One of the protective mechanisms of skin is the thickening of skin layers or the production of a callus or corn. By definition, a callus is thickening of the skin layers with a hard tissue called keratin (or hyperkeratosis). This thickening is usually created by friction or repetitive stress. (Think callus on the finger of a guitar player or callus to hands after working in the yard for several days without gloves.)
Types Of Callus
- Callus: The typical thick skin presenting to skin layers on the side or bottom of the foot and top of toes (such as hammertoes). Although a callus can present on the top of the foot, this is much less common.
- Corns: Identical to a callus where it produces a thickening of the skin, but is usually identified on the surfaces between toes or in the crest of the toes. Callus would still be a correct name for these, but corn is more common.
- Porokeratosis: A unique form of callus often misdiagnosed as a plantar wart. In this hyperkeratosis (thickening of the skin), the callus forms in a sweat gland and forms thickened tissue into a spike or thorn on the foot. These are typically quite painful as they form deep, but are still just a form of callus.
Treatments for callus tissue or hyperkeratosis come in three basic forms: padding, reducing pressure and trimming. In rare situations, removal of the underlying bone or correction of the causative deformity may be necessary. Remember that with all treatments the tissue will return if the causing pressure happens again.
- Padding: There are multiple pads that can be utilized to reduce pressure areas. These can include types of insoles, callus pads, callus cushions, corn pads, metatarsal pads, moleskin (to reduce friction) or even gel tubes. Care should be utilized with many corn pads you find at grocery stores or pharmacies, because they often have an acid to reduce the callus and can injure the surrounding tissues. Utilizing these pads reduce the pressure and reduce progression but will not solve the underlying cause of the callus. Therefore padding is a longterm treatment.
- Reducing Pressure: Some of the padding options above reduce pressure, but other options are splinting of toes or foot to change pressure areas or modifying insoles to reduce pressure areas. This is also a longterm treatment, or callus tissue will recur.
- Trimming: The most common treatment is trimming down the callus. This can be done at home, but is best performed by a physician, since more callus can be removed usually without bleeding. This will give you much longer periods of relief. Use of cheese grater style callus removers at home or some very rough pumice stones are not recommended as additional injury may occur.
If you have callus tissue on your skin, it is worth determining if it is a callus or some other lesion. Visualization by a physican may ease your mind and start the process of continued comfort while walking.