Do You Have Hard Skin on Your Feet?
If you live in Bournemouth or Poole, you probably enjoy the outdoors — from the countryside to the beach. But have you ever noticed that hard skin can build up on your feet?
One of the most common complications seen by podiatrists in clinic is hard skin. It usually presents in the form of corns and calluses, which may form over bony prominences or joint surfaces. Dry, hard skin is often vulnerable to cracking (fissures), and if the skin splits (pathological fissures), it can be painful.
Corn reduced via scalpel enucleation on the plantar aspect of the metatarsal head.
Corns can appear on the base of the foot (plantar aspect), for example on the metatarsal heads, but they can also appear on the tops of the toes, such as on hammer toes, or even between the toes (interdigital corn — Heloma Molle). They can sometimes appear in multiple clusters, also known as seed corns (Heloma Durum). Similarly, calluses can present as a plate of hard skin at the base or edge of the heel, or around the metatarsal heads (the plantar ball of the foot). A flat plate of callus may develop a central corn if the forces acting against the foot are high or concentrated enough.
Corns and calluses are usually diagnosed based on their appearance and texture. Corns can be slightly yellow in colour and contain a hard, dense, compressed ball of skin. Calluses present as a flatter region of thickened skin.
Hard skin on the feet is usually the result of mechanical pressure and friction. Increased shearing forces (pressure and friction), caused by walking or footwear, can lead the body to lay down extra hard skin (hyperkeratosis) to protect itself.
The following factors may increase the risk of complications from hard skin build-up: diabetes, arthritis, psoriasis, a compromised immune system, underlying medical conditions, circulation issues, age (being elderly), loss of the protective fibro-fatty pad on the feet, bony prominences, hammer toes, or treatments such as chemotherapy.
If you find small stains of blood in the hard skin — especially if you have diabetes — you should contact your medical practitioner for further advice.
Active individuals, working professionals, athletes, or anyone who takes part in physical activity may be more prone to developing corns or calluses. Even your social life can contribute — for example, wearing firm, narrow, or hard fashion shoes can increase the risk of corn and callus formation.
The best way to resolve or manage corns and calluses is to remove or reduce the cause of the problem, offload pressure and reduce or prevent re-formation of the corn and or callus, advise daily use of an emollient or moisturiser, and review your footwear. Skin reduction by careful paring down with a scalpel is a standard method of treatment.
For interdigical corns, they can be reduced or removed with a standard N15 scalpel blade, and smoothed with micro burrs which can be very helpful for a successful finish. Custom made interdigital silicone devies can also be made on-site in clinic for more comfortable walking, pain relief and in preventing re growth of the corn.
Silicone custom made interdigital toe separator
Checking your footwear is especially important if you have diabetes. For example, wearing narrow, hard-soled shoes with a stiff leather upper and firm soles (made of hard leather, rubber, or plastic) increases the risk of skin trauma, which can lead to callus formation.
Your podiatrist may recommend wider, softer, deeper, and more supportive shoes with low-friction qualities to prevent rubbing. Some modern-day running trainers are an excellent place to start, and there are many well-fitting and extra-wide day shoes available. Even fashionable, orthopaedic-inspired footwear is now available and popular on the market. In extreme cases, if your foot is very wide or unusually shaped, you may require custom-made shoes — and the NHS may be able to assist.
Comfort arch supports, cushioned insoles and prescription custom made orthotics can be a great addition in providing comfort and offloading pressure from the plantar aspect of the foot and are often very useful in significantly reducing corn and callus formation on the base of the foot. As podiatrists we successfully make devices offering significant comfort and pain relief to patients. With improvements in material science we can make pretty much make any shape orthotic and use a vast range of materials to give you that tailored fit.
Different types of Custom made orthotics and material top Covers. Lower left, Carbon fibre general every day fit. Central, diabetic friendly EVA, Right, Slim fit Carbon Flex ideal for heels and fashion and shoes.
Cautions when self treating
We do not advise the use of caustics, chemicals, or acids for treating corns and calluses. For people with diabetes or other health conditions, these treatments may put the foot at serious risk. The use of chemicals in some cases can be very dangerous — especially for those with compromised health, a weakened immune system, the elderly, those with significantly reduced fibro-fat pads, or anyone with a condition that may affect skin integrity, healing, or recovery.
Therefore, we do not recommend treatments such as medicated corn plasters on diabetics or persons with an underlying medical condition. Always read the manufacturers label when applying any treatment to your skin. Damage to the skin caused by chemicals can lead to trauma, ulceration, and infection, which could have catastrophic consequences for foot health and may result in irreversible medical complications. Anyone with a health condition that may compromise foot health should not attempt self-treatment and should instead seek professional medical advice.
If you have painful corns, a build-up of hard skin, or simply want to get your feet summer-ready, your podiatrist or chiropodist can help manage the condition. Treatment may include paring down hard skin and removing corns through scalpel reduction (debridement and enucleation), as well as using skin burrs and micro burrs to smooth the callus and manage corns. Often, the gentle application of a recommended moisturiser can help restore flexibility and comfort to the skin after treatment.
Want to learn more or manage your painful or hard skin? Appointments are now available at Coastal Podiatry.