Calluses are areas of thickened of hard skin that are usually across the ball of the foot, on the outer part of the big toe, or on the heel. This is mistakenly considered by many to be a problem with the skin, but it is actually a sign of a bone problem.
Beneath calluses there can be painful fluid-filled balloons called bursal sacs act as shock absorbers, but have clusters of nerves below them that can cause sharp, shooting pains while walking or a dull persistent ache.
The Calluses are formed due to repeated pressure and friction when the shoe or the ground rubs against a bone spur or bony prominence on the foot or toe. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot) that is carrying more than its fair share of the body weight, usually due to it being dropped down or due to its longer length.
Calluses can be treated with over-the-counter callus removers that have strong acids that peel this excess skin away after repeated application. We don't recommend these products as they can cause chemical burns when not used correctly. This is especially dangerous for those people that have diabetes. Begin by soaking your feet in warm soapy water and gently rubbing away any dead skin that loosens. A pumice stone or emery board is then used to “file” this thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can relieve calluses but should be removed carefully to avoid tearing the skin.
If you need assistance relieving calluses, contact our office and schedule an appointment with Dr. Jairo Cruz. Calluses can be trimmed and comfortable padding can be applied to these painful areas. In addition to medication to relieve inflammation, cortisone may be injected into the underlying bursal sac to rapidly reduce pain and swelling.
A plantar callus forms when one metatarsal bone is longer or lower than the others, and it hits the ground first, and with more force, than it is equipped to handle, at every step. As a result, the skin under this bone thickens like a rock in your shoe. Plantar calluses that are recurring are sometimes removed surgically in a procedure called an osteotomy, which relieves pressure on the bone. However, more conservative options are used first such as orthotic devices. Gentle Foot Care Clinic specializes in custom orthotic devices, especially for your foot.
A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a “dropped metatarsal,” which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form. A “dropped metatarsal” can either be an inherited problem, a result of a metatarsal fracture, or a structural change that may have occurred over time.
Corns are calluses that form on the toes because the bones push up against the shoe and put pressure on the skin. These may form on hammertoes. The surface layer of the skin thickens and builds up, irritating the tissues underneath. Hard corns are usually located on the top of the toe or on the side of the small toe. Soft corns resemble open sores and develop between the toes as they rub against each other.
Improperly fitting shoes are a leading cause of corns. Toe deformities, such as hammertoe or claw toe, also can lead to corns. In a visit to our office, your corns can be shaved with a specialized instrument. Self-care includes soaking your feet regularly and using a pumice stone or callus file to soften and reduce the size of the corn. Special over-the-counter non-medicated donut-shaped foam pads also can help relieve the pressure.
At Gentle Foot Care Clinic in Zephyrhills and Brandon, Florida, Jairo Cruz, DPM, specializes in the diagnosis and treatment of corns and calluses. To make an appointment, call the office nearest you or click the online booking tool today.
