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corns

Corns

Discussion

Many of us with lymphedema report constant problems with corns and calluses. These growths, which is a thickening of the skin is a response to pressure. For us it is not only the normal pressure of a shoe, but pressure caused by the swelling and in our wearing shoes that often do not fit properly.

Corns generally do not in themselves initially cause any complications. However, if the corn continues to grow, they may become inflamed. When that happens there is an increased risk of bursitis the development of an ucleration or open sore.

Even if they have not caused any complication they are incredibly painful and can make walking a miserable experience.. In either case we need to treat or remove them.

However, people with conditions like leg lymphedema or diabetes will need to treat calluses with special care. The very worse thing you can do is to try and trim them with a knife or razor blade. This is very dangerous and one cut could expose you to a serious bout of cellulitis, erysipelas or worse lymphangitis.

Also, people with lymphedema generally have skin problems or have skin that is very sensitive to chemicals,and different types of tapes and bandages. Special care has to be exercised in treating them.

Types of Corns

There are two basic types of corns. Hard corns (heloma durums) are the most common type. They are caused primarily by ill-fitting shoes and toe deformities. They usually develop on the tops and tips of the toes and on the sides of the feet. Soft corns (heloma molles) usually occur as the result of bone abnormalities in the toes. They develop between the toes and are sometimes referred to as “kissing corns.”

Hard Corns

In many people, the toes curl downward and do not lie flat. Fitting curled toes into shoes with tight toe boxes is the most common cause of hard corns. The toes remain curled inside the shoe and press against the inside of the shoe, usually at the toe joints. Additionally, the tip of the curled toe presses against the sole of the shoe. The skin compensates for this added pressure by thickening at the point of contact and hard corns develop to protect the underlying structure.

Soft Corns

Soft corns typically develop between the fourth and fifth toes when one of the toe bones (phalanges) is slightly too wide. Normally, phalanges are hourglass-shaped and the ends are wider than the middle. Soft corns result when the ends of the toe bones are too wide, causing friction in between the toes. This problem is aggravated by tight-fitting shoes.

People with normal toe bones can also develop soft corns. This condition is especially common in women who wear high-heeled shoes with narrow, tapering toe boxes. These shoes shift the body's weight to the front of the foot and often do not provide enough room for the toes. (1)

Treatment of Corns

If you have lymphedema, diabetes, peripheral arterial disease, peripheral neuropathy, or other conditions that cause circulatory problems or numbness, talk to your doctor before trying any treatment for calluses or corns. Hard corns can be treated by either cutting them off (by a physician) or burned off with a topical acid solution. You can buy them over the counter at any super market or pharmacy.

However, Remedies such as corn paint, cure or plasters will generally only treat the symptom of the corn and not the problem that causes it. These chemicals contain acid that are supposed to 'eat away' the corn, but the chemical can not tell what is corn and what is normal - it will eat what ever you put it on. While this can be risky in healthy people, it can be very dangerous and risky in those with poor circulation and/or diabetes. The use of “corn plasters” in those who are at risk or have frail skin are very likely to cause an ulcer (a breakdown of the skin) which could become infected and it the circulation is poor, an amputation is a possibility. (2)

Important: Do not try cutting off the corn with a knife or razor blade.

Using a pumice stone for calluses or corns

A pumice stone can be used to remove the dead skin from a callus or corn. Reducing the size of the callus or corn may result in less pressure or friction and less pain.

  • Soak your foot or other affected area in warm, soapy water for 5 minutes or until the skin softens.
  • Wet the pumice stone.
  • Rub the pumice stone on the wet callus or corn with light to medium pressure for 2 to 3 minutes. This will remove dead skin.

Use the stone daily, and rinse the stone after each use.

Be careful when using a pumice stone. If you take off too much skin and go too deep, it can result in bleeding and infection. (3)

Prevention

There are a number of things you can do to help prevent corns.

(1) Wear proper fitting shoes. I know, with lymphedema, this is easier said then done. Some people buy two different sized shoes. Others, like myself have gotten by quite well in buying shoes that specifically fit the lymphedema foot. That shoe may be a bit large on the other foot. But there is less chance of getting a corn on the bad one. For the looser fitting shoe, I would use a sole insert to help it fit better. Also, I have never gotten a corn by wearing a shoe that was a bit loose – but, I have had a couple terrible ones from shoes that were to tight.

(2) Use of pads and inserts. These products which are readily available at any pharmacy can take the pressure off critical foot parts helping reduce pressure.

(3) If the corn is caused by a bony prominence, surgery can be done to correct this. Again though, with lymphedema special care must be used. If the doctor feels surgery is necessary, it will be important for you to start a course of antibiotics at least five days before the surgery.

References

Podiatry Channel (1)

Foot Corns ePodiatry (2)

Calluses and Corns WebMD (3)

Corns and calluses

Last reviewed: June 4, 2011.

Corns and calluses are thickened layers of skin caused by repeated pressure or friction.

Causes, incidence, and risk factors

Corns and calluses are caused by pressure or friction on skin. A corn is thickened skin on the top or side of a toe, usually from shoes that do not fit properly. A callus is thickened skin on your hands or the soles of your feet.

The thickening of the skin is a protective reaction. For example, farmers and rowers get callused hands that prevent them from getting painful blisters. People with bunions often develop a callus over the bunion because it rubs against the shoe.

Neither corns nor calluses are serious conditions.

Symptoms

Skin is thick and hardened.

Skin may be flaky and dry.

Hardened, thick skin areas are found on hands, feet, or other areas that may be rubbed or pressed.

Signs and tests

Your health care provider will make the diagnosis after observing the skin. In most cases tests are not necessary.

Treatment

Usually, preventing friction is the only treatment needed. If a corn is the result of a poor-fitting shoe, changing to shoes that fit properly will usually eliminate the corn within a couple of weeks. Until then, protect the skin with donut-shaped corn pads, available in pharmacies. If desired, use a pumice stone to gently wear down the corn.

Calluses on the hands can be treated by wearing gloves during activities that cause friction, such as gardening and weight lifting.

If an infection or ulcer occurs in an area of a callus or corn, unhealthy tissue may need to be removed by a health care provider and treatment with antibiotics may be necessary.

Calluses often reflect undue pressure placed on the skin because of an underlying problem such as bunions. Proper treatment of any underlying condition should prevent the calluses from returning.

Expectations (prognosis)

Corns and calluses are rarely serious. If treated properly, they should improve without causing long-term problems.

Complications

Complications of corns and calluses are rare. People with diabetes are prone to ulcers and infections and should regularly examine their feet to identify any problems right away. Such foot injuries need medical attention.

Calling your health care provider

Very closely check your feet if you have diabetes or numbness in the feet or toes. If you have diabetes and notice problems with your feet, contact your health care provider.

Otherwise, simply changing to better-fitting shoes or wearing gloves should resolve most problems with corns and calluses.

If you suspect that your corn or callus is infected or is not getting better despite treatment, contact your health care provider. Also call your health care provider if you have continued symptoms of pain, redness, warmth, or drainage.

References

Scardina RJ, Lee SM. Corns. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 79. American Diabetes Association. Standard of Medical Care in Diabetes – 2009. Diabetes Care. 2009;32:S13-S61. [PubMed]

NIH

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corns.txt · Last modified: 2012/10/16 14:40 (external edit)