Calluses and Corns: Symptoms, Causes & Treatment

What Are Calluses and Corns?

Calluses and corns are areas of thickened, hardened skin (hyperkeratosis) that develop as a protective response to repeated friction, pressure, or irritation. Calluses are larger, flat areas that typically form on weight-bearing surfaces, while corns are smaller, circular lesions with a central core that usually develop over bony prominences.

When skin is subjected to repeated mechanical stress, such as friction from shoes or pressure from walking, it responds by producing extra layers of keratin - the tough protein that makes up the outer layer of skin. This process, known as hyperkeratosis, creates the thick, hardened areas we recognize as calluses and corns. The body essentially creates its own protective padding to shield the underlying tissues from damage.

Calluses and corns are extremely common, affecting between 30-65% of the adult population at some point in their lives. They occur more frequently in women than men, likely due to footwear choices such as high heels and narrow-toed shoes that increase friction and pressure on the feet. The incidence also increases with age, as the skin's natural fat padding decreases and the feet undergo structural changes over time.

While often used interchangeably in everyday conversation, calluses and corns are distinct conditions with different characteristics. Understanding the difference is important for proper treatment, as the approach may vary depending on which type you have and where it's located on your body.

Understanding the Difference Between Calluses and Corns

Calluses (also known as tylomas) are broad, diffuse areas of thickened skin that typically develop on weight-bearing areas of the feet, such as the heel, ball of the foot, or the undersides of the big toe. They can also form on the palms of the hands in people who do manual labor or play certain musical instruments. Calluses are generally not painful because they don't have a concentrated center pressing on nerve endings. In fact, they can be beneficial by providing extra protection for areas that receive a lot of stress.

Corns (also known as helomas or clavi) are smaller, more concentrated areas of hardened skin with a distinct cone-shaped core that points inward toward the deeper layers of skin. This core is what makes corns potentially painful - when pressure is applied, the hard center presses on the nerve endings beneath it, causing discomfort or even sharp pain. Corns typically develop on non-weight-bearing areas such as the tops and sides of toes, between toes, or on the balls of the feet where there are bony prominences.

Types of Corns

There are several types of corns, each with unique characteristics based on their location and composition:

Hard corns (heloma durum) are the most common type. They appear as compact, dense areas of hard skin with a translucent central core. Hard corns typically form on the tops of toes, the outer edge of the little toe, or on the sole of the foot. They develop in response to pressure from bone rubbing against skin and shoe material.

Soft corns (heloma molle) develop between the toes, most commonly between the fourth and fifth toes. Unlike hard corns, they have a rubbery texture because the moisture from sweat in this area keeps them soft and white. Soft corns can be particularly uncomfortable because the tight space between toes puts constant pressure on them.

Seed corns are tiny, discrete calluses that typically appear in clusters on the bottom of the foot. They are thought to be caused by blocked sweat ducts and are generally painless unless they develop in weight-bearing areas.

What Causes Calluses and Corns?

The primary cause of calluses and corns is repeated friction, pressure, or irritation to the skin. The most common culprits are ill-fitting shoes, foot deformities like bunions or hammertoes, walking barefoot, and repetitive activities that create friction on the hands or feet.

The formation of calluses and corns is fundamentally a protective mechanism. When skin experiences repeated mechanical stress, it responds by accelerating the production of keratinocytes - the cells that form the outer layer of skin. This leads to a buildup of thick, hard skin that creates a barrier against further damage. While this response is beneficial in protecting deeper tissues, the resulting thickened skin can become problematic if it grows too thick or develops in sensitive areas.

Understanding the underlying causes is essential for effective treatment and prevention, as simply removing the thickened skin without addressing the source of friction will result in the callus or corn returning.

Footwear-Related Causes

Ill-fitting shoes are the leading cause of calluses and corns on the feet. Shoes that are too tight compress the toes and create friction against the skin with every step. High heels shift body weight forward onto the balls of the feet, increasing pressure in this area and often leading to callus formation. Shoes that are too loose allow the foot to slide around, creating friction that stimulates callus development.

