Corns and calluses

Corns and calluses are areas of tough, thickened, dead skin. Corns form on the tops of the toe joints, between the toes and, less commonly, on the soles of the feet. Calluses can form anywhere on your body, but they generally appear on the palms, fingertips and soles of the feet. Corns are typically smaller than calluses, often less than ¼ inch in diameter.


Causes/associated factors
Corns and calluses are caused by frequent pressure or recurring friction on the skin. Your body responds by protecting the tissue through thickening the skin in that area.
Poorly fitting shoes are often the cause of corns or calluses on the feet. Calluses on the hands are often caused by repetitive activities, such as shoveling or playing a stringed instrument. Construction work, farming and other hand-intensive occupations can have the same effect. Othopedic deformities, such as bone spurs, can also cause corns or calluses to develop.


Signs/symptoms
You'll notice tough areas of skin and, when pressed, tenderness or pain at the site. A "soft" corn appears as a whitish thickening between your toes, often between the fourth and fifth toes. A "hard" corn is cone-shaped and frequently develops on the top of the toe or the bottom of the foot. You'll notice normal skin lines throughout a corn or callus.

Diagnosis
The doctor will ask questions about your medical history and do a physical exam. Your footwear and gait may be evaluated. An accurate diagnosis is usually easily made, but in some cases an X-ray may be done to check for physical deformities or identify bony growths in your feet.

Treatment
Corns and calluses generally resolve within a few weeks after the source of pressure is removed or altered. Try wearing well-fitting shoes made of soft leather. Make sure there's plenty of room near your longest toe and the top of your foot.
You can also gradually thin some of the thickened skin by rubbing it with a towel after taking a shower or bath. The alkalinity of the soap combined with water will soften your skin so that you can gently rub off the upper layer of the corn or callus. You may want to use a pumice stone as a mild abrasive during and after bathing. Sometimes a plain over-the-counter corn or callus pad can help prevent the growth from returning.

If you have diabetes or poor circulation, consult your doctor about any type of sore on your foot. You can prevent complications if you seek medical care promptly. It's especially important to seek care if the area around the corn or callus appears red, puffy or infected.

If these treatment measures aren't effective, your doctor may suggest a prescription or over-the-counter solution, cream or ointment to help dissolve the area. In some cases, your doctor may need to trim the area with a scalpel or even surgically remove the corn or callus.


Complications
If a corn or callus becomes blistered or appears red, puffy or cracked, there's a chance of infection. If the corn or callus causes severe pain, you may compensate by changing the way you walk. In turn, this may result in back, hip, knee or ankle pain. If you have diabetes or circulatory problems, it's especially important to work with your doctor to prevent complications.

Pregnancy-specific information
Pregnancy can change your center of gravity and cause the bones of your feet to shift. Your feet may become swollen as well. All of these factors can change pressure points in your feet and lead to corns or calluses. If your shoes become too small, be sure to buy new shoes that fit properly.

Senior-specific information
Older adults are more likely to experience foot changes due to aging-related changes, as well as conditions that may hinder the healing process. If you have a circulatory disorder or diabetes, consult your doctor before attempting to remove any corns or calluses. If you notice any unusual skin developments, consult your doctor right away.

Prevention
To prevent corns and calluses, consider the following suggestions.
Wear gloves when using hand tools.

Soften and moisturize skin that appears to be hardening.

Don't wear tight shoes or footwear with pointed toes or high heels.

Place a cushion in shoes where there might be a pressure point. If a foot deformity causes friction or pressure, ask your doctor about an orthotic shoe pad (a specially made shoe insert designed to decrease stress on your lower leg).
If you have diabetes or circulatory problems, it's important to inspect your skin regularly and consult your doctor at the first sign of a sore or infection.