Corns and Calluses
Corns and Calluses
Definition
A corn is a small, painful, raised bump on the outer skin layer. A callus is a rough, thickened patch of skin.
Description
Corns and calluses are one of the three major foot problems in the United States. The other two are foot infections and toenail problems. Corns and calluses affect about 5% of the population.
Corns usually appear on non-weight-bearing areas like the outside of the little toe or the tops of other toes. Women have corns more often than men, probably because women wear high-heeled shoes and other shoes that do not fit properly. Corns have hard cores shaped like inverted pyramids. Sharp pain occurs whenever downward pressure is applied, and a dull ache may be felt at other times.
Calluses occur most often on the heels and balls of the feet, the knees, and the palms of the hands. However, they can develop on any part of the body that is subject to repeated pressure or irritation. Calluses are usually more than an inch wide-larger than corns. They generally don't hurt unless pressure is applied.
Types of corns
A hard corn is a compact lump with a thick core. Hard corns usually form on the tops of the toes, on the outside of the little toe, or on the sole of the foot.
A soft corn is a small, inflamed patch of skin with a smooth center. Soft corns usually appear between the toes.
A seed corn is the least common type of corn. Occurring only on the heel or ball of the foot, a seed corn consists of a circle of stiff skin surrounding a plug of cholesterol.
Types of calluses
A plantar callus, a callus that occurs on the sole of the foot, has a white center. Hereditary calluses develop where there is no apparent friction, run in families, and occur most often in children.
Causes and symptoms
Corns and calluses form to prevent injury to skin that is repeatedly pinched, rubbed, or irritated. The most common causes are:
- shoes that are too tight or too loose, or have very high heels
- tight socks or stockings
- deformed toes
- walking down a long hill, or standing or walking on a hard surface for a long time
Jobs or hobbies that cause steady or recurring pressure on the same spot can also cause calluses.
Symptoms include hard growths on the skin in response to direct pressure. Corns may be extremely sore and surrounded by inflamed, swollen skin.
Diagnosis
Corns can be recognized on sight. A family physician or podiatrist may scrape skin off what seems to be a callus, but may actually be a wart. If the lesion is a wart, it will bleed. A callus will not bleed, but will reveal another layer of dead skin.
Treatment
Corns and calluses do not usually require medical attention unless the person who has them has diabetes mellitus, poor circulation, or other problems that make self-care difficult.
Treatment should begin as soon as an abnormality appears. The first step is to identify and eliminate the source of pressure. Placing moleskin pads over corns can relieve pressure, and large wads of cotton, lamb's wool, or moleskin can cushion calluses.
Using hydrocortisone creams or soaking feet in a solution of Epsom salts and very warm water for at least five minutes a day before rubbing the area with a pumice stone will remove part or all of some calluses. Rubbing corns just makes them hurt more.
Applying petroleum jelly or lanolin-enriched hand lotion helps keep skin soft, but corn-removing ointments that contain acid can damage healthy skin. They should never be used by pregnant women or by people who are diabetic or who have poor circulation.
It is important to see a doctor if the skin of a corn or callus is cut, because it may become infected. If a corn discharges pus or clear fluid, it is infected. A family physician, podiatrist, or orthopedist may:
- remove (debride) affected layers of skin
- prescribe oral antibiotics to eliminate infection
- drain pus from infected corns
- inject cortisone into the affected area to decrease pain or inflammation
- perform surgery to correct toe deformities or remove bits of bone
Alternative treatment
Standing and walking correctly can sometimes eliminate excess foot pressure. Several types of bodywork can help correct body imbalances. Bodywork is a term used for any of a number of systems, including Aston-Patterning, the Feldenkrais method, and rolfing, that manipulate the body through massage, movement education, or meditational techniques.
Aloe (Aloe barbadensis ) cream is an effective skin softener, and two or three daily applications of calendula (Calendula officinalis ) salve can soften skin and prevent inflammation. One teaspoon of lemon juice mixed with one teaspoon of dried chamomile (Martricaria recutita ) tea and one crushed garlic clove dissolves thickened skin.
