Whether on the fingertips of a guitar player or the palms of a gardener, skin gets thicker and stronger under pressure. A buildup of skin may be a blessing when you're playing chords or pulling weeds, but it can be a major nuisance on your feet.

Corns and calluses are extra-thick pieces of skin that form as a defense against friction or pressure on the feet. Corns come in two major varieties, hard and soft. Hard corns are solid, tough bumps that most often form on the tops of toes or on the side of the small toe. Soft corns grow between the toes, where they soak up sweat and become rubbery. Both hard corns and soft corns can be painful when pressed or rubbed, but soft corns are especially excruciating.

Calluses are rough, thick patches that can form wherever the foot supports weight, especially under the toes and on the ball of the foot. Some calluses don't hurt at all, but others can be quite painful.

Corns and calluses are caused by unusual pressure and friction on your feet. Often, the problem starts with your footwear. Tight shoes or socks that cramp the toes are a major source of corns, and high-heeled shoes put so much pressure on the balls of the feet that calluses are almost inevitable. You can also get corns if your shoes are so loose that your feet slide forward with every step.

Footwear isn't always to blame. Corns and calluses can form if you're overweight, your foot pronates (leans to one side) when you walk, your toes are crooked (hammer toe or claw toe), your feet are flat or highly arched, or your foot bones are oddly shaped.

You can ease the pain of a soft corn by putting a bit of lamb's wool between your toes. For hard corns and calluses, try soaking your foot in warm water for about 20 minutes. Once the skin softens, gently rub the problem area with a pumice stone or an emery board to remove some of the dead skin. You may need to do this several times. You can also protect the corn or callus with nonmedicated pads or moleskin.

The corn-removing solutions sold in drug stores may be tempting, but you're better off without them. The harsh chemicals often eat away at healthy skin, causing even more pain and raising the risk of infection.

People with diabetes or other conditions that cause poor blood circulation to the feet need to take special care with corns and calluses. Without proper treatment, these sores can become badly infected. All too often, the infected foot has to be amputated. If you have diabetes, inspect your feet daily and call your doctor at the first sign of a corn or callus. For more information on foot care for people with diabetes, see diabetes and foot care.

If self-help measures aren't enough to bring relief, you should see your family doctor or a foot specialist. Don't delay if you see signs of infection such as redness or swelling or if you have diabetes or other circulation problems.

Doctors can quickly remove corns and calluses with a scalpel and using a local anesthetic if necessary. Once the corn or callus is removed, you can help prevent future problems by trimming the spot with a pumice stone (available at your local pharmacy) or emery board at least once a week.

Corns and calluses will keep coming back until you relieve the pressure on your feet. For most people, prevention should start at the shoe store. Here are some tips for finding the right shoes:

•Make sure your toes have enough wiggle room in the width and length of your shoes. There should be at least one-half inch of space between your longest toe (probably your second toe) and the tip of the shoe. Your shoes should not pinch your toes at the sides.

•Choose shoes with flat heels, solid arch support, and soft, breathable uppers.

•Even if you think you know your size, have a shoe salesman check the fit of your shoe.

•Don't try to squeeze extra mileage out of your shoes. Once the heels or soles start to wear out, it's time to get a new pair.

If your feet or toes are shaped in an unusual way or if your feet pronate when you walk, the best shoes in the world may not be able to prevent corns and calluses. Your doctor may recommend special shoe inserts called orthotics to relieve the pressure on your feet (sometimes these can be purchased cheaply over the counter, but sometimes they need to be custom made). If all else fails, you may need surgery to straighten your toes or correct other deformities.

-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was a staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

References

First published June 26, 2002
Last updated December 21, 2007
Copyright © 2002 Consumer Health Interactive

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