#Corns or Calluses
Calluses and corns are treated the same.
-Prevention: Wear shoes that properly fit. Avoid tight-fitting shoes. Get shoes that are the right size and shape for your feet. Keep toenails trimmed.
-Treatment: File the corn/callus and apply salicylic acid plaster (treatment of choice). Use OTC corn pads or corn cushions e.g. from Dr. Sholls, to protect the corn/callus from further irritation.
-Will consider referring for orthotic consultation to fit inner soles or metatarsal bars if the corn becomes a severe recurrent problem.
-Will consider getting a foot radiograph to evaluate for underlying bony abnormality if lesions are recalcitrant or recurrent.
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Method 1
“A simple method is to debulk the corn using a No. 15 scalpel blade and apply a nonprescription salicylic acid plaster (40%) trimmed to the size of the lesion and left in place for 48 to 72 hours. The area should be kept dry. When the plaster is removed, the white (dead) skin is pared using a pumice stone or metal nail file. The plaster is then replaced every 48 hours for 14 days or until the lesion resolves. Plaster should be avoided in patients with peripheral neuropathy, because they may not feel pain with improper patch placement, and damage to normal skin can result. In patients with diabetes or peripheral vascular disease, if the plaster is left on too long, the acid may erode through the dermal skin layer, causing ulceration that can progress to osteomyelitis.” AAFP, 2010
Method 2
-Soak the corn or callus in warm water for about 5-10 minutes to soften the skin.
-File the corn or callus with a pumice stone or metal nail file. Wet the pumice stone in warm water use gentle circular or sideways motions to remove the white (dead) skin. Be careful not to take off too much skin because that could cause bleeding.
-Apply a salicylic acid (or ammonium lactate or urea) moisturizing lotion or cream (to the area daily to soften hard corns and calluses
-Use padding to prevent corns from making contact with your shoes or calluses from being irritated. (from AAD, 2016)
What are calluses and corns and how do they form?
A corn (or clavus, plural clavi or clavuses) is a distinctively shaped callus. Calluses are a diffuse thickening of the outermost layer of the skin, the stratum corneum, in response to repeated friction or pressure. Corns develop in the same way but differ by having a central “core” that is hyperkeratotic and often painful.
Where do corns typically occur?
Corns usually occur at pressure points 2/2 to ill-fitting shoes, an underlying bony spur, or an abnormal gait. These lesions are typically located on the plantar aspect of prominent metatarsals, between toe clefts, or on the dorsal aspect of toe joints.
How do you distinguish between a wart and a corn?
After paring down the lesion, warts will have several dark specks that represent punctate capillary thromboses. Warts also disrupt normal skin markings so that the skin lines are no longer evident. Skin lines are more prominent in callosities.
Resources:
http://www.aafp.org/test/fpcomp/FP-E_379/pt2-s1-s1.html
https://www.aad.org/public/skin-hair-nails/skin-care/corns-and-calluses
https://www.drscholls.com/productsandbrands/corncushions/