Foot Focus Podiatry

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Hard Skin?  What is the Difference Between Callus and Corns?

callus-Corn-in-perth

A callus (See Figure 1) generally refers to the thickening of the skin, commonly on the ball of the foot.  This can sometimes cause mild discomfort.

A corn (See Figure 2) is a deeper more focal formation of hard skin commonly on the toes. A corn can form under a callused area and is more painful when bearing weight. If pain persists while not bearing weight, it could mean that your corn is infected.

Causes of Callus and Corns

This is usually the result of an underlying foot problem e.g. deformities in the toes or feet, a particular style of walking, thin skin, bony toes or inappropriate footwear.  Uneven pressure on the feet, causes the bone to rub again the skin.  The body responds by producing thickenings in the surface layer of the skin.  People with Bunions are also likely to develop Callus & Corns. If untreated, Calluses & Corns can become quite painful.  Our Podiatrists can help identify the cause and recommend appropriate treatment.

How to treat?

Our Podiatrists will:

  • remove the hard skin, a painless procedure which gives immediate relief. Then assess to determine the cause and address the problem to prevent re-occurrence.
  • redistribute pressure on the foot with special shoe inserts (orthotics) that fit in the shoe.
  • custom make a toe device using a special silicone material that moulds to your toes.  A wedge or prop to help alleviate the is used for corns between your toes or a prop if on the end of your toe to lift your toe off the ground. (See Figure 3)
  • give advice on properly fitting  The key is that it fits you correctly and your footwear isn’t too tight which results in pressure or too loose which causes rubbing friction.

It is better not to treat yourself as the key is to determine the cause and prevent it from reoccurring.  This is imperative if you have high risk feet such as diabetes or poor circulation.

Callus-Pic-288x300 Callus vs Corn

Figure 1- Callus example

Corn-Pic-1-300x254 Callus vs CornCorn-Pic-2-300x268 Callus vs Corn

Figure 2 – Corn examples

Toe-Devices-300x80 Callus vs Corn

Figure 3 – Toe Devices examples

  • Winograd procedure- This procedure will be done in hospital setting under local and or general anaesthesia and it is reserved upon failure of the phenolization or if there is significant amount of skin overlapping the nail with soft tissue growth. This procedure involves removing a portion of the skin along with the nail down to the level of the bone. Sutures (stitches) will be applied to close the surgical site. The procedure takes about 10-15 minutes to be performed and your foot will be bandaged. You will be seen within first 5 days and then the sutures will be removed in 10-14 days. Currently this procedure can only be performed by Reza Naraghi (podiatric surgeon).  He will prescribe appropriate pain medication for your post-operative pain management. You will be in open sandal and or post op shoe for 2 weeks. This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a Winograd then please click here.
  • Zadik Procedure- This procedure is used with permanent total nail removal is desired. The indications for the procedure are significant ingrowing nail on both borders, thickened and painful nails and bony growth under the nailbed. This procedure can be done under local with sedation and or under general anaesthesia at a hospital and or day surgery centre. Sutures will be applied and will be removed 14 days post surgery. You can not get your foot wet and your foot will be in a sterile bandage for 2-3 weeks. You may need pain medication post surgery. On average it will take six weeks for your nail bed area to heal. Following that you can wear most close shoes.

Matrixectomy with phenolization- This procedure involves removing the nail partially or totally and ablating (destroying) the root using a weak acid called phenol. This will cause permanent ablation of the root of the offending nail and prevent ingrown nail recurrence. This procedure is successful 95% of the time. The procedure takes about 10-15 minutes and can be performed in our rooms using local anaesthesia with or without sedation. Post operatively you will be required to soak your toe and apply a daily dressing. Wearing open toe shoes for at least 3-4 days is recommended. You maybe required to take oral antibiotics. Most patients do not require pain medication following the procedure, and if needed Panadol is sufficient for pain management. You can go back to regular shoes after one week.  This is not for everyone (especially if you don’t like seeing surgical procedures) but should you be keen to see a step by step process involved in a partial nail matrixectomy with phenolisation then please click here.