“Corns” are a commonly used term for painful bumps or lumps on the foot or toe. Many times used in error, “corns” are accurately used to describe a thickening of skin over an area of irritation on a toe. Just as we develop a thickening of our skin on the palms of our hands after performing a repetitive movement over a period of time, the same bodily reaction occurs when outside pressure on a boney prominence on one, or more, of our toes. The word “corns” describe this skin thickening on a toe, and only toes, as compared to the thickening of the skin of the bottom or side of the foot, which are referred to as “calluses”. Discoloration of the skin on a toe, without any thickening, cannot necessarily be referred to as corns.
The key to understanding what “corns” are is to understand the causes that produce a corn. Without pressure from a, tight shoe, improper foot function, or some other exterior irritation, “corns” will not occur. However, if a “hammer toe” deformity is present, it is almost impossible to prevent corns. In most cases, a corn results from a structural contraction of the toe, that causes pressure from shoes, socks, or foot function that initiates a reaction from the body to form a “keratosis” over the pressure point. This keratosis is an attempt by the body to protect the area of bone from this abnormal pressure. Simply put, “corns” are a protective response of the body in an attempt to cushion the area of bone that is getting too much pressure. The word “keratosis” is medical terminology for a hardening of skin, anywhere on the body.
Treatments for corns consist of removing pressure from the area of bone that is irritated. Removing pressure from the area, with a pad, wider shoe, or band-aid are commonly used conservative, over- the counter treatments for a corn. If the irritation was the result of a one-time incident, these conservative methods should be successful. If the cause is from a structural foot problem or deformity, simple pressure reducing treatments are usually unsuccessful.
Many self applied “corn pads” contain a very powerful acid. The acid is used to burn away the hard skin, therefore reducing pressure and pain from the irritated area. This may be acceptable in some instances, but with patients with compromised health, such as vascular disease, neuropathy, or diabetes, should not use this type of treatment i due to the possibility of tissue injury and subsequent infection.
In most cases, corns are secondary to a hammer toe deformity. The toe is abnormally contracted, which causes a rigid deformity of the knuckle of the toe and a prominent pressure point on the toe. Any irritation from a shoe or sock on this knuckle will cause a blister and subsequent corn to form on the toe. The best treatment of this problem is surgical correction of the hammer toe. Other treatments may give temporary relief, but if the deformity continues, so will the corns.
Conservative treatment with pads, acid therapy, and wider or longer shoes may give temporary relief. Seeing your Podiatrist to remove the corn by shaving off the hard skin will also give temporary relief. However, it is important that one realizes what is causing their corn problem, and what can be done to give you temporary or permanent relief of your symptoms; long lasting relief usually requires surgical correction.
