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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:

  1. 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.
  2. 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.
  3. 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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