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Corns
Corns like calluses
develop from an accumulation of dead skin cells on the foot, forming
thick, hardened areas. They contain a cone-shaped core whose point
can press on a nerve below, causing pain. Corns are a very common
ailment that usually form on the tops, sides and tips of the toes.
Corns can become inflamed due to constant friction and pressure from
footwear. Corns that form between the toes are sometimes referred to
as soft corns.
CAUSE
Some of the common causes of corn development are tight fitting footwear,
high heeled footwear, tight fitting stockings and socks, deformed toes, or
the foot sliding forward in a shoe that fits too loosely. Soft corns
are result from bony prominences and are located between the toes.
They become soft due to perspiration in the forefoot area.
Complications that can arise from corns include bursitis and the
development of an ulcer.
TREATMENT & PREVENTION
There are very simple ways to prevent and treat the development of corns.
You should wear properly fitted footwear with extra room in the toe box
(toe area). Avoid shoes that are too tight or too loose. Use
an orthotic or shoe insert made with materials that will absorb shock and
shear forces. Also avoiding tight socks and stockings to provide a
healthier environment for the foot.
Try to steer away from corn removing solutions and medicated pads.
These solutions can sometimes increase irritation and discomfort.
Diabetics and all other individuals with poor circulation should never use
any chemical agents to remove corns.
What are corns?
Corns are annoying and sometimes painful thickenings that form in the skin
in areas that are being pressed on by underlying bones. They occur on
parts of the feet and sometimes the fingers. Corns can be painful to walk
on even when they are small. Common locations are:
- On the sole, over the metatarsal arch
(the "ball" of the foot);
- On the outside of the fifth (pinky)
toe, where it rubs against the shoe; and
- Between the 4th and 5th toes. Unlike
other corns which are firm and flesh-colored, corns between the toes are
often whitish and messy; they are sometimes called "soft corns."
It's usually hard to know where finger
corns come from since they often don't appear at sites of obvious
pressure.
How can corns be prevented?
Generally speaking, corns are a disease of civilization. If we didn't wear
shoes, we wouldn't have them. Potential preventive measures therefore
include:
- Moving to Tahiti to stroll on the sand
in your bare tootsies! This is a pleasant approach, as long as you never
have to go back home and walk in shoes again.
- For the incurably civilized, wearing
comfortable shoes is useful. The idea is to avoid having footgear press
on the outside of the 5th toe, or pressing the 4th and 5th toes
together.
- Another approach is to pad the
potentially affected area. You can buy many sorts of padding at the
drugstore:
- Cushions to put between the toes;
- Foam or moleskin pads to put over the
places where corns form;
- Foam pads with holes in the center
(like doughnuts or bagels), which redistribute pressure around the corn
instead of right over it; and
- Cushioned insoles to pad your feet and
alleviate mechanical pressure.
How can corns be treated?
You can buy many types of medicated products to chemically pare down the
thickened, dead skin overlying the corn. These products are share the same
active ingredient -salicylic acid.
Salicylic acid is a keratolytic, which
means it dissolves the protein (keratin)
that makes up most of both your corn and the thick layer of dead skin
which often tops it. Used once a day as indicated on the package
directions, these products are gentle and safe. Salicylic acid treatments
are available in different forms including:
- Applicators
- Drops
- Pads
- Plasters
All of these treatment will turn the top
of the skin white and allow you to trim or peel away dead tissue, making
the corn protrude and hurt less.
It generally is recommended that
salicylic acid not be used in diabetics or when there is poor circulation
(because of concern about how normally the skin can heal); however, in
practice, salicylic acid is withheld only when there are clear signs of
ongoing inflammation of the skin.
When
should you seek professional treatment for corns?
If the corn bothers you and doesn't respond to salicylic acid and
trimming, you might consider seeing a physician or podiatrist who can
physically pare corns with scalpels. (It's better not to do this yourself,
especially if you're elderly or diabetic.) Podiatrists also can measure
and fit you with orthotic devices to redistribute your weight on your feet
while you walk so that pressure from the foot bones doesn't focus on your
corns. (Off-the-shelf cushioned insoles are one-size-fits-all and may not
be effective.)
Surgery for corns is rarely necessary.
There is never a point to cutting out a corn. The pressure that caused it
to form in the first place will just make it come back. When necessary,
surgery for corns involves shaving the underlying bone that is pressing on
the skin to reduce the pressure.
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