Corns & Callous

Corns are hyperkeratoses of the skin. This a thickening of the surface layer of the skin in response to repetitive trauma or pressure.

Corns usually form on the toes, where the bone is prominent and presses the skin against the shoe, ground, or other bones.

As a corn thickens, the tissues under the corn are subject to increased irritation. There may be a deep-seated core or nucleus where the corn is thickest and most painful.

As corns become inflamed, there is pain and sometimes swelling and redness.

Common places where corns form are: The top surface of the toe, at the tip of the toe, and between the toes.

Callous or thickening of the skin forms where there is a general increase in pressure but no specific focal point.
Corns form at pressure ‘hot spots’ and contain ‘glass’ like centers and are associated with structural changes within the toe as shown above

Symptoms
A hard growth on the skin of the toes

• Pain on direct pressure against the corn
• Sometimes redness and swelling around the corn, with severe discomfort
• Increased discomfort in tight fitting shoes
• More common in women than men

Causes

• Tight-fitting shoes
• Deformed and crooked toes
• Tight socks and stockings
• Seam or stitch inside the shoe which rubs against the toe
• Sometimes shoes which are too loose, can cause the foot to slide forward with each step causing callous
• Prolonged walking on a downward slope

What you can do

• Avoid shoes which are to tight or too loose
• Buy shoes with an extra depth toe box (the part of the shoe over the toes)
• Do not apply socks or stockings tightly around the toes
• Use a pumice stone or other abrasive to reduce the thickness of the corn
• Apply non-medicated pads around the corn to relieve pressure

What the Podiatrist may do

• Carefully debride (pare down) the corn and any deep seated core it may have. It should be stressed that this provides only temporary relief, if the pressure continues after treatment.
• Apply various pads and devices to the toes to relieve pressure.
• Recommend appropriate shoes.
• Surgically straighten crooked or deformed toes, or remove bony prominences.

Complications that can result from corns

• Development of a bursitis - the formation of a painful inflamed fluid-filled sac beneath the corn
• Infection
• Development of an ulcer which is an open area that forms within the corn. In severe cases the ulcer may even extend down to bone.
• Because of the serious consequences of infection, diabetics and those with diminished circulation should always seek professional help.

Other conditions which can resemble corns

• Verruca (warts)
• Various tumors of the skin and subcutaneous (below the skin) tissues
• Reaction to a foreign body (ie. splinter or animal hair)