Calluses and corns
are areas of thick, hardened, dead skin. They form to protect the skin and
structures under the skin from pressure, friction, and injury. They may appear
grayish or yellowish, be less sensitive to the touch than surrounding skin, and
feel bumpy. Calluses on the hands and feet of an active person are normal.
Calluses and corns become a problem when they grow
large enough to cause pain.
Calluses generally form on the hands or feet,
although they may form wherever there is pressure on the skin, such as on the
knees or elbows.
Calluses on the hands generally form at
the base of the fingers. They usually are not painful and may be useful. For
example, a carpenter might develop calluses that protect his or her hands from
scrapes and cuts while working. A tennis player might develop calluses on the
palm that protect his or her hand from the pressure and friction of handling a
tennis racket.
Calluses on the feet generally form on the ball of
the foot, the heel, and the underside of the big toe. They often form where the
foot and the beginning of the toe meet (under the end of the
metatarsal bone).
Corns generally are found where toes rub
together. Corns have an inner core that can be soft or hard. A soft corn is
found between toes (usually the fourth and fifth toes). A hard corn is
often found over a bony part of a toe (usually the fifth toe).
Calluses and
corns are caused over a period of time by repeated pressure or friction on an
area of skin. The pressure causes the skin to die and form a hard, protective
surface. A soft corn is formed in the same way, except that when perspiration
is trapped where the corn develops, the hard core softens. This generally
occurs between toes. Calluses and corns are not caused by a virus and are not
contagious.
Repeated handling of an object that puts pressure on
the hand, such as tools (gardening hoe or hammer) or sports equipment (tennis
racket), typically causes calluses on the hands.
Calluses and
corns on the feet are often caused by pressure from footwear.
Tight shoes squeeze the
foot.
High-heeled shoes squeeze the front part of the
foot.
Loose shoes may cause your foot to slide and rub against the
shoe.
Shoes with a thin sole can create more pressure on the ball
of the foot when walking than do thicker-soled shoes.
Wearing
sandals and shoes without socks can lead to increased friction.
The
foot may rub against a seam or stitch inside the shoe.
Socks that
don't fit may result in pressure where a sock bunches up.
Walking barefoot also causes calluses.
Calluses and corns often form on the bumps caused by
rheumatoid arthritis or on
bunions or
hammer, claw, or mallet toes. Calluses and corns on
the feet may also be caused by repeated pressure due to sports (such as a
callus on the bottom of a runner's foot), an odd way of walking (abnormal
gait), or a bone structure, such as flat feet or bone spurs (small,
bony growths that form along joints).
What are the symptoms?
You can tell you have a
corn or callus by the way it looks. A callus is hard, dry, and thick, and it may
appear grayish or yellowish. It may be less sensitive to the touch than
surrounding skin, and it may feel bumpy. A hard corn is also firm and thick. It
may have a soft yellow ring with a gray center. A soft corn looks like an open
sore.
Calluses and corns often are not painful, but they can
cause pain when you are walking or wearing shoes. And they may make it hard for
your feet to fit in your shoes. Any type of pressure applied to the callus or
corn, such as squeezing it, can also cause pain.
How are calluses and corns diagnosed?
Calluses and
corns generally are diagnosed during a physical exam. Your doctor may also ask
you questions about your work, your hobbies, or the types of shoes you wear. An
X-ray of the foot may be done if your doctor suspects
a problem with the bones.
Calluses and corns do not need
treatment unless they cause pain. If they do cause pain, the treatment goal is
to remove the pressure or friction that is causing the callus or corn, to give
it time to heal. This is done by wearing footwear that fits properly and using
doughnut-shaped pads (such as
moleskin) or other
protective padding to cushion the callus or corn. Some other types of padding
include toe separators,
toe crest pads, and
toe caps and toe sleeves. Also, the callus or corn can be softened and the dead
skin can be removed by using products such as salicylic acid.
Your
doctor may use a small knife to pare (trim) the callus or corn. You may reduce
the size of the callus or corn yourself by soaking your foot in warm water and
then using a pumice stone to rub the dead skin away. Never cut the corn or
callus yourself, especially if you have diabetes or other conditions that cause
circulatory problems or numbness. In some cases, surgery may be done to remove
the callus or corn or to change the bone structure beneath the callus or corn.
How common are calluses and corns?
Most people get
calluses and corns. They are seen more frequently in people who have bony feet and
in women, probably because women often wear shoes that create friction on the
feet, such as high-heeled or thin-soled shoes.
