Corns

A corn is a well-defined localized induration with a painful hard core of keratin formed as a reaction to pressure or friction. The conical core is the characteristic symptom of corns, which causes piercing pain by pressing on a nerve at its base. They are formed on parts of the feet that do not bear weight but subjected to friction or pressure, and sometimes on fingers. Corns are therefore, mostly a modern disease.

Types: Corns may be hard and soft.

• ‘Hard corn' (heloma durum), is the most common type with its typical painful hard nucleus, and often appears on the side of the little toe or upon or at the tip of other toes.

• ‘Soft corns' (heloma molle) develop between any of the toes, more commonly between the last-but-the-little toe and the little toes.

Development of Corns

• Like calluses, corns too are natural defensive reactions to pressure created by abnormal biomechanical factors. Pressure due to friction or shock induces formation of corns, which are outgrowths with a central hard part called keratin from the top layers of skin. Thus, corns are natural responses to mechanical stimuli and not a disease of the skin. Neglect of such effects and symptoms will only further aggravate corns by subjecting them to new form of irritations.

• Abnormal biomechanical conditions cause stress to develop in foot due to several factors arising from causes within (like bony protuberances, hammertoe deformities, foot types like high arch & flat foot, or overweight) or from factors without (like improper shoes & accessories, energetic activities, or bad walking postures).

Treatment should be based mainly on identification and elimination of the fundamental causes of corns. Otherwise, all efforts will be futile leading to complications and recurrence.

Simple treatment for immediate and temporary relief consists of carefully trimming the core, and paring down the outgrowth using a chisel blade and suitable abrasives. You can make your task easy by softening the corn with medicated products, mostly containing an ingredient, salicylic acid. However, especially if you are a diabetic prone person, you are warned against the use of salicylic acid or any other chemicals to remove corns, which may only increase irritation and discomfort.

Corns can mostly be controlled by the use of proper footwear with correct shoe fit. So, modification of footwear includes complete removal of construction and design defects or corrections, without disregarding even minor flaws like open seams, which too may increase friction or abrasion.

Hammertoe deformity is the main cause of hard corns, which need shoes with additional toe room - narrow or pointed shoes increase pressure on both corns and deformed toes. You can conveniently use wide shoes for hard or soft corns occurring on the fifth toe. Avoid use of tight socks or stockings, which will keep your feet healthy.

Pressure or friction is the primary cause of corns. You can simply wear down corns by using therapeutic pads or foam pads. Protective silicone sleeves for toes release mineral oil to smooth away soft corns, and also provide cushion to heal reduced corns. You can provide further relief by padding inter-digital space with a foam toe spacer or lamb's wool. Cheap, over-the-counter medicated pads quickly wear out and are ineffective and must be avoided.

When all the options are exhausted, you may think of surgery, which should involve removal of bony prominence, the underlying cause of pressure. But you cannot be sure that more mechanical pressure would not make it recur.

Complications of corns are rare. Corns may occur on bunion, another foot disorder. Sometimes complicated corns cause bursitis, which is an inflammation of fluid-filled sac beneath the corn. Corns may become ulcerated and further deepen affecting the underlying bone. Due to poor blood circulation and diminished resistance to infection, diabetics should be extra careful about their foot care and avoid developing corns or calluses, which may otherwise lead to complications.