Corns & Callous
Corns and callous usually occur on the feet in response to physical stresses such as compression and friction. The increase in skin production is initially a protective action. A chemical is produced by the skin cells in response to abnormal physical stress and this causes an increase in the rate at which skin cells in that area divide and reproduce. The number of cells coming off in this area remains the same or reduces, therefore, the skin density increases. As the skin becomes more dense it becomes less useful as protection and eventually becomes problematic, producing corns and callous.
Corns tend to be concentrated areas of very dense skin; callous wider areas of less dense skin. Corns and callous may cause a variety of symptoms and may appear together or individually.
Corns may cause pain by pressing on sensory nerves, causing inflammation in underlying or surrounding soft tissue. If compression on the area is great or sustained or circulation is poor, ulceration can occur beneath the corn: this condition can be extremely painful. Abnormal pressure can be transferred through a nail plate to the nail bed resulting in corn formation under the nail. This can also be extremely painful.
Callous under the feet can cause a general soreness usually from the soles of the feet. A burning sensation may also be a symptom of callous. It is more difficult for moisture to evaporate from an area of callous and in warmer weather itching may result. Callous around the heels and occasionally the sole of the foot may split due to loss of elasticity: this condition can be extremely painful and occasionally the splits can become infected.
Periodic routine treatment is often sufficient to maintain comfort. This involves the removal of the unwanted skin and is usually pain-free. The period between treatments will vary depending on skin type, occupation, weight, shoe-type, foot mechanics and foot shape. Routing treatment does not deal with the cause of the corns and callous and for this reason they eventually return. The time taken for recurrence is dependent on various factors. It can be extended considerably using modern techniques such as silicones to reduce pressure on and between the toes. If treatment is directed at the cause of the corn or callous, for example the surgical correction of a hammer toe, this will permanently clear a corn. The assessment of foot mechanics and production of orthoses will provide a more normal foot function and over a period of time callous will improve and routine treatment can be reduced.
Acute symptoms caused by inflammation can be treated with ultra-sound, anti inflammatory dressings and padding, after the removal of unwanted skin.