Self-Treatment of Minor Foot Problems

W. Steven Pray, PhD, RPh

Disclosures

US Pharmacist. 2002;27(3) 

In This Article

Calluses

The etiology of the callus is identical to that of the corn -- namely, pressure or friction against the skin. However, the callus is a diffuse thickening of the skin overlying the area where pressure has been applied. Any type of pressure can cause calluses if it is sustained for a prolonged period of time. For instance, repeated use of an engraving tool can cause a set of hand calluses where the tool exerts pressure against the epidermis.

In the case of the foot, weight-bearing areas such as the heels and balls of the feet are most prone to developing calluses. The risk of callus formation is increased when patients wear shoes that allow the heel to move during ambulation, increasing the shear forces. Patients should be instructed to wear shoes that have a snug fit for the heel.

Removal of the callus is complicated by two factors. First, unlike the corn, which serves no purpose, the callus protects underlying skin from the continued friction that caused it. Second, the callus is rarely painful because it has no central core that pushes against underlying tissues with each step. For these reasons, removal is purely cosmetic in most cases and actually exposes newer, softer skin beneath. It is preferable to allow the calluses to remain in place as long as they are not troublesome. The person who ignores this advice and removes all callused skin from the soles of the feet with the products known as callus reducers or callus files may experience pain when he or she walks on the newly exposed nonhornified surfaces of the feet. It will take a while for the calluses to regrow and again shield the feet.

Calluses may occasionally, however, be so thick that they cause pain upon ambulation.[5] In these cases, reduction may be necessary. Since it involves removal of tissue, a preferable method of reduction would be through a visit to a podiatrist or a physician. Professionals are aware that judicious use of a rotary sanding tool is useful for callus removal. Removal is halted if the area begins to feel warm, or if drainage is visible from any callus fissures. Dust particles will also change texture from a large amount of thick particles to a small amount of fine powdery substance as the procedure approaches its end. The skin should feel thinner and smoother to the touch when appropriate reduction is completed. Calluses may fissure or crack open. In these cases, a physician/podiatrist visit is advisable to ensure that the area has not become infected.

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