About Calluses and Corns
Corns and calluses are thickened areas of skin that develop in response to prolonged rubbing, pressure, or friction. They are both protective mechanisms of the skin to shield underlying tissues from injury. Here are the key differences between corns and calluses:
Corns:
- Form on bony areas of the feet, such as toes
- Have a dense central core
- Can be dry and firm (hard corns) or moist and pliable (soft corns)
- Often caused by ill-fitting shoes or deformed toes
Calluses:
- Develop on areas of the skin exposed to prolonged rubbing
- Have an evenly distributed thickening of skin
- Typically larger than corns
- Commonly occur on weight-bearing areas of the feet, like the heel or ball of the foot
Both corns and calluses are usually painless, but they can become painful if they become infected or if there is prolonged pressure. It's important to seek medical supervision before attempting to remove them at home.
The pathophysiologic causes of calluses and corns are primarily pressure and friction on the skin. When the skin is repeatedly subjected to these forces, it responds by thickening and hardening to protect itself. This thickened skin forms the callus or corn.
Non-modifiable risk factors for calluses and corns cannot be controlled or changed. They include:
- Increasing age
- Genetic predispositions, such as a positive family history of calluses or corns
- Previous history of calluses or corns
- Inflammatory bowel diseases (Crohn's disease and ulcerative colitis)
Modifiable risk factors for calluses and corns can potentially be influenced by individual habits and lifestyle. They include:
- Wearing shoes that are too tight, too loose, or have a high heel
- Having badly placed seams in shoes
- Wearing socks that do not fit well
- Walking barefoot regularly
- Using hand tools, sports equipment, or musical instruments without gloves
- Cycling frequently
- Kneeling or resting elbows on a table repeatedly
It is important to note that maintaining proper foot hygiene and wearing well-fitting shoes can help prevent the development of calluses and corns. If you have any concerns or need further guidance, it is recommended to consult with your healthcare professional.
Early symptoms of calluses and corns:
- Raised, hardened bump
- Thick and rough area of skin
- Pain or tenderness under the skin
Other common symptoms that may occur with higher severity calluses or corns:
- Very painful corns or calluses
- Leaking fluid from the affected area
- Warmth or redness in the area
- Signs of infection
- Discolored area (brown, red, or black) under a large corn or callus
- Separation of thick and normal skin, exposing the area to possible infection
It's important to note that people with poor circulation, fragile skin, nerve problems, numbness in the feet, diabetes, peripheral neuropathy, or peripheral arterial disease should seek medical advice before treating corns and calluses at home.
To diagnose calluses and corns, the following examinations and tests are commonly performed:
- Medical history: The doctor may ask about your shoe choices, foot history, and any underlying medical conditions like diabetes or circulation problems that can contribute to the development of calluses and corns.
- Foot examination: The doctor will assess your feet for any abnormalities, such as toe deformities or poor bone alignment, which can increase the risk of calluses and corns. This examination helps determine if foot abnormalities are contributing to their formation.
- Dermoscopic examination: In some cases, a dermoscopic examination may be performed to differentiate between plantar warts, corns, and calluses. This procedure involves shaving down the thickened skin and looking for specific features like tiny blood vessels or the absence of normal skin ridges.
The diagnosis of calluses and corns is primarily based on visual observation and medical history. However, if there are concerns about an underlying medical condition or complications, further tests or imaging studies may be recommended by your healthcare provider. It is important to consult with your doctor for a personalized assessment and appropriate management plan.
The goals of treatment for calluses and corns are to alleviate pain and discomfort, reduce pressure on the affected areas, and prevent further development or recurrence. Here are the recommended treatments and how they work to achieve these goals:
Home treatment:
- Over-the-counter (OTC) treatments: These include corn plasters and callus pads that help relieve pressure and soothe pain.
- Soaking: Soaking the affected area in warm water for 20 minutes can soften the skin, making it easier to remove with gentle rubbing or a pumice stone.
- Topical remedies: Apple cider vinegar and tea tree oil soaks can also help soften the skin.
- Health behavior changes: Identifying and addressing the cause of calluses or corns, such as tight footwear, can prevent further development.
Medical intervention:
- Podiatrist or orthopedic surgeon referral: In severe cases or when home treatments are ineffective, a specialist may be consulted for further evaluation and treatment.
- Surgical removal: In very rare cases, surgery may be recommended to remove persistent calluses or corns that cause significant pain.
It's important to note that specific medication types are not mentioned in the provided documents. Always consult with a healthcare professional for personalized advice on medication options and dosing.