Calluses and Corns
Calluses or keratosis represent normal thickenings of the skin in response to friction and pressure over bone. This is a normal process for protecting the skin whether it be on the feet or the hands. These thickenings come and go in response to changes in friction and pressure. Consider someone with the task of splitting many cords of wood for the winter. Gripping the axe or moll initially causes blisters to form or there is a slow progression of thickening of skin until heavy callous is formed over bone as contact is made with the ax handle. Once all the wood is split and put away along with the axe, the calluses gradually wear away. Same thing goes with feet. Some calluses form predictably secondary to the biomechanics of gait and individual anatomy. Some form because of contact with poorly fitting shoes or because angular deformities of the feet, such as bunions and hammer toes, rub against shoes. Callouses and corns form with increased frequency and intensity when the protective fat pad between the skin and bones reduces with age…wear and tear..circulation, etc.
When people have healthy circulation and full sensation to all parts of their feet, calluses are, relatively, just a nuisance. Most can be made to disappear by eliminating or reducing friction and pressure. This may easily be done by wearing better fitting shoes and/or replacing the inserts inside the shoe. Replacing insert alone or replacing the insert with modifications can significantly reduce friction and pressure. These changes will either eliminate the callused areas or greatly increase the time it takes for them to form. Designing and modifying inserts to protect foot in these trouble areas is a specialty of my practice. It is not an expensive process either.
When people have health problems such as poor circulation to the feet and / or peripheral neuropathy, where the normal protective sensation of pain is reduced or lost, calluses and corns become a problem. Some diabetics fall into this category.
This is why those at risk should have regularly scheduled appointments with a podiatrist forefoot examination with nail and callous care approximately every 10 weeks. This treatment is covered under medical insurance for qualified patients. Persons at risk should never cut their own nails or trim their own calluses. This task should not be performed by a spouse, a relative, or the neighbors, either. Be safe.