An ayurvedic practitioner may recommend the following treatment:
- apply each day a paste made by combining one teaspoon of aloe vera gel with half that amount of turmeric (Circuma longa )
- bandage overnight
- soak in warm water for 10 minutes every morning
- massage gently with mustard (Brassica cruciferae ) oil
Prognosis
Most corns and calluses disappear about three weeks after the pressure that caused them is eliminated. They are apt to recur if the pressure returns.
Extreme pain can change the way a person stands or walks. Such changes can, in turn, cause pain in the ankle, back, hip, or knee.
Bursitis, a painful, inflamed fluid-filled sac, can develop beneath a corn. An ulcer or broken area within a corn can reach to the bone. Infection can have serious consequences for people who have diabetes or poor circulation.
Prevention
Corns and calluses can usually be prevented by avoiding friction-causing activities and wearing shoes that fit properly, are activity-appropriate, and are kept in good repair. Soles and heels that wear unevenly may indicate a need for corrective footwear or special insoles. Socks and stockings should not cramp the toes. Gloves, kneepads, and other protective gear should also be worn as needed.
Feet should be measured, while standing, whenever buying new shoes. It is best to shop for shoes late in the day, when feet are likely to be swollen. It is also important to buy shoes with toe-wiggling room and to try new shoes on both feet.
Resources
ORGANIZATIONS
American Podiatric Medical Association. 9312 Old Georgetown Road, Bethesda, MD 20814-1698. (301) 571-9200. 〈http://www.apma.org〉.
OTHER
"Foot Disorders." Foot Talk Home Page. 〈http://www.foottalk.com/corns.htm〉.
KEY TERMS
Ayurveda— Ayurveda is a system of wholistic medicine from India that aims to bring the individual into harmony with nature. It provides guidance regarding food and lifestyle, so that healthy people can stay healthy and people with health challenges can improve their health.
Bursitis— Inflammation of a bursa, a fluid-filled cavity or sac. In the body, bursae are located at places where friction might otherwise develop.
Corns and Calluses
Corns and calluses
Definition
A corn is an overgrowth of skin on a bony prominence, usually occurring on the feet and toes. It manifests as a rough and painful bump. A callus is a rough, thickened lump of dead skin that is usually painless. It may be found on the feet, the hands, or anywhere else there is repeated friction and pressure.
Description
Corns and calluses affect about 5% of the population of the United States. Women have corns more often than men, probably due to wearing ill-fitted shoes more often. Although calluses may form anywhere on the body, they are generally found on the heels and balls of the feet, the knees, and the palms of the hands. Calluses are usually larger than corns—they may measure more than an inch (2.5 cm) wide. Calluses usually only hurt if pressure is applied to them.
Causes & symptoms
Corns and calluses form to prevent injury to skin that is repeatedly pinched, rubbed, or irritated. Hereditary calluses may develop where there is no apparent friction. This condition runs in families and occurs most often in children.
The most common causes of the formation of corns and calluses are:
- shoes that have very high heels and shoes that do not fit properly
- tight socks or stockings
- deformities of the toes
- walking or standing on a hard surface for an extended time
- jobs or hobbies that cause steady or recurring pressure on the same spot
Corns may be extremely sore and surrounded by inflamed, swollen skin. A sharp pain will probably occur whenever downward pressure is applied, and a dull ache may be felt at other times.
Diagnosis
Corns can be recognized on sight. They are sometimes mistaken for warts . However, if the lesion is a wart, it will bleed when scraped with a sharp implement. A callus will not bleed, but will shed a layer of dead skin. This can provide the basis of a general diagnosis.
Treatment
Standing and walking correctly can sometimes eliminate excess foot pressure and minimize the development and recurrence of corns and calluses. Bodywork systems such as Aston-Patterning , the Feldenkrais method, and rolfing , may help to correct body imbalances that lead to corns and calluses.
Two or three daily applications of calendula (Calendula officinalis ) salve can soften skin and prevent inflammation. A mixture of one teaspoon of lemon juice, one teaspoon of dried chamomile (Martricaria recutita ), and one crushed garlic clove (Allium sativa ) can be applied directly to dissolve thickened skin.
