Calluses are thickened, dead tissue involving the outer layer of the skin (epidermis). They are similar to corns, with the difference being their location. Calluses are located on the soles of the feet, particularly the ‘balls’, while corns are located on the toes. A callus may form secondarily to a bunion deformity or a prominent metatarsal bone. Often a callus is mistaken for a wart.
A callus (like a corn) is caused by excessive pressure from underlying bones. The metatarsal bones, which are the long bones forming the ‘balls’ of the feet, are the usual cause. These metatarsal bones can be long, rotated, enlarged or lowered in relation to the other metatarsal bones, causing excessive pressure. Abnormal weight distribution can also cause calluses. This ‘thickened’ tissue is built up out of the natural defense of the body to protect these areas from abnormal pressure. Footwear can aggravate the condition, however hereditary factors and structural problems are the major cause of this bony abnormality.
To remove the callus tissue, we do not recommend commercial acid medications which may cause blistering and infection. Trimming the callus should only be done with a pumice stone or regular sandpaper. Do not use sharp tools to remove calluses.
Shoes with a thicker cushion sole may be beneficial in absorbing the abnormal pressure. If abnormal weight distribution is the cause of the callus formation, an orthotic can control the pressure across the balls of the feet. The excessive callus tissue can be trimmed in our office for temporary relief.
If the symptoms persist, there are alternatives that will permanently prevent the recurrence of the callus or corn. If a bunion is the cause of callous formation, surgical correction of the bunion would be appropriate. If a hammertoe is the cause, rebalancing the tendons in the toe and straightening the digit will eliminate the callus. When a metatarsal bone is prominent, the bone is repositioned, thus preventing further callus. These are minor surgical procedures performed as an outpatient under local anesthesia. Patients are able to walk out of the hospital or surgery center wearing only a surgical shoe. Usually only minor discomfort is experienced following these type of procedures. The surgical shoe is worn approximately two to three weeks, and reasonably normal ambulatory activities can be continued during this time.