Skincare Corns & Callous (Hard Skin)
Corns and callouses are common foot complaints dealt with every day in the podiatry clinic, and it's not just the older population either. Corns and calluses are caused by a response to friction and pressure. Repetitive injury results in the skin trying to protect itself from blistering. The basal epidermal cells (keratinocytes) increase in number resulting in thicker prickle cell layer and thicker stratum corneum.
The most common cause is shoes that don’t fit properly. With a little bit of attention and care, most cases of corns or calluses can be prevented/ reduced.
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Why do I develop hard skin?
Hard skin occurs on areas of high pressure. Excessive pressure (or as podiatrists call it - Ground Reaction Force) causes the skin to lay down extra layers to protect the structures underneath. So what can cause excessive pressure in the foot? The following are some of the factors which could influence the pressure on your feet.
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Barefoot walking
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Improper footwear / sizing
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Deformities within the foot
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Hard Flooring (links in with a lack of footwear).
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The rapid increase in a person's weight
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Other factors which can cause hard skin are dry skin disorders, biomechanical disfunctions of the foot and muscular problems causing the foot to land, move, and take off in an unorthodox method.
Keep in mind, hard skin is a result of something not functioning or being supported correctly, not a diagnosis of a condition.
It only happened when I moved to Singapore! Am I the only one?
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Not at all! Most expats come from countries where houses have carpet / wooden flooring. However, in Singapore, we are pretty much a concrete jungle. Which means the amount of pressure going through your foot has drastically changed, causing your skin to thicken (protective mechanism by your body, to protect underlying structures from getting injured). Many people walk bare-foot around the home, which is just as bad for the feet as wearing shoes with no cushioning in the sole. A worn carpet, with little or no underlay, will give very little cushioning to the foot, and also increase pressures.
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Can I prevent this permanently?
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​Hard skin will keep coming back IF the underlying problems causing it in the first place are not addressed. Good shoes with soles / insoles which absorb and distribute the pressure, rather than have it absorbed by the foot. If you have a foot deformity, be it a bunion, or stiff joints, a custome made insole should help absorb or deflect pressure from the vulnerable areas of the foot.
If you have excessively dry skin, then regular applications of moisturiser should help keep your skin supple, soft and flexible. Moisurisers containing 10% urea will help build a 'water-proof' type barrier on your skin, which will help your body 'retain' it's natural moisurising oils, rather than keep simply putting moisure back in. To help get the most out of a moisuriser, after applying it, wrap your foot in cling-film for about 20-30 minutes (remain seated during this time -don't try to walk around!).
Are corns and callous the same?
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Corns are simply extremely concentrated area of hard skin forming a small lump or mound on the outer surface of the skin. Which can cause complications for diabetic individuals. Click here to learn more. Just like callous, they are caused by pressure but usually appear on areas of extra pressure, such as boney prominences of the foot. While callous usually forms at the bottom of the foot, mainly weight-bearing areas.
There are three basic types of corns that podiatrists see on a daily basis.
Hard corns
Occurs due to excessive pressure against the area, rather than be distributed evenly across the bottom of the foot. Often mistaken for a wart. Click here to learn the differences.
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Commonly under the joint of the greater toe and the small toe, as these are common areas of increased pressure in unbalanced feet.
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Due to foot deformities
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Upper joints of toes with deformities where the joint is pressing on footwear.
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At the ends or 'apex' of toes, where deformities have caused the digits (toes) to bend at the end.
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Interdigital or 'soft' corn
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Occurs between toes, usually on areas where the toes are pressing against each other. This can be as a result of ill-fitting footwear or foot-deformities ( where the bone is putting extra pressure) .
How can I maintain :
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Regular podiatry visits for debridement (shaving of hard skin using a scalpel) - don't worry you won't feel a thing!
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Using a foot file for maintenance
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Using urea-based foot cream
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Most importantly, avoid barefoot walking
If you don't see any improvement within a few applications, seek advice from your local friendly podiatrist, dermatologist or your doctor.
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General foot care in an important part of our home visit Podiatrist’s job. If you need a friendly podiatrist to visit you at your home/ aged care facility, contact us today!
Treatment options​
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Corns, like callous, need to be reduced and debrided from the skin, along with any hard skin surrounding them.
Over-the-counter corn plasters can be used. They contain a mild acid, which softens / damages the surrounding skin until the central skin will drop off, or can be 'pulled off'. However, not everyone can use this. Diabetic individuals and people with thin and frail skin should NEVER use this as it would cause more harm than benefit.
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Filing or using a pumice stone at home, may only remove surface build-up and not deeper layers. That being said, you should NEVER use any form of sharps to attempt self-removal of corns.
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It's always best to get an 'expert' opinion before trying any treatment yourself, especially if you are diabetic.
How to prevent reoccurrence?
Some corns only need one treatment by your podiatrist and can go away for years. However, if the corn has been caused by ill-fitted shoes, then the footwear has to be changed. Some corns may reoccur despite all of those changes due to structural factors. Recurrence of such corns can be prevented or slowed down with an insole to deflect pressure away from the areas of build-up, thus reducing pressure. Hence, cause and solution vary according to individual, which can be assessed and treated by your podiatrist.
Seed corn
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The seed corn is very similar to the hard corn in terms of the locations it occurs on the foot, except it is a tiny version. They are extremely small in size, and can look like small 'millet' seed that you see in a bird cage!
These are often described as a feeling of 'having a small stone or fragment of glass' in the foot. These occur mainly on the bottom of the foot ( ball of foot and heel), and between areas of pressure.
