When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker to withstand the pressure from the body onto the floor. When this pressure becomes excessive, some areas of skin thicken in the form of corns and callus, as a protective response to the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground.
Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type. Elderly people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot.
Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core which may cause pain if it presses on a nerve. There are five different types of corns, the most common of which are ‘hard’ and ‘soft’ corns:
These are the most common and appear as a small area of concentrated hard skin up to the size of a small pea usually within a wider area of thickened skin or callus. This may be a symptom of the feet or toes not functioning properly.
These develop in a similar way to hard corns but they are whitish and rubbery in texture and appear between toes where the skin is moist from sweat or from inadequate drying.
These are tiny corns that tend to occur either singly or in clusters on the bottom of the foot and are usually painless.
These can be very painful, bleed easily and have been related to smoking.
These arise when corns have been present for a long time and are more firmly attached to the deeper tissues than any other type of corn. They may also be painful.
There are many causes of pressure that ultimately result in corns and callus, footwear being the main one, ill-fitting shoes that are either too narrow, short or have limited depth will exert pressure. Biomechanical issues (abnormal foot function) will also cause hotspots resulting in both corns and callus. Reduced fatty padding over the metatarsal heads (knuckle joints of the feet) will leave the joints exposed to increased pressure.
Always consult a HCPC registered Podiatrist who will be able to remove corns painlessly, apply padding or insoles to relieve pressure or fit corrective appliances for long-term relief. For callus, a Podiatrist will also be able to remove hard skin, relieve pain and redistribute pressure with soft padding, strapping or corrective appliances/insoles which fit easily into your shoes. The skin should then return to its normal state.
Podiatrists do not recommend using corn plasters, as they contain acids than can burn the healthy skin around the corn and this can lead to serious problems such as infection. Home remedies, like lambswool around toes, are potentially dangerous. Commercially available ‘cures’ should be used only following professional advice.
Emollient creams delay callus building up and help improve the skin’s natural elasticity. A Podiatrist will be able to advise on the most appropriate skin preparations for your needs.
Usually corns and callus present with pain, it is advisable to consult a Podiatrist immediately as corns grow in size and can exert more pressure on the healthy tissue underneath and will ultimately ulcerate the tissues, causing even more pain and possible infection, which is an increased problem for people who are diabetics or have other high risk conditions.