Managing Corns and Calluses

Corns and calluses can be painful and frustrating problems in the foot. Imagine having a rock in your shoe that you can’t kick out from under your foot.  It just stays there so that everytime you walk in feels like it burrows deeper and deeper into your skin.  That’s what a corn feels like.

A callus is a thickening of the skin that happens in an area that is experiencing pressure.  The skin reacts to the pressure by becoming thicker.  Sometimes the skin gets so thick that the dead portions (the part of the skin closest to the surface is essentially dead skin cells waiting to flake off) begin to break down and crack.  A corn is when the calluses, because of the constant pressure of weight or pinching of the skin between two bones, grow into the skin, pushing the normal skin away.  This makes things worse, because the normal skin is the fat that cushions bones and the skin.  It can put so much pressure on the skin that sores (ulcers) and infection and damage the underlying structures.

Calluses and corns are easy to treat.

1. If you have nerve damage due to diabetes or another medical problem or have flexibility or vision problems that make working on your feet difficult, the safest thing to do is have them managed by your physician, podiatrist, or nurse foot care specialist.  If there is any drainage or bleeding from them, they should be evaluated.

2. If they are not painful and you have normal sensation, leave them alone.

3. Corns in between your toes are caused by the bones pressing against one another.  Wear shoes with a loose fitting toe box.  A spacer placed in between the toes can also be helpful, but choose one that does not press against the corn itself.  Remove any soft skin with a wash cloth.  Allow any hard skin to flake off naturally.

A planer type of callus remover.

A planer type of callus remover.

4.  Corns beneath the ball of the foot should be gradually shaved off.   A pumice stone or other appliance can be used to abrade and rub off the skin as it loosens up.  This is easiest after a shower when the foot is moist.  Sharp safety scrapers that work much like a planer that you use to remove thin shavings from a door, can be used to decrease the thickness of the callus.  They should be sharp and must be used in a careful gradual way. When passing this appliance over the callus, it is important not to press into the skin.  A gentle sweeping motion with minimal pressure should remove the lesion safely and gradually, in thin slices.  Usually, the stiffness of the callus will be cut preferentially to the soft pliable normal skin.   If the surrounding skin becomes soft and pink, you’re getting about as deep as you want to get.

5. The pressure can be relieved beneath the metatarsal head by wearing a shoe with a firmer sole (how can I tell whether my shoe is stiff?).  Using a insole with a metatarsal pad can also give relief.  Adhesive silicone or felt doughs can be placed around the area to decrease direct pressure on this.  These cost about $4.00 for 18 but will need to be replaced every a day or two.

6. I do not recommend topical medication or wart preparations.  Most of these contain salicylic acid and can damage the surrounding normal skin.  At most, they soften the skin so that it can be removed with a pumice stone.  It will not get rid of a corn.  This can only be accomplished by progressive thinning of the lesion beneath the bony prominence.  Even when you get rid of it, it may come back unless you keep at it.

These simple and easy to use products can be obtained at any drugstore or grocery store and are often effective at eliminating the corn, even permanently.  However, the same pressure that formed it can make it come back so persistent treatment may be necessary.  If it is possible it is something other than a corn or callus, it is recommended that you seek professional medical advice as soon as possible.