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Diseases and Conditions
Corns and calluses
From MayoClinic.com
Special to CNN.com

Introduction

You ask a lot of your hands and feet. You cram your feet into shoes and walk around all day. And you may apply great force to your hands as you work with tools in your job or at home. These actions subject your skin to friction and pressure. Your skin often protects itself by building up corns and calluses — thick, hardened layers of skin.

Although corns and calluses can be unsightly, you need treatment only if they cause discomfort. For most people, eliminating the source of friction or pressure helps corns and calluses disappear. If you have diabetes or another condition that causes poor circulation to your feet, you're at greater risk of complications. Seek your doctor's advice on caring for corns and calluses.

Signs and symptoms

You may have a corn or callus if you notice:

  • A thickened layer of skin
  • Tenderness or pain under your skin
  • Flaky, dry or waxy skin

Corns and calluses are often confused, but they're not the same thing. Corns are smaller than calluses and have a hard center. Corns usually develop on parts of your feet that don't bear weight, such as the tops and sides of your toes. Corns can be painful. Calluses, which may feel rough, are rarely painful and vary in size and shape, but are often more than an inch in diameter. Calluses usually develop on your palms and soles, especially underneath the bottom ends of your foot bones (metatarsals).

Causes

Pressure and friction from repetitive actions cause corns and calluses to develop. Some causes include:

  • Ill-fitting shoes. When shoes are too tight or have heels that are too high, they compress areas of your foot. When they're too loose, your foot may repeatedly slide and rub against the shoe. Your foot may also rub against a poorly placed seam or stitch inside the shoe.
  • Skipping socks. Wearing shoes and sandals without socks can lead to friction on your feet. Socks that don't fit properly also can be a problem.
  • Using hand tools. Calluses on your hands may result from the repeated pressure of using tools on the job, around the house or in the garden.

Risk factors

These factors may increase your risk of corns and calluses:

  • Not protecting your hands. Using hand tools without wearing gloves exposes your skin to repeated friction.
  • Bunions or hammertoe. A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. A hammertoe is a toe deformity in which your toe becomes curled-up like a claw. Both of these conditions can cause constant rubbing inside your shoe.
  • Foot deformities. A pre-existing foot deformity, such as a bone spur, may put extra pressure on certain parts of your foot.

When to seek medical advice

If a corn or callus becomes very painful or inflamed, see your doctor. If you have diabetes or poor circulation, call your doctor before self-treating corns or calluses. Even a relatively minor injury to your foot could lead to an open sore (foot ulcer) that's difficult to heal.

Screening and diagnosis

Your doctor will examine your feet and rule out other causes of thickened skin, such as warts and cysts. Your doctor may also request an X-ray to see if a physical abnormality is causing the corn or callus.

Treatment

If a corn persists or becomes painful despite self-care, several treatments can provide relief. Your doctor can pare down a large corn with a scalpel, usually during an office visit. Your doctor may also suggest applying an antibiotic ointment to reduce the risk of infection.

If you have an underlying foot deformity, your doctor may prescribe custom-made padded shoe inserts (orthotics) to prevent recurring corns. In rare instances, your doctor may also recommend surgery to correct the alignment of the bone causing the problem.

Prevention

Eliminating sources of friction or pressure should help you prevent corns and calluses from developing. These approaches may help:

  • Wear shoes that give your toes plenty of room. If you can't wiggle your toes, your shoes are too tight. Have your shoe shop stretch your shoes at any point that rubs or pinches.
  • Wear padded gloves when using hand tools. Or try padding your tool handles with cloth tape or covers.

Self-care

These suggestions may help you clear up corns and calluses:

  • Wear comfortable shoes. Stick to loosefitting, cushioned shoes until your corn or callus disappears.
  • Use over-the-counter pads. Apply pads to protect areas where corns and calluses develop. Be careful using over-the-counter liquid corn removers or medicated corn pads. These contain salicylic acid, which can irritate skin and cause infection, especially in people with diabetes and poor circulation.
  • Thin your thickened skin. During or after bathing, rub corns or calluses with a pumice stone or washcloth to help remove a layer of toughened skin. Don't use a pumice stone if you have diabetes because your risk of infection is higher. Whether or not you have diabetes, don't cut or shave corns or calluses. Doing so could lead to an infection.
  • Moisturize your skin. Apply moisturizer to hands and feet to help keep your skin soft.

April 05, 2005

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