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Suffering with hard skin, cracked heels or painful corns?
None of us like to have thick, hard skin on our feet. It’s unsightly and can feel uncomfortable. Read on to find out how hard skin and corns develop and how to prevent or treat them.
Hyperkeratosis
The medical term for excess, thickened skin is ‘hyperkeratosis’. A condition where the body produces extra keratin, a tough fibrous protein found in skin, nails and hair. There are many forms of hyperkeratosis. The 2 main types are pressure related and non-pressure related. This blog focuses on pressure related hyperkeratosis.
When an area of the skin is subject to increased forces, such as direct pressure or friction, it responds by thickening the surface layer of the skin. This is the body’s defence system to protect tissue. Hard thick patches of skin develop, called calluses. If the pressure is concentrated in a small area such as a toe joint, a hard corn may appear.
Anyone can get callus or corns, especially older people who lose fatty tissue and flexibility with age or those who spend lots of time on their feet.
Callus
Thick skin on the weightbearing areas of our feet such as the ball of the foot or heel is called ‘callus’ and has a typically yellow appearance. It can also develop on the toes in areas in contact with footwear.
Corns
Corns are typically found around the toes or on the ball of the foot and are painful lesions with a central core or plug of hard skin. Soft corns may develop between the toes, where the skin is moist from sweat or inadequate drying. These corns are white and rubbery.
Common causes.
Shoes
Friction or direct pressure from poor fitting shoes is a common cause of callus and corns. Wearing comfortable shoes that accommodate the shape of the foot and toes will help reduce friction forces. Seams within the shoe and even sock seams can cause pressure. Feel around the inside surface of the shoe for any lumps/bumps that may be rubbing the feet.
High heels cause excessive pressure to the front of the feet, leading to corns and callus around the toes and structural abnormalities such as clawed toes and bunions. Check out our previous blog for shoe fitting advice.
Bodyweight
Your feet bear the weight of your body as they carry you through your day, so there’s no surprise that excess weight will put a strain on our feet. Increased forces add pressure to the ball of the foot and heel, leading to increased keratin production and hard skin. Losing weight not only benefits your general health, it helps your feet too!
Thin skin & bony deformities
As we age, the ball of the foot can lose its fatty protection and the skin’s strength & elasticity is reduced. This exposes joints in the area to more pressure. Bony deformities such as bunions and clawed toes lead to areas of pressure around the toes. Choose shoes with cushioned soles or use cushioned insoles to help reduce pressure. Choose a deep, wide toe-box to accommodate toe deformities. Padding such as bunion protectors can also help.
Treatment advice.
Home treatment includes using a pumice stone or foot file to exfoliate any dead skin, and daily application of a foot cream containing urea. Urea helps to hydrate the skin by drawing in moisture and preventing water loss. It also acts as a natural exfoliant.
Avoid medicated plasters for corns as they contain an acid which can damage the surrounding healthy skin.
If callus & corns become uncomfortable, it is best to visit a podiatrist to have the excess hard skin removed. Podiatrists have extensive knowledge about foot anatomy and are trained to use a scalpel to reduce the callus or corn painlessly. Don't attempt to use a sharp implement at home as it is unlikely to be sterile, and you risk infection, turning what was initially a harmless situation into a medical complication. Podiatrists may also use padding, insoles or orthotics to address any structural abnormality.
The best way to prevent callus and corns is by reducing or eliminating the source of the pressure and caring for the skin. The hyperkeratosis may be due to other underlying conditions or may indicate a structural abnormality. Often it is due to inappropriate footwear. Pay attention to your feet, keep them moisturised daily and ensure you have properly fitting shoes.