders with more vulnerable skin. Skin problems, including bruising, dryness, itching, hair loss, warts, gangrene (tissue death), and skin ulcers are very common indications of such conditions.

Elderly people should be aware that the timely, proper treatment is extremely important for them [3].

It’s no secret that the best way to deal with calluses and corns on the feet is their prevention. Therefore, here’s a list of a couple recommendations you could also have in mind:

    • Wear comfortable, soft shoes made of natural materials. The goal is to lower the pressure from the exterior side on the fifth finger as well as the severe pressure between the fourth and fifth finger.
    • You can also provide comfort for your feet by applying special pads, plasters, and cushions on the skin areas that are more prone to the appearance of pressure sores.
    • Avoid too sharp or too high shoes.
    • Note that it would be always better to have at least a centimeter distance between your longest toe and your shoe.

Usually, pharmacies sell various products based on salicylic acid, but before choosing your own treatment, note that such products may not be the most appropriate for you because it is possible to get quite nasty skin burns.

Self-treatment can also lead to some sort of infection or ulceration (the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing out of inflamed necrotic tissue).

It is highly recommended to soften the skin of your feet with appropriate creams. The most effective treatment effect can be accomplished right after showering.

You will have best results if you rub a pumice stone gently over the calloused area, then dry thoroughly your feet, apply some moisturizing cream or lotion and even sleep with soft cotton socks if possible.

Additionally, you can soak your feet in warm soapy water then try to gently remove the calluses with a foot file. There are Urea [1] creams and lotions, which are indeed useful and effective.

However, if the reason is the presence of deformation of the feet or toes, you will need a consultation with a podiatrist who will consider what measures need to be taken.

One of the most popular and effective methods used in dermatology is the nitrogen treatment also known as cryotherapy (the use of extreme cold in surgery or other medical treatment) [2].

Thus the treatment is concentrated directly on the problem area and has control of the depth. After the cryotherapy, the surrounding skin may be sore for a day or so.

A small blister (sometimes a ‘blood blister’) may form as a result of the freezing and if this does happen, it is best not to pop it but to cover the area with a band-aid or plaster.

Treatment of corns and calluses

For the treatment, it is necessary to remove the pressure and improve the statics of the foot by wearing suitable supporting shoes and/or orthopedic shoes. Soft and comfortable shoes are a must.

When corns and calluses affect the hands because of fitness, you should never forget to wear your weight lifting gloves right before training as well as to apply lifting chalk on your hands’ rig. The proper positioning is also extremely important.

Traditional Medicine for corns and calluses removal

  • 3-4 nights (in a row) soak your feet in hot water for about 15 minutes. Apply a lemon slice on the affected area and tighten it with a bandage or cloth. Instead of lemon, you can also use onions. When the callus is softened, it can be easily removed.
  • Grind onion and mixed with vinegar. Apply the mixture on the callus before going to bed. Onions contain biologically active substances that have very good bactericidal and bacteriostatic properties, which will reduce the inflammation, caused by skin abrasion.
  • Soak your feet in soapy water for 10-15 min every day. In 1 liter of warm water (about 40 degrees) add 1 tsp baking soda. Then use a pumice abrasion to remove the rough skin surface. Rinse again with warm water, pat dry with a towel and apply a nourishing cream.
  • Take a small piece of pure propolis and heat it up until it softens. Apply on the corn or the callus after a hot bath and let it dry. Re-apply every day until it disappears.

References

  1. http://escholarship.org/uc/item/11x463rphttp://escholarship.org/uc/item/11x463rp
    Urea: a comprehensive review of the clinical literature
  2. http://www.aafp.org/test/fpcomp/FP-E_379/pt2-s4-s2.html
    Corns, Calluses, and Plantar Warts
  3. https://www.ncbi.nlm.nih.gov/pubmed/12931298
    Healing of elderly patients with diabetic foot ulcers, venous stasis ulcers, and pressure ulcers.
  4. https://sydney.edu.au/medicine/diabetes/foot/Fcare1.html
    Foot Care: Foot care for those at high risk of developing a foot ulcer

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