A recommended Ayurvedic remedy is the nightly application of a paste made by combining one teaspoon of aloe vera gel with one half teaspoon of turmeric (Curcuma longa ). The corn or callus should be covered with the paste and bandaged overnight. It should be soaked in warm water for 10 minutes every morning, and given a daily massage with mustard oil (Brassica cruciferae ).
Allopathic treatment
The attention of a physician may be required if there is numbness, reduced feeling, or severe pain. Occasionally, an orthopedist may have to perform surgery to correct toe deformities or remove bits of bone that may be causing corns or calluses to develop. Medical attention is
not usually required unless diabetes mellitus , poor circulation, or other problems make self-care difficult. The first step in home care of corns and calluses is to identify and eliminate sources of pressure and friction. Doughnut-shaped pads, wads of cotton, lamb's wool, or other kinds of inserts can be used to cushion affected areas. Soaking the feet in a solution of Epsom salts, or using hydrocortisone creams, petroleum jelly, or lanolin lotions can soften calluses. After which, they can be reduced or removed by rubbing the area with a pumice stone. This is not recommended for corns, however, as rubbing just makes them more painful.
It is important to consult with a healthcare provider if there is broken skin because it may become infected. In the case of an infection, affected layers of skin need to be removed, and pus may need to be drained. Oral antibiotics may be given to eliminate the infection. Cortisone may be injected into the affected area to decrease pain or inflammation.
Expected results
Most corns and calluses disappear within three weeks after the pressure that caused them is eliminated. However, if the causes of the condition are not remedied completely, or are allowed to recur, the corns and calluses may return. If there is continual pain associated with corns, it can change the way a person stands or walks. Such changes may eventually cause pain and dysfunction in the ankles, back, hips, or knees.
If a corn develops near a toe joint, bursitis may result, causing severe pain and inflammation. If cracks or other breaks in the skin develop, a staph infection may result. This is especially serious for people who have diabetes or poor circulation, as gangrene may develop from a resistant infection.
Prevention
Corns and calluses can usually be prevented by wearing shoes that fit properly. Feet should be measured, while standing, whenever buying new shoes. It is best to shop for shoes late in the day, when feet are likely to be swollen. It is also important to buy shoes with toe-wiggling room and to try new shoes on both feet. Pointytoed shoes and high heels should be avoided. Worn down or uneven shoe soles and heels should be replaced or repaired. Corrective footwear or special insoles may be necessary. Socks and stockings should also be fitted appropriately at the feet. Gloves, kneepads, and other protective gear should be worn as needed to prevent rubbing and friction, especially when engaging in heavy work or sports activities. Cutting or paring dead skin should be avoided, as it may lead to further injury or infection.
Resources
BOOKS
Editors of Time-Life Books. The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments. Alexandria, VA: Time-Life, 1996.
Gottlieb, Bill, ed. New Choices in Natural Healing. Emmaus, PA: Rodale Press, 1995.
ORGANIZATIONS
American Podiatric Medical Association. 9312 Old Georgetown Road, Bethesda, MD 20814-1698. http://www.apma.org.
Patience Paradox
callus
cal·lus / ˈkaləs/ (also cal·lous) • n. a thickened and hardened part of the skin or soft tissue, esp. in an area that has been subjected to friction. ∎ Med. the bony healing tissue that forms around the ends of broken bone. ∎ Bot. a hard formation of tissue, esp. new tissue formed over a wound.
callus
1. (in botany) A protective tissue, consisting of parenchyma cells, that develops over a cut or damaged plant surface. Callus tissue can also be induced to form in cell cultures by hormone treatment.
2. (in pathology) A thick hard area of skin that commonly forms on the palms of the hands and soles of the feet as a result of continuous pressure or friction.
3. (in physiology) Hard tissue formed round bone ends following a fracture, which is gradually converted to new bone.
callus
1. the composite mass of tissue that forms between bone ends when a fracture is healing. It initially consists of blood clot and granulation tissue, which develops into cartilage and eventually new bone, which unites the fracture.
2. see callosity.