Wearing shoes without socks eliminates the protective barrier that socks provide, allowing direct contact between the skin and shoe material. This significantly increases friction and the likelihood of developing calluses or corns. Similarly, thin-soled shoes provide inadequate cushioning and allow pressure from the ground to concentrate on certain areas of the foot.

Foot Structure and Biomechanics

Foot deformities alter the distribution of weight and create abnormal pressure points. Bunions cause the big toe joint to protrude outward, creating a bony prominence that rubs against shoes. Hammertoes cause the middle joint of a toe to bend abnormally, raising the top of the toe where it contacts the shoe. Flat feet or high arches change how weight is distributed across the foot, leading to increased pressure in certain areas.

Gait abnormalities can also contribute to callus formation. If someone walks with an unusual pattern due to leg length discrepancy, hip problems, or neurological conditions, certain parts of the foot may bear more weight than they should, leading to callus development in these areas.

Other Risk Factors

Several other factors increase the risk of developing calluses and corns:

• Age: As we get older, the fatty padding on the soles of the feet thins out, providing less natural cushioning and making callus formation more likely
• Occupation: Jobs that require standing for long periods, walking on hard surfaces, or using hand tools create repetitive stress that leads to callus formation
• Sports and hobbies: Activities like running, hiking, weightlifting, and playing musical instruments create friction that can cause calluses
• Dry skin: When skin lacks moisture, it's more prone to cracking and callus formation
• Diabetes: People with diabetes often have reduced sensation in their feet and may not notice developing calluses until they become problematic

What Are the Symptoms of Calluses and Corns?

The main symptoms of calluses include thick, hardened areas of skin that are usually painless and yellowish in color. Corns present as smaller, raised bumps with a hard center that can cause significant pain when pressure is applied. Both may have surrounding skin that is dry, flaky, or inflamed.

Recognizing the symptoms of calluses and corns helps distinguish them from other skin conditions and determines when home treatment is appropriate versus when professional care is needed. The symptoms can range from mild cosmetic concerns to significant pain that affects daily activities.

Callus Symptoms

Calluses typically present with the following characteristics:

• Thick, rough area of skin that feels hard to the touch
• Yellowish or grayish discoloration compared to surrounding skin
• Dry, flaky, or waxy appearance
• Decreased sensitivity in the affected area (the thick skin acts as a barrier)
• Generally painless, though very thick calluses may cause mild discomfort
• Variable size, often larger than 1 centimeter in diameter

On the feet, calluses most commonly develop on the heel, the ball of the foot (metatarsal heads), the sides of the big toe, and underneath the toes. On the hands, they frequently appear on the palms at the base of the fingers, on the fingertips, or wherever tools or equipment create repetitive friction.

Corn Symptoms

Corns have more distinctive symptoms that set them apart from calluses:

• Small, round, well-defined area of thickened skin
• A hard, dense central core that may be visible as a dark spot
• Pain or tenderness when direct pressure is applied (such as when walking or pressing on the area)
• Surrounding skin may be inflamed or red
• Sharp or burning sensation when the corn presses on nerves

Soft corns between the toes have a distinctive whitish, rubbery appearance and may be accompanied by a slight odor due to the moist environment. They can be quite tender because the tight space between toes creates constant pressure.

When Symptoms Indicate a Problem

While calluses and corns are generally benign, certain symptoms warrant medical attention:

How Are Calluses and Corns Treated?

Treatment for calluses and corns involves removing the thickened skin and eliminating the source of friction. Home treatments include soaking, gentle filing with a pumice stone, moisturizing, and using protective padding. Over-the-counter salicylic acid products can help soften and remove the hardened skin. Severe or recurring cases may require professional treatment from a podiatrist.

