Excessive pressure on the skin may cause a thickening of the outer layer which presents as corns or callouses. A callous is a diffuse area of thickened skin, whereas a corn is more localized and conical in shape. Both are common overlying bone prominences of the feet or between the toes where pressure in high. Excessively perspiration or moisture can lead to ‘soft corns’.
Skin lesions on the feet or toes that cause pain with direct pressure may be to a corn or a callous.
Factors that contribute to increased pressure causing the skin to thicken include:
• Abnormal foot anatomy such as claw toes, hammer toes and bunions
• Footwear that is too small or too tight
• High heeled shoes
• Abnormal gait and foot posture
Corns and Callous treatment involves lightly and painlessly debriding the circumscribed corns and diffuse area of callous with a scalpel.
Treatment is then aimed at offloading the area to reduce pressure and prevent the corn or callous growing back.
Footwear must be well fitted with enough room for the toes to ‘wiggle’.
Podiatrists may use:
• Padding to offload boney prominences
• Protective digital coverings
• Silver nitrate which is corrosive and destroys skin cells
• Orthotics for long-term pressure relief