You can tell you have a callus or corn by the way it looks. A callus is hard, dry, and thick and may appear grayish or
yellowish. It may be less sensitive to your touch than surrounding skin, and it
may feel bumpy. A hard corn is also firm and thick. It may have a soft yellow
ring with a gray center. A soft corn looks like an open sore.
Calluses and corns often are not painful, but they can cause pain
while you are walking or wearing shoes, and they may make it hard for your feet
to fit in your shoes. Pressing or squeezing the callus or corn may also cause
pain.
A callus or corn may be confused with a
wart. Warts are generally tender and painful when
pinched side to side, whereas calluses and corns can be painful when pressing
directly on them. See pictures of
types of warts similar to calluses and corns. For more information, see the topic
Warts and Plantar Warts.
Other conditions
that can look like a callus or a corn include:
Calluses and corns generally are diagnosed during a physical exam. If the calluses or
corns are on your feet, you will be asked to take off your shoes and socks so
your feet can be examined. If you have calluses on another part of your body,
such as your knee or elbow, your doctor will look at those areas also.
Your doctor may also ask you about your work,
hobbies, or shoes. If your doctor suspects a problem with the bones of the
foot, he or she might do an
X-ray of your foot.
If a callus or corn
is not located over a bony part of the foot or a pressure point is not obvious,
your doctor may look for another cause, such as
skin cancer, or may try to find a
genetic cause.
Calluses or corns usually do not need treatment unless they cause pain. If they do
cause pain, the treatment goal is to remove the pressure or friction that is
causing the callus or corn, to give it time to heal. Initial treatment
generally involves things you can do at home. These include carefully choosing
your footwear, using a pumice stone, and using over-the-counter (nonprescription) salicylic acid products.
Depending on the location of the
callus or corn and on other conditions that you may have, such as diabetes, you
have several treatment options. You can:
Have your doctor pare (trim) the callus or
corn with a small knife. Your doctor can do this in his or her
office.
Reduce the size of the callus or corn yourself by soaking
your callus or corn in warm water and then
using a pumice stone to lightly wear away the dead skin. Never cut the corn or
callus yourself, especially if you have diabetes or other conditions that cause
circulatory problems or numbness.
Wear shoes that fit well and are
roomy, with wide and deep toe boxes (the area that
surrounds the toes). A wider toe box keeps the toes from pressing against each
other, relieving pressure on soft corns. A deeper toe box keeps the toes from
pressing against the top of the shoe, relieving pressure on hard corns. Thicker
soles can help relieve pressure on calluses when you are walking. For more
information, see:
Use
protective padding such as
moleskin or
orthotic shoe inserts to cushion the callus or corn or
to hold the foot and toes in a more comfortable position to prevent rubbing.
Your doctor can help you position padding on your feet or in your shoes.
Use
salicylic acid to soften the callus or corn. You can
then rub the callus or corn off with a pumice stone. Some doctors advise
against using salicylic acid because it can damage surrounding skin. If you use
salicylic acid, be sure to apply it only to the callus or corn and not to the
surrounding skin.
Use metatarsal bar inserts for your shoes, to
distribute your weight more evenly over the ball of your foot. Athletes who run
a lot may wear orthotic shoe inserts for the same purpose.
Surgery
Surgery is rarely used to treat calluses
or corns.1 But if a bone structure (such
as a
hammer toe or
bunion) is causing a callus or corn, surgery can be
used to change or remove the bone structure. This is used only if other
treatment has failed. If treatment for soft corns does not work, the skin
between the bases of the two toes can be sewn together (syndactylization). This
creates a partial webbing where the soft corn had been. Another corn cannot
form over this webbing.
Complications
Untreated calluses and corns can
cause:
Pain while you are walking or wearing shoes.
A
change in posture or walking style to avoid pain.
Inflammation of
the fluid between the skin and the bone (bursitis).
If you have
diabetes, you are more likely to get sores on your
feet. In one study of more than 200 diabetic foot sores, people who had
calluses and corns pared frequently by a doctor had fewer foot sores, fewer
visits to the hospital, and fewer surgeries because of the sores.2
What To Think About
Be careful when you use a pumice
stone to reduce the size of a callus or corn. If you take off too much skin and
go too deep, the area may bleed or become infected.
Some corn pads
contain medicine inside the pad. This often softens the corn too much and
causes infection. It is best to avoid this type of pad.
If a corn
or callus on your foot is painful and does not go away, you may want to see a
doctor who specializes in foot problems (podiatrist).