The treatment approach for calluses and corns depends on their severity, location, and the individual's health status. For most healthy people, home treatment is effective and safe. However, certain populations - particularly those with diabetes or circulation problems - should seek professional care to avoid complications.

Home Treatment Methods

The foundation of home treatment involves softening the hardened skin and gently removing it over time. This process requires patience and consistency, as trying to remove too much skin at once can cause injury.

Soaking: Start by soaking the affected area in warm water for 10-15 minutes. This softens the thickened skin and makes it easier to remove. You can add Epsom salt, mild soap, or a few tablespoons of baking soda to enhance the softening effect. Some people find that adding a small amount of white vinegar helps break down the hardened skin more effectively.

Filing: After soaking, use a pumice stone, foot file, or emery board to gently rub the callus or corn. Always file in one direction rather than back and forth, and remove only a thin layer of skin at a time. Stop immediately if you feel discomfort or reach pink, healthy skin. Never use sharp instruments like razors or knives to cut away calluses - this significantly increases the risk of infection and injury.

Moisturizing: After filing, apply a thick moisturizing cream or lotion to keep the skin soft. Products containing urea (10-40%), salicylic acid (up to 6%), lactic acid, or ammonium lactate are particularly effective for softening callused skin. Apply moisturizer at night and cover with cotton socks to maximize absorption.

Over-the-Counter Products

Several types of products are available without a prescription to help treat calluses and corns:

Salicylic acid products are the most commonly used treatment. Available in concentrations from 12-40%, salicylic acid works by dissolving the keratin protein that makes up the thickened skin. These products come in various forms including medicated pads, liquid solutions, and gel applicators. Follow the package directions carefully and protect surrounding healthy skin, as salicylic acid can damage normal tissue.

Protective padding helps relieve pressure and friction while the callus or corn heals. Donut-shaped corn pads redistribute pressure away from the center of the corn. Toe sleeves and separators can protect soft corns between toes. Moleskin can be applied around calluses to prevent further friction.

Professional Treatment Options

When home treatment isn't effective or when there are complicating factors, professional treatment may be necessary:

Professional debridement: A podiatrist or dermatologist can safely pare down the thickened skin using specialized instruments. This provides immediate relief, especially for painful corns. The procedure is typically painless and doesn't require anesthesia.

Custom orthotics: For calluses caused by foot structure abnormalities, custom-made shoe inserts can redistribute pressure and prevent calluses from recurring. A podiatrist can assess your foot mechanics and prescribe appropriate orthotics.

Surgical correction: In cases where bone deformities are causing recurring calluses or corns, surgery to correct the underlying structural problem may be recommended. This is typically reserved for severe cases that don't respond to conservative treatment.

Cryotherapy: Some healthcare providers use liquid nitrogen to freeze and remove stubborn corns, similar to the treatment used for warts.

How Can You Prevent Calluses and Corns?

Prevention focuses on eliminating friction and pressure. The most effective measures include wearing properly fitting shoes with adequate cushioning, using protective padding on pressure points, moisturizing feet daily, and addressing foot deformities with orthotics. Regular foot inspection and care are essential, especially for people at higher risk.

Because calluses and corns will return if the underlying cause isn't addressed, prevention is just as important as treatment. By eliminating the sources of friction and pressure that cause these conditions, you can keep them from developing in the first place or prevent them from recurring after treatment.

Proper Footwear Selection

Choosing the right shoes is the single most important preventive measure for foot calluses and corns. Follow these guidelines for optimal foot health:

• Shop for shoes in the afternoon or evening when your feet are naturally slightly swollen from daily activity - this ensures you get the right size
• Have both feet measured each time you buy shoes, as foot size can change over time; if your feet are different sizes, buy shoes that fit the larger foot
• Choose shoes with a wide toe box that allows your toes to move freely without rubbing against each other or the shoe
• Avoid high heels higher than 2 inches when possible, as they shift weight forward and increase pressure on the ball of the foot
• Look for shoes with good