The skin protects the body from many threats and stresses. In places where the outer layer of skin is exposed to stress (especially pressure and shear force or friction), the body adapts by forming a callus (tyloma)–a thickened area of skin that protects the exposed location. On the feet, calluses commonly occur on the toes, the ball of the foot and the heel.
“Soft“ corns often occur on the sides of toes that adjoin other toes, where friction or pressure is present. Although callus formation is a natural reaction of the body to pressure and friction stresses, it is important not to allow them to become too large or painful.
People with diabetes should be aware that corns and calluses can set the stage for foot ulcers.
Causes
During walking and other activities, the feet are exposed to stress and trauma, largely because of poorly designed and fitted shoes and the inherent problem of a dynamic (moving) foot in a static shoe. A callus is created as part of the body’s effort to protect the skin from the repetitive pressure and shear forces between certain areas of the dynamic foot and the static shoe.
Foot anomalies also create pressure points that contribute to the formation of calluses. For example, hammertoes expose the skin on the top of the toes to pressure and friction, and bunions expose the skin to pressure and rubbing in the protruding area.
If you have gait issues (abnormal movements or lack of coordination in movements) when walking or running, you may be especially prone to calluses and should see your doctor.
Everyone’s risk of developing calluses increases with participation in vigorous activities such as running, tennis, basketball, hiking and other activities.
Prevention and Treatment
To prevent calluses and corns, IPFH suggests the following:
Wear only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by your physician. Peer-reviewed, published studies have shown that wearing clinically-tested padded socks can help protect against injuries to the skin/soft tissue of the foot, a major cause of diabetic ulcerations. Padded socks also reduce stress on the feet, and thereby the possibility of abnormal pressure points and overstress in areas where calluses may form.
It’s also important to wear properly designed and fitted footwear with few seams or raised areas that can cause pressure points or rub the skin.
Don’t try to cut or remove a callus on your own. Gentle paring with a pumice stone or an emery board may help reduce the callus if it is enlarged. People with diabetes or circulatory problems should seek medical help to remove a callus. Check your feet at least a few times a week to see if any red or rough areas have formed. If you see unusual or severe pressure points, see your doctor.
Medical Considerations
Corns and calluses typically are not serious conditions unless you have diabetic neuropathy or other circulatory problems. However, always talk to your doctor if you have soreness, pain, redness, swelling, or other indications of problems in any area of the foot that persist for more than a few days.
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