Hard Skin & Complications

Hard & Soft Corns

Corns can be described as inverted (upside down) cones of hard skin.

They are often associated with dry feet and commonly affect the tops of the toes and the balls of the feet.

They can also occur between the toes, (Soft Corns) where they are particularly painful.

Corns are caused by intermittent focal pressure on specific areas of the foot which result in abnormal growth of skin tissue cells. This focal pressure can occur through improper footwear or abnormal foot function.They will not resolve unless the pressure that caused them is taken away.

Damage can result in deeper tissue resulting in ulceration.These can become infected and infection can spread. Infection of corns on the toe is more common than a callus. This can be a serious complication for those with poor circulation, peripherial neuropathy and/or diabetes.

Soft corns are areas of white moist skin between the toes with a hard core.

They commonly occur between the 4th and 5th toes and are often due to irregularly shaped bones.

They can be very painful and if not treated can form small ulcerations that can become infected.

 

Callus

Callus is a yellowish plaque of thick, hard skin that results from excessive friction over bony prominences.

The most common area for callus formation is the ball of the foot, especially if there is some misalignment within the long bones of the foot. These areas can become quite painful and potentially damage deeper structures.

Diabetes sufferers can be at risk of these areas breaking down and producing ulcers that can become infected. In these cases feet should be regularly checked for callus build up.

 Treatment

Podiatric management of corns and callus include:

  • a proper assessment to determine the cause of the corn and/or callus
  • implementation of a management plan

The management plan is likely to take into account several options:

  • regular maintenance to keep the corn and callus reduced
  • use of padding to prevent the pressure
  • advice about the fitting of foot wear
  • the use of foot orthotics or supports to relieve the pressure under the foot

 

 Cracked Heels

This is a common problem whereby dryness of the feet together with excessive weight and/or poor foot wear can cause the heels to become fissured.

The fat pad within the heel can become deformed with increased tension round the back of the heel. Friction caused by foot wear can cause callus complication and fissures can become deep and painful. Bleeding and infection can result.

Common causes of this dryness include systemic conditions such as psoriasis, hypothyroidism or diabetes.

Treatment

Callus removal is vital in order to uncover healthy more elastic skin that can heal.

Strapping in the form of steri-strips can be used to encourage fissures to close.

Padding in the form of heel cups can be used to prevent expansion of the heel. Insoles maybe needed to alter gait.

Advice is given on use of emollients to limit callus formation and restore normal epidermal water content.