Care of Corns and Calluses

Corns and calluses can cause much discomfort and frustration for clients seen by McDermott Footcare.  Clients often say that the pain caused by corns and calluses limits their participation in daily and social activities.

What is a corn?

A corn, or heloma, is a thickened area of dry skin that has a visible centre, or nucleus, at the area of greatest pressure.  It is caused by direct pressure from shoes upon a bony surface of the foot.  The centre, or nucleus, presses on nerve endings in the skin.  If it is large enough, it can be quite painful.

Soft corns form between toes, caused by direct pressure from neighbouring toes.
In this case, the skin between the toes is moist.

In the picture, two large, painful corns are visible – one on the ball of the foot underneath the third toe and one on the tip of the fourth toe.

What is a callus?

A callus (tyloma) is an area of hardened skin caused by shearing friction – a constant rubbing back and forth – over the heels, balls of the foot and along the sides of bony areas of the foot.  The hardened areas may be whitish, yellowish or brownish in colour.  The picture shows callus formation around the corn on the ball of the foot, on the area underneath the big toe, and on the side of the big toe.

Common Causes of Corns and Calluses

  • ill-fitting shoes are the biggest culprit – shoes that are too tight, too small, too big, too high, squish the toes, lack cushioning, have seams that rub against the foot
  • structural deformities of the foot such as hammertoes and bunions that rub against the inside of the shoe.  Part of the problem are shoes that don’t accommodate the deformity.
  • walking too much on the outside of the foot (oversupination)
  • walking too much on the inside of the foot (overpronation)

Preventing Corns and Calluses

  • wear supportive, well cushioned shoes that fit well.  Wear socks that absorb moisture.  For tips on buying shoes and socks, read here.
  • daily washing, exfoliating and moisturizing the feet
  • if overpronation or oversupination is a concern, a chiropodist or pedorthist can fit you with corrective orthotics

Home Remedies for Corns and Calluses

Home remedies for treating dry, cracked heels work well for getting rid of corns and calluses since both are caused by a build-up of dry skin.   Read 8 tips for dry, cracked heels here.

Avoid over-the-counter medicated corn and callus pads since the acid in these pads can irritate healthy skin around the affected area.  A u-shaped, unmedicated pad is fine for corns since it avoids putting direct pressure on the area. Using razor blades and other sharp objects to cut away corns or calluses is just plain unsafe…..enough said.

Corns and Calluses in Diabetics

Diabetics must be extra careful with corns and calluses.  Because of poor circulation and decreased nerve functioning in the feet, diabetics have an increased risk of infection from corns and calluses.  The same applies to anyone who is not diabetic but has poor circulation or decreased nerve sensitivity in the feet.   Self-care of corns, calluses and other foot problems could put you at risk for infections and trauma.  Seek out the care of a certified foot care nurse who is trained in diabetic foot care such as at McDermott Footcare.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Why Assessment is Important in Foot Care

When a potential client phones or emails McDermott Footcare to ask about available services, I briefly explain that since I offer a nursing procedure, my first visit includes a very short assessment to find out what medications the person is taking and any medical conditions that affect the feet and toenails (and there are many).  Most people are fine with this.  On rare occasions, a person doesn’t want  the assessment  and decides not to have me come in.  That’s OK.  However, here’s why the strictly confidential assessment is so important:

  • As a Registered Nurse, it’s necessary to know what’s going on medically so I can give the best care possible.  Anyone who’s diabetic, has a heart, lung, blood pressure or circulation condition, is arthritic, has low immunity,  has difficulty walking, bending or seeing is going to be concerned about more foot care issues than overgrown  toenails.
  • Some commonly prescribed medications for the above conditions will cause changes to the health of the feet and toenails.  For example, long-term antibiotic use increases fungal infections to the toenails and skin of the feet.  Different types of steroids used in conditions of the lungs, the joints and cancer treatments make nails brittle and increase fungal infections of the feet and nails.
  • Past surgeries to the lower limbs and hips may cause poor circulation to the feet.  Fungal, thickened, discoloured toenails, lack of feeling in the feet (known as neuropathy) and poor skin condition are the result.  These surgeries may cause a change in the way we walk and the way we carry our weight.   In turn, corns and calluses may develop, making walking painful.

