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Corn and Calluses

Overview

Corn and calluses develop when your skin hardens over time due to repeated friction or pressure against a particular region. They are most commonly observed on toes and feet. Your feet carry the entire weight of your body and are exposed to repeated friction whenever you walk, run, jog or perform other activities. In an attempt to protect itself, the skin layer thickens over the years, forming corns and calluses. They can also develop in the hands and some other parts of the body. Minor cases that are not painful or uncomfortable do not require any treatment. 

Causes

Corns and calluses are two different things, even though the causes of both of them are similar. A corn is a small, hardened bump that forms on the top or sides of your toes. There can be hard corns, soft corns, and seed corns. In most cases, corns develop due to the inappropriate size of the shoes or heels. The friction between your toes and shoe surface is even greater if you wear shoes without socks.

 

Calluses are thickened patches of skin that are more spread out in shape. They do not have a bumpy appearance like corns. They also form on regions exposed to friction, such as the bottom surface of your heel, ball of the foot, and bog toe. Calluses can also be seen on hands of individuals whose work requires repeated rubbing or friction against an object e.g., tips of fingers of a guitar player, hands of craftsmen, etc. People with bunions may develop callus over that region because the bunion constantly rubs against the shoe. Neither corns nor calluses are considered a serious skin disease and mild to moderate skin thickening is considered normal. 

Risk Factors And Epidemiology

The risk factors of corns and calluses are linked with its cause. If you wear ill-fitted shoes or heels repeatedly, the friction between your feet and shoes will cause hardening of the skin surface in certain areas. Wearing shoes without socks is another risk factor. Some forms of corns have a genetic link, so they may pass on from one generation to another. Certain occupations, such as farmers, rowers, craftsmen, guitarists, violinists, etc., can make you more prone to develop calluses on your hands.

 

The incidence of corns and calluses increases with age. People over the age of 65 have a higher risk compared to young adults. Corns are more prone to develop in people with darkly pigmented skin. It can occur in both males and females. 

Signs And Symptoms

The basic signs and symptoms of corns and calluses and almost the same. The skin in these regions is thicker and harder compared to normal skin. It appears dry and flaky. Corns will appear as a small, round bump. They have a hard center which is surrounded by red, swollen skin. Corns can be painful when pressed. Compared to corns, calluses resemble the color of your skin. They are usually painless and appear as a dry, thick patch of skin on your feet or hands. Their size may vary depending on the degree of friction exposure. In many cases, they are bigger than corns and have an irregular shape. Both corn and calluses have reduced sensitivity to touch because of hardening of the skin. 

Diagnosis

It is not difficult to diagnose corns and calluses. They can be analyzed based on their clinical presentation alone. Your doctor may ask about your occupational history or physical activity questions to understand the possible cause. A brief clinical examination of the affected areas can help in accurate diagnosis. If you have small painful bumps on your toes, they are most likely corns. If you have patches of hardened skin on your feet, hands, or elsewhere, they are most likely calluses. No specific laboratory or imaging tests are required. 

Differential Diagnosis

Both corns and calluses can be diagnosed with ease on the basis of history and appearance. But they need to be differentiated from other skin conditions such as warts and cysts. Your doctor can distinguish between these conditions by performing a detailed clinical examination.

Treatment

Mild to moderate cases of corns and calluses can be treated using some home remedies. Soak your feet or hands in warm water for 10 minutes. Take a pumice stone or emery board and rub it over the affected areas to remove dead skin tissues. Apply a moisturizer afterward. This can be done repeatedly to soften the skin over corns or calluses. Find the right size of shoes to wear and wear them with socks. This helps in reducing friction. Cut your toenails regularly, and don’t let them grow too long. If you are unable to treat corns or calluses at home, consult a specialist for this purpose. Your doctor may trim away the excess skin with care. If you have any foot deformities, it is suggested to wear padded shoe inserts that help in reducing friction. Surgical options are only indicated for painful or severe cases or corns and calluses.

Medication

 

Medicated patches containing 40% salicylic acid can be used to soften the skin of a corn or callus. If a callus is large, your doctor may recommend a gel or liquid form of salicylic acid to apply over hardened skin. 

Prognosis

Corns and calluses can remain for a lifetime if they are left untreated. They don’t cause any major complications but may be a cause of pain or aesthetic concern in some cases. Treatment options can help in softening the skin and reducing its recurrence. 

Prevention

Corns and calluses can be prevented by wearing the correct size footwear. Whether you are wearing shoes or heels, ensure that your toes have enough space to wiggle. Your toes should not hurt while walking in shoes or heels. Use shoe pads or bandages to cover such areas if you have a deformed foot, bunion, or any other foot condition that makes you more prone to develop corns and calluses.