A callus is a thickening of the skin that occurs in response to repeated shear or friction forces. Calluses are similar to corns, but calluses occur when abnormal forces are exerted over a larger area. Certain deformities of the feet, such as crookedness of the toes, may predispose one to the development of calluses. Calluses may cause pain, typically a burning sensation. Excessive weight-bearing and certain types of shoes are often contributing factors.
An epidemiological study performed at Johns Hopkins University looked at 784 elderly individuals to closely identify such afflictions of the foot. They found that over half had corns or calluses. Thickened toenails, cracks and fissures, maceration, and ulcers or lacerations were more common in men, whereas corns and calluses were more common in women. Women's footwear is often suggested as the reason. Increasing height of heels increases the pressure placed on the balls of the feet. Bunions are reported to have been undetected in Japan before the introduction of Western footwear. Individuals of African descent had a significantly higher prevalence of corns and calluses followed by non-Hispanic white individuals, and finally Puerto Rican individuals. This could be secondary to different rates of chronic conditions such as vascular disease, diabetes (diabetic neuropathy), obesity, and footwear styles.
A callus (tyloma) is a thickening of the skin that occurs in response to excessive, repeated shear or friction forces, commonly due to constant rubbing of the skin. Calluses are similar to corns, but calluses occur when abnormal forces are exerted over a larger area. Certain deformities of the feet, such as crookedness of the toes, may predispose to the development of calluses. Calluses may cause pain, typically a burning sensation. Excessive weight bearing and certain types of shoes are often contributing factors.
Who’s At Risk
Calluses may occur in all people with the exception of non-weight-bearing infants.
Signs & Symptoms
Calluses are most frequently located on the feet and sometimes on the hands. They usually are located next to bony prominences.
Self-Care Guidelines
Avoidance of the repetitive forces causing calluses, such as altering shoe style, is the best method of prevention.
Gentle paring with an emery board or a pumice stone may help to decrease the thickened skin. A soft fabric, such as felt, should be applied after paring to protect the underlying skin. Or, shoe pads that go inside your shoes should be used to help relieve the pressure so foot calluses can heal.
When to Seek Medical Care
Calluses do not require medical intervention, but seek evaluation if they become bothersome. Diabetics should pay careful attention to their feet given the risk of development of diabetic ulcers on the feet.
Treatments
Your physician may:
Pare the callus with a scalpel.
Prescribe a topical medication such as urea to help dissolve thickened skin.
Refer the patient to a podiatrist, a health care provider specializing in foot care.
References
Bolognia, Jean L., ed. Dermatology, pp.1399. New York: Mosby, 2003.