Dr Pradeep Moonot, a Mumbai-based Orthopaedic Surgeon and Podiatrist, tells all you need to know about pesky feet corns
A corn, technically known as hyperkeratosis, is a cone of dead excess skin made of keratin (the tough protein that makes up the epidermis). It is with a hard center core that develops on or between your toes. It can be annoying, but your body forms them to protect sensitive skin. Or, we can say it is the body’s protective response to repeated friction or pressure, typically caused by two toes rubbing together or a toe rubbing on your shoe.
Corns on the top of toes, or on the outer edge of the smallest or largest toe, form a hard crusty surface with a point that can press on a nerve below, causing pain. They don’t usually hurt unless they have pressure on them. The longer or tighter the pressure, the more they hurt.
Types of corns
Corns can be classified depending on its size and position. The most common type of corns, or hard corns appear on the top of the toes, on the bottom of the foot, between the toes, and even under the nail or sides of the nail. Soft corns are the same as hard corns, but are made soft by sweaty or wet feet. They almost always appear between the toes and are white and soggy due to moisture.
Vascular corns are either hard or soft corns. These have blood vessels which are forced into the corn formation usually due to the squeezing or pinching of shoes. Neuro-vascular corns are like vascular corns. But these have the added presence of nerve tissue as well as blood vessels forming within the growing corn.
Intractable plantar keratoma are unlike other types of corns. These are caused by plugged sweat glands on the sole of the foot, combined with excessive pressure due to foot structure in the ball of the foot.
What causes corns
Some corns on the feet develop from an improper walking motion, but most are caused by ill-fitting shoes. If shoes are too tight, they can squeeze the feet thereby increasing pressure. High-heeled shoes are the worst offenders. They put pressure on the toes and make women four times as likely as men to have foot problems. If they are too loose, the feet may slide and rub against the shoes, creating friction. Also, because feet spend most of their time in a closed, moist environment, they are ideal for breeding bacteria.
Toe deformities, such as hammer toe or claw toe, or even socks that don’t fit properly, can also cause corns to develop.
How to treat it
Corns are best treated by a podiatrist or an ankle and foot surgeons only. The best form of treatment is to treat the underlying problem. These small, hard lumps can be the source of much discomfort and may even require surgical intervention
If the corn is caused by a bone spur, it’s usually removed by simple procedure of small surgical incision. For corns on top of the toes, a podiatrist can reduce the bulk in several different ways which could be by shaving the dead layers of skin off with a scalpel, but, of course, under sterile conditions.
Most surgeons are against using corn removing solutions and medicated pads, which can be purchased over the counter. These solutions can sometimes increase irritation and discomfort. Diabetics and people with poor circulation, in particular should never use any chemicals to remove corns. They should see an expert immediately.
If it’s due to a wrong shoe fit, buying shoes in the proper length and width can make a huge difference. Best option is to get your feet measured professionally by a salesperson who understands the difference between the arch and toe length.
Also, you can comfort corns by using a corn pad, which is usually a circular foam stick-on pad with a hole cut in the middle. This helps to take the pressure off the corn. Corns can also be managed by using a silicone gel pad between the toes or on top of the toe to provide cushioning.
As a precaution, if you are susceptible of getting corns, keep the feet dry and friction-free. Wear cotton socks and avoid nylon and synthetic ones. If a podiatrist or orthopaedist thinks your corn is caused by abnormal foot structure, walking motion, or hip rotation, orthopaedic shoe inserts or surgery to correct foot deformities may help correct the problem.
Avoid being aggressive with a pumice stone or foot file as this can further lead to a possible ulceration and ultimately an infection which can cause more damage. Keeping corns soft helps because the harder they are, the more pain they cause as there’s more pressure pushing down on the bone. Moisturise and exfoliate your feet daily if you can. Regular treatments are usually sufficient to keep them under control, and you can expect them to resolve completely with appropriate care and attention.