Sometimes there is excessive repetitive pressure put on parts of the foot that is out of balance with other areas. These areas generally around bony prominences or joints. The body will respond to this by creating thicker skin in that area. This is known as callus and are part of the body’s defence system to protect the underlying tissue. If the pressure or friction continues then this new protection can actually become painful. If the pressure becomes concentrated in a small area, a hard corn may develop. Sometimes the pressure of the corn or callus may produce inflammation which can result in acute pain, swelling and redness.
Corns are often misdiagnosed as calluses, which are also hard skin lesions resulting from excess friction. However, calluses develop from forces distributed over a broad area of skin, whereas corns develop from more localized forces. Callus isn’t generally painful whereas corns will generally be painful.
There is a few common types of corns. Hard corns (Heloma durum), soft corns (HelomA molle) and seed corns (Heloma miliare). Hard corns are generally larger and covered with hard skin. They will appear over areas of pressure like bony prominences and joints. Soft corns are generally associated with soft macerated skin due to excessive moisture. These commonly develop in between the toes. Seed corns are a lot smaller in size and appear in clusters. Usually occurring in areas of friction such as the ball of the feet.
Corns are often seen in athletes and in patient populations exposed to uneven friction from footwear skin types or gait abnormalities, including elderly persons, diabetic patients, and amputees. Abnormal foot mechanics, foot deformities, high activity level, and more serious conditions such as peripheral neuropathy also contribute to the formation of corns. Also people who work in occupations that require them to spend a lot of time on their feet are prone to developing corns.
The most important thing to remember about treating calluses and corns is to never do it yourself without seeing a podiatrist first. To treat painful corns, your podiatrist will gently remove some of the hard skin off the callus so that the centre of the corn can be removed. It is often quick and painless. Over the counter remedies such as corn ointments or plasters generally only treat the symptoms not the actual problem and its cause. Also they can easily damage the healthy skin surrounding the corn if not used properly. Over the counter remedies should never be used by people with diabetes.
Treating a corn is important but prevention is the key. Don’t forget these problems are caused by pressure. If you feel you may be developing a callus or corn, or you already have one, the best thing to do is to seek advice and treatment from your podiatrist. Your podiatrist will not only recommend ways to relieve pain and get rid of the corn or callus, but can also help with isolating the cause and preventing reoccurring problems.