It seems to me that most of us don’t see the connection between what goes on in our feet and the rest of our body, but everything is connected very intricately.  That’s why conscientious, properly trained, certified foot care nurses get to know the whole person – not just their feet.

In my experience, not everyone wants a nursing assessment and decide that their needs are better addressed elsewhere.  On the other hand,  those who take the few minutes needed to answer the confidential assessment questions receive personalized, holistic, quality nursing foot care.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

High Heels vs. Foot Care

This is my daughter taking great delight in her brand new , fashion-forward sandals.   With 4 inch heels.  And a teeny tiny platform.  I have to admit, she looks really good in them.

That’s the dilemma of high heels, don’t you think?  They make our legs look great, kick our outfit up a notch, and they make us feel confident, attractive, even  powerful.  On the other hand, high heels wreck our posture and eventually, our feet.

High heels pitch our posture forward and put most of our weight on the metatarsals, a.k.a. the forefoot or the ball of the foot.  Over time, this can result in metatarsalgia, a constant strain and pain over the forefoot.  Morton’s neuroma is a potential problem between the third and fourth toe that produces a sharp, burning pain over the ball of the foot and numbness in the toes.

As well, shearing friction along the ball of the foot creates calluses.  Pressure from weight concentrated on the forefoot creates corns.  Both conditions can be very painful.

Our hips, lower back and knees have to realign to maintain balance and posture.  This causes lower back, knee and hip pain because of the stress and strain on these areas.  We’ve all seen pictures of pregnant celebrities wearing stilettos……….do I really need to comment?

What happens to the toenails in high heels? Here’s my daughter again to illustrate the point.  Since the entire foot pushes forward in high heels, toenails are jammed against the top of the  narrow toe box.  The pressure on the toenails damages them and can lead to fungal, involuted, and/or ingrown toenails.

Toes crammed into a narrow toe box and pushed forward by the pitch of the shoe can develop hammer toes, claw toes and overlapping toes.   There’s also the potential for forming a bunion, a painful, bony prominence along the outside of the big toe.  The picture (not my daughter!) clearly shows these conditions.  Note the callus on the raised hammer toe.  This is due to the hammer toe rubbing against the top of the toe box.  Yes, it’s painful.

So, what’s a girl to do?  Give up high heels?  That’s unrealistic.  I don’t wear heels at work but, like most women, I have a wardrobe of high-heeled shoes and boots that I enjoy wearing when possible.  Admittedly, none of them have 4-inch heels.  My limit is 3 inches.

I think the key is moderation and common sense.  Leave the 4 -inch stilettos for very special occasions.  Don’t wear them every day – that’s just asking for trouble.

Wear a moderate high heel with a wider toe box on a daily basis.   A 2 -inch heel with a wider base is comfortable and fashionable.  Women who wear heels at work can change into them while sitting at their desk but can put on walking shoes or low-heeled dress shoes when commuting to and from the workplace.  I’ve recommended black, loafer-style nurse shoes to foot care clients who want something more fashionable than a typical walking shoe.  I wear them when I’m visiting McDermott Footcare clients.  Vary your heel heights from day-to-day by alternating low heels with moderate heels.

High heels are part of our culture and for many women, part of our self-image.  We will never give them up but that doesn’t mean we have to fall victim to their harmful effects.  We can continue to enjoy them as long as we take measures to reduce potential problems.

I would like to thank my daughter (and her stilettos) for inspiring this blog and for being such a good sport.  May you have many wonderful years enjoying your heels.

For more tips on proper footwear, read my McDermott Footcare page , above, on “Socks and Shoes.”  Let me know how you feel about high heels.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author