CORNS

Author:  Gary F Ochwat, DPM                                 

Corns are areas of thickened skin on the toes of the foot which occurs in areas of pressure.  A hard corn will occur on the top or tip of the toe as a result of a hammertoe. A hammertoe may be flexible or rigid, and can occur on any of the lesser toes. The reason that the toe “hammers or buckles” is because ligaments and tendons have tightened, cocking the toe upward, causing a pressure point for shoes to rub on, therefore causing the corn.  The most common toes affected are the second toe and the baby toe.

A soft corn occurs between the toes. Soft corns are most commonly found between the fourth and fifth toes. 

 Causes of corns are tight shoes, toe deformities such as hammertoes or a bony prominence or spur on the toe.  Sometimes all the toes can be affected. Corns that are not treated will eventually become painful and irritated when wearing closed shoes.

Treatments for   corns include wearing wider or extra depth shoes, and using over the counter corn pads to provide a cushion between the corn and the shoe.  Beware of medicated pads which contain salicylic acid as over use of these pads can cause infections and ulcers.  This is especially true if you have diabetes or poor circulation. Never try to cut the corn yourself.  Try soaking your foot in warm water, then use a pumice stone to gently file away the thickened skin.

 Visit a Podiatrist to have   painful corns properly evaluated and treated.  After a thorough history and examination, the Podiatrist will first determine the cause of the corn, and then develop a treatment plan.  X-rays may be taken to evaluate which type of bone pathology is the cause of the corn.  An x-ray will also show if the joint is affected by arthritis.

  Treatment options include periodic professional trimming of   corns.  Removing the corn will give temporary relief, but over time the corns will return until the underlying cause (hammertoe or spur) is addressed.    If conservative measures fail to alleviate the pain, a surgical consultation is indicated.

Surgical procedures involve straightening the toe (arthroplasty) or removing a bone spur.    Either is an out-patient procedure performed under local anesthesia or local with sedation (twilight sleep).   Sometimes the procedure can be performed in the Podiatrist’s office.  After the surgery, a bandage and surgical shoe will be worn for approximately 2-4 weeks depending on the severity of the problem. Splinting of the toe with a flexible gauze is applied by your surgeon to keep the toe in the correct position while it is healing.  

Corns are sometimes associated with other foot deformities such as bunions.  When you have a   bunion the big toe can cross over or push up the second toe causing a hammertoe and increased irritation when wearing closed shoes.  Often this is the time professional help is sought. 

If you have been suffering from corns and or hammertoes, and would like to know what can be done to correct the problem,  make an appointment with your Podiatrist for a thorough evaluation.