The initial treatment for
calluses and corns usually is self-treatment at home.
This includes carefully choosing your footwear, using a pumice stone, and using
over-the-counter (nonprescription) salicylic acid
products.
Reduce the size of a callus or corn by soaking
your foot in warm water and then
using a pumice stone to lightly wear away the dead skin. Never cut the corn or
callus yourself, especially if you have diabetes or other conditions that cause
circulatory problems or numbness.
Wear shoes that fit well and are
roomy, with wide and deep toe boxes (the area that
surrounds the toes). A wider toe box relieves pressure on soft corns by keeping
the toes from pressing against each other. A deeper toe box relieves pressure
on hard corns by keeping the toes from pressing against the top of the shoe.
Thicker soles can help relieve pressure on calluses when you are walking. For
more information, see:
Use
protective padding, such as
moleskin or
orthotic shoe inserts, to cushion the toe or hold the
foot and toes in a more comfortable position. Your doctor can help you position
the pads on your feet or in your shoes.
Use
salicylic acid to soften calluses or corns. You can
then rub them off with a pumice stone. Some doctors advise against using
salicylic acid because it can damage surrounding skin. If you use salicylic
acid, be sure to apply it only to the callus or corn and not to the surrounding
skin.
Take care of your feet. Wash them regularly, and use lotion
to keep them from drying out. Dry skin makes it easier for a callus to crack
and bleed.
Prevention
Calluses and corns can be prevented by
reducing or eliminating pressure on the skin.
Wear roomy shoes that fit
well.
Wear socks that fit. Loose socks can bunch up and cause
pressure.
Wear gloves while using a tool such as a garden spade or
rake. If you expose other parts of your body to friction, wear appropriate
padding. For example, if you are on your knees laying carpet, wear knee
pads.
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
Web site contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
American College of Foot and Ankle Orthopedics and
Medicine
5272 River Road
Suite 630
Bethesda, MD 20816
Phone:
1-800-265-8263 toll-free (301) 718-6505
Fax:
(301) 656-0989
E-mail:
info@acfaom.org
Web Address:
www.acfaom.org
The American College of Foot and Ankle Orthopedics and Medicine is
affiliated with the American Podiatric Medical Association. Its Web site
contains information on the foot, foot conditions, and foot care and a search
feature to help you locate a podiatrist.
American Orthopaedic Foot and Ankle
Society
6300 North River Road
Suite 510
Rosemont, IL 60018
Phone:
1-800-235-4855 (847) 698-4654
Fax:
(847) 692-3315
E-mail:
aofasinfo@aofas.org
Web Address:
www.aofas.org
The American Orthopaedic Foot and Ankle Society (AOFAS) provides
information on a variety of topics, including foot care for adults, children,
and people with diabetes; proper shoe fit; and how to select children's shoes
and sports shoes. Some information is available in several languages besides
English.
American Podiatric Medical
Association
9312 Old Georgetown Road
Bethesda, MD 20814-1621
Phone:
1-800-FOOTCARE (1-800-366-8227) (301) 571-9200
Fax:
(301) 530-2752
E-mail:
info@apma.org
Web Address:
www.apma.org
The American Podiatric Medical Association (APMA)
provides information about foot and ankle injuries, sports-related foot
concerns, surgical and nonsurgical treatment of foot problems, special medical
issues such as diabetes, and resources in your local area. Some information is
available in Spanish.
Lebowitz BS (2007). Common problems of the feet. In LR
Barker et al., eds., Principles of Ambulatory Medicine,
7th ed., pp. 457–465. Philadelphia: Lippincott Williams and
Wilkins.
DeLauro TM (2003). Corns and calluses. In IM Freedberg
et al., eds., Fitzpatricks's Dermatology in General Medicine, vol. 1, pp. 1247–1249. New York: McGraw-Hill.
Other Works Consulted
Frey C, et al., eds. (2005). Corns and calluses
section of Foot and ankle. In LY Griffin, ed., Essentials of Musculoskeletal Care, 3rd ed., pp. 610–613. Rosemont, IL: American
Academy of Orthopaedic Surgeons.
Mann JA, et al. (2006). Deformities of the lesser toes
section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 475–480. New York:
McGraw-Hill.
Mann JA, et al. (2006). Keratotic disorders of the
plantar skin section of Foot and ankle surgery. In HB Skinner, ed.,
Current Diagnosis and Treatment in Orthopedics, 4th ed.,
pp. 484–486. New York: McGraw-Hill.
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