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Both corns and calluses are terms used to describe hyperkeratotic skin on the foot.  They both result from pressure or friction over a boney prominence.

Corn

The term corn is used to describe hyperkeratotic skin that forms on the top of a toe or on the side of a toe. The top of the 5th toe is a common location where corns form. In this case, the 5th toe rubs against the shoe and the skin goes into protective mode and builds up skin forming a corn.

Callus

The term callus is used to describe hyperkeratotic skin that forms on the bottom or tip of a toe, on the side of the foot, and most commonly on the bottom of the foot.  The ball of the foot is a common location to form a callus. When there is a prominent metatarsal bone on the ball of the foot the skin goes into protective mode and builds up skin forming a callus.

Symptoms

  1. Pain, more commonly with walking and while wearing shoes
  2. Corns and calluses are risk factors foot ulcers. Although foot ulcers can occur in healthy individuals, they more commonly occur in the diabetic foot, peripheral neuropathy, and peripheral arterial disease
  3. Foot ulcers are at risk for infection. The signs of infection include redness, swelling, warmth, pus, odor, drainage, and loss of function. Patients should contact Dr. Stewart immediately with concerns of infection

Diagnosis

Diagnosis is made by a comprehensive foot and ankle exam by Dr. Stewart along with x-rays of the foot.


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Treatment

Conservative treatment options are available for corns and calluses. If pain and limitation continues after all conservative care has been exhausted, then surgical intervention is generally recommended.

Conservative treatment for corns and calluses includes:

  1. Trimming of corns and calluses is a routine service provided by Dr. Stewart. Patients, especially high-risk patients, are discouraged to cut corns and calluses with sharp instruments themselves as this can lead to infection and potential amputation
  2. Modification of shoe gear, including deeper and wider shoes, to reduce friction and pressure
  3. Padding over boney prominences with donut pads, silipos pads, and metatarsal pads
  4. Custom foot orthotics to offload prominent bones
  5. Urea based skin lotions or creams help to break down thick skin

Surgical treatment

If all conservative care fails, then surgical intervention is recommended. There are many surgical options for corns and/or calluses and if surgery is indicated, Dr. Stewart will choose the right procedure for you. The goal of surgery is to reduce the boney prominence to prevent recurrence of the corn and/or callus. The surgical recovery depends on the procedure performed.

Surgical treatment for corns and calluses includes:

  1. Corns are frequently associated with toe deformities and therefore they both share the same surgical treatment options including:
    1. Simple removal of the prominent bone and joint (arthroplasty)
    2. Interphalangeal joint fusion (arthrodesis)
    3. Tendon release (tenotomy)
    4. Fusion of toes (syndactyly)
  2. Surgical treatment for calluses include:
    1. Simple removal of prominent bone (ostectomy)
    2. Cutting of bone (osteotomy) and fixation with screws, plates, or wires
    3. Joint fusion (arthrodesis)
  3. Corns and calluses are frequently associated with foot ulcers, particularly in the diabetic foot, peripheral neuropathy, and peripheral arterial disease. Surgical options for corns and calluses associated with foot ulcers include:
    1. Simple removal of prominent bone (ostectomy)
    2. Cutting of bone (osteotomy) and fixation with screws, plates, or wires
    3. Joint fusion (arthrodesis)
    4. Partial or total foot amputation