Developing corns or calluses is an extremely common occurrence. Most people have a corn or callus, with varying degree of severity and cause. In some cases what a person thinks is a callous is actually something else.
Calluses are a build up of skin due to increased pressure or shear forces. The excess pressure causes the body to defend itself by building up tissue as a cushion. This inherent defense system actually causes the pressure to increase in the area of the callous. This causes the callous to progressively increase in size and cause pain while walking and trouble wearing shoe gear.
The majority of the time calluses form on the bottom of the foot in an area under a bony prominence or joint. Calluses can also form on the sides or the top of the foot. A callous on the top of the foot is a corn. Corns are usually caused by shoes rubbing against the area. This excess shear force can be caused by wearing shoes that are too small or deformities of the toes or foot such as hammertoes or bunions.
In extremely severe cases calluses can progress and form ulcerations underneath them. These ulcerations are wounds which can become infected and cause serious health problems. In these cases it is important to keep the calluses from progressing to prevent the ulcerations and infections.
The prevention of progression can be accomplished in several ways. First there is maintenance debridement. This is when you come into the office and one of the doctors decreases the callous through a number of methods. In severe cases this maintenance is performed every nine weeks and is covered by most insurance plans. During your visit your doctor will also discuss at home maintenance techniques for keeping the calluses reduced in between visits. A second method of decreasing callous progression is by wearing accommodated shoe gear and having inserts that decrease pressure and shear forces. In some cases insurance will also cover special shoes to accomplish this. In cases where the calluses are caused by an abnormal bony prominence or abnormally positioned bones, surgical intervention may be recommended. The surgeries are utilized to decrease the prominence of the bone that is causing the callous.
As stated before there are instances where people believe they have a callous and it is actually something else entirely. One such instance is what's called a porokeratosis. This describes a clogged sweat gland. When a sweat gland becomes clogged the body builds up skin tissue around it, again to protect itself. This buildup of tissue like a callous will cause pain with walking. Often these can be identified and differentiated from a callous in their location and configuration. They are often located in areas that have decreased weight bearing, thus they do not have increased force applied to them. Porokeratosis are also usually deep but small in circumference. This differs from the normal callous which has a larger circumference compared to the depth. A second instance of a disorder that may be mistaken as a callous is a planters wart. Planters warts are caused by a virus entering the skin. This virus grows and causes a callous like build up of skin. The planters wart is easily identifiable by your doctor and differentiated from a callous. Special procedures are used to eliminate the virus that causes the wart.
Though calluses are an extremely common occurrence, they are a progressive disorder and can cause severe |