What are calluses and can we treat them?

What are calluses and how to get rid of them?

Calluses are areas of thick dry skin that develop when skin is exposed to excessive pressure or friction. Usually patients suffer from callus on the soles of their feet and palms of hands, they appear as a thick yellowish or pale plaque. They typically form over the bony area just under the toes, areas of skin that take the person’s weight when they are walking. Hardening of the s skin is the body’s way of protecting itself from diffuse pressure or friction. Poorly fitted or worn footwear can also contribute to the formation of hard skin. Some patients with dry skin are predisposed to developing callus, which left untreated can lead to deep painful cracks or fissures.

Treatment for calluses typically involves a patient seeing a podiatrist, who would debride the callus sites with a scalpel and smooth using a file. Treatment is totally painless and after treatment patient would usually state that they “feel as if they are walking on air”

Patients would routinely see a podiatrist every 6 to 12 weeks for callus debridement between appointments patients are recommended to file down callosity sites and apply a urea-based emollient to soften and hydrate the skin. Footwear would also be recommended to the patient as good footwear will reduce pressure and friction on high weight bearing regions of the foot. Do not self-treat if you have diabetes, poor circulation on a reduced immune system, instead seek help from a podiatrist.

Painful persisting calluses can be treated using orthotics or insoles to offload pressure at weight bearing regions of the foot. Patients can pronate or supinate causing callus build up on either the medial or lateral aspect of the foot. Orthotics can be used to correct a patient gait by putting the foot into a neutral position and hence reducing excessive pressure and forces on the foot.

What are calluses and what causes them?

When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker to withstand the pressure. When this pressure becomes excessive, some areas of skin thicken in the form of corns and callus, as a protective response to the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground. 

Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type. Elderly people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot.

Calluses are usually caused by friction and pressure. They’re often a protective reaction from your body that helps prevent blisters or other damage to your skin. The most common cause of calluses are shoes that don’t fit well. If your shoes are too tight or don’t fit properly, they may rub against your skin, causing friction and pressure.

Walking or running a lot can lead to corns and calluses, even if you’re wearing shoes that fit well. Standing up for very long periods of time can also cause corns and calluses. If you wear high heels frequently, you’re likely to develop calluses over the balls of your feet, due to the pressure that high heels put on your feet while walking.

Other possible causes of corns and calluses include:

• going barefoot
• wearing socks or shoes with linings that bunch
• taking part in athletic activities that put pressure on your feet
• performing manual labour that puts pressure on your feet
• You’re more likely to get calluses if you:
• walk with over-pronation, which happens when your ankles roll inward too much
• walk with over-supination, which happens when your ankles roll outward too much
• have damaged sweat glands, scars, or warts on your feet
• Bunions. A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe.
• Hammertoe. A hammertoe is a deformity in which your toe curls like a claw.
• Other foot deformities. Certain conditions, such as a bone spur, can cause constant rubbing inside your shoe.

How to get rid of calluses?

It is advised not to treat calluses yourself, especially if you are elderly or have diabetes. A podiatrist will be able to reduce the calluses using a scalpel and files to smooth the site after debridement. This will relieve pain and the podiatrist will be able to redistribute pressure with soft padding, strapping or corrective appliances that fit easily into your shoes. The skin should then return to its normal state.

Elderly people can benefit from padding to the ball of the foot, to compensate for any loss of natural padding. Emollient creams delay callus building up and help improve the skin’s natural elasticity. Your podiatrist will be able to advise you on the best skin preparations for your needs.

Footwear advise would also be given during the treatment wide fitting comfortable shoes would be advised to help reduce pressure and friction on feet. Patients would be advised to treat calluses yourself occasionally by gently rubbing with a pumice stone or a foot file when you are in the bath and apply moisturising cream to help soften thickened skin a little at a time or relieve pressure between the toes with a foam wedge. Do not self-treat if you have diabetes, poor circulation on a reduced immune system, instead seek help from a podiatrist.

Ways to prevent calluses?

Once you’ve cleared up an area of hard skin, there are a few steps you can take to keep the area soft. You may first need to determine why the hard skin developed in the first place. For example, if it’s the result of friction from wearing a particular pair of shoes, you’ll need to avoid these items to prevent future cases of hard skin.

You can also prevent harmful skin friction by wearing properly fitting shoes and insoles or orthotics to redistribute weight and forces to off load pressure on high weight bearing regions.

Another way to prevent hard skin is to regularly use a moisturising lotion. This helps keep skin tissues from drying out. Try to apply it immediately after taking a bath or shower in the evenings. Patients usually recommended to apply moisturiser every day for the first 4 to 6 weeks and the 2 to 3 times a week after.