Corns and Calluses Health Article

Definition

A corn is a small, painful, raised bump on the outer skin layer. A callus is a rough, thickened patch of skin.

Description

Corns and calluses are one of the three major foot problems in the United States. The other two are foot infections and toenail problems. Corns and calluses affect about 5% of the population.

Corns usually appear on non-weight-bearing areas like the outside of the little toe or the tops of other toes. Women have corns more often than men, probably because women wear high-heeled shoes and other shoes that do not fit properly. Corns have hard cores shaped like inverted pyramids. Sharp pain occurs whenever downward pressure is applied, and a dull ache may be felt at other times.

Calluses occur most often on the heels and balls of the feet, the knees, and the palms of the hands. However, they can develop on any part of the body that is subject to repeated pressure or irritation. Calluses are usually more than an inch wide—larger than corns. They generally don't hurt unless pressure is applied.

Types of corns

A hard corn is a compact lump with a thick core. Hard corns usually form on the tops of the toes, on the outside of the little toe, or on the sole of the foot.

A soft corn is a small, inflamed patch of skin with a smooth center. Soft corns usually appear between the toes.

A seed corn is the least common type of corn. Occurring only on the heel or ball of the foot, a seed corn consists of a circle of stiff skin surrounding a plug of cholesterol.

Types of calluses

A plantar callus, a callus that occurs on the sole of the foot, has a white center. Hereditary calluses develop where there is no apparent friction, run in families, and occur most often in children.

Causes and symptoms

Corns and calluses form to prevent injury to skin that is repeatedly pinched, rubbed, or irritated. The most common causes are:

• shoes that are too tight or too loose, or have very high heels
• tight socks or stockings
• deformed toes
• walking down a long hill, or standing or walking on a hard surface for a long time

Jobs or hobbies that cause steady or recurring pressure on the same spot can also cause calluses.

Symptoms include hard growths on the skin in response to direct pressure. Corns may be extremely sore and surrounded by inflamed, swollen skin.

Diagnosis

Corns can be recognized on sight. A family physician or podiatrist may scrape skin off what seems to be a callus, but may actually be a wart. If the lesion is a wart, it will bleed. A callus will not bleed, but will reveal another layer of dead skin.

Treatment

Corns and calluses do not usually require medical attention unless the person who has them has diabetes mellitus, poor circulation, or other problems that make self-care difficult.

Treatment should begin as soon as an abnormality appears. The first step is to identify and eliminate the source of pressure. Placing moleskin pads over corns can relieve pressure, and large wads of cotton, lamb's wool, or moleskin can cushion calluses.

Using hydrocortisone creams or soaking feet in a solution of Epsom salts and very warm water for at least five minutes a day before rubbing the area with a pumice stone will remove part or all of some calluses. Rubbing corns just makes them hurt more.

Applying petroleum jelly or lanolin-enriched hand lotion helps keep skin soft, but corn-removing ointments that contain acid can damage healthy skin. They should never be used by pregnant women or by people who are diabetic or who have poor circulation.

It is important to see a doctor if the skin of a corn or callus is cut, because it may become infected. If a corn discharges pus or clear fluid, it is infected. A family physician, podiatrist, or orthopedist may:

• remove (debride) affected layers of skin
• prescribe oral antibiotics to eliminate infection
• drain pus from infected corns
• inject cortisone into the affected area to decrease pain or inflammation
• perform surgery to correct toe deformities or remove bits of bone