ASK THE DOCTOR: Calluses, corns affect women more
By DR. JIM MITTERANDO
For The Patriot LedgerQ. What can I do about my corns and cracked heels?
A. Corns and calluses are thickening of the skin on the foot resulting from excessive pressure and friction by shoes and foot bones. Corns occur on the toes and calluses on the soles of the feet. The thickened skin causes foot pain that feels like a pebble in the shoe.
Corns and calluses affect women more than men because narrower shoes and heels place more stress on the foot. Foot abnormalities such as hammer toes and bunions also contribute to extra pressure.
Choose comfortable shoes with wider toe boxes. You can also reduce friction and calluses by wearing socks, avoiding sandals and not walking bare foot. Feet tend to grow longer and wider with age - you should get your foot measured every one to two years to ensure proper fitting shoes.
Treating corns and calluses
Pare down the thickened skin with a pumice stone or nail file to get relief. Do not use scissors or razor blades. You can soak the foot to soften skin and apply moisturizing creams. If this does not help soften skin, try the more potent moisturizing products such as lactic acid (Lac Hydrin, Kerasal) and urea that also help dissolve keratinized skin.
Cushions can be applied on or around the area to reduce pressure and inflammation and promote healing. Donut-shaped cushions (Dr. Scholl’s corn cushions) are applied over the corn to reduce pain and pressure. Metatarsal pads are applied near the ball of the foot to redistribute pressure on the problem bone.
Pressure on toes may be relieved with Silipos toe sleeves, polymer gel (Cushlin Gel), or with padding of foam or lamb’s wool. Lamb’s wool can be placed between toes and beats cotton padding because it does not retain moisture and does not compress.
If these gentler techniques do not help, you can try salicylic acid to dissolve and loosen thickened skin. Be careful to avoid applying the acid on healthy skin since it can be irritating. Do not use salicylic acid on soft corns between toes.
I prefer the salicylic tapes or plasters over the liquid formulation. Cut a piece of the medicated tape the size of the callus or corn and apply it overnight. In the morning, the treated area will be white and softer. Soak the foot to further soften it and then use a pumice or nail file to remove the layers of dead skin. You can apply the tape nightly for up to two weeks. Remove the tape in the morning to minimize irritation.
Start with a lower strength 17 percent salicylic acid tape (Duofilm, Dr. Scholl’s) to reduce skin irritation. If this strength does not help, try the stronger, 40 percent strength Mediplast tape that is, usually, reserved for warts. Do not use the medicated tapes if you have diabetes, nerve damage (neuropathy) or circulation problems without doctor supervision.
Corns and calluses tend to recur unless the cause is treated. Lose weight, wear comfortable shoes and socks and address foot deformities to take pressure off the problem spot.
If your foot problems do not improve after several weeks, follow up with your doctor, who may shave the thickened skin with a scalpel.
Abnormal foot mechanics can be treated with orthotics, metatarsal pads and occasionally surgical repair of hammer toes and bunions.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2005 The Patriot Ledger
Transmitted Tuesday, October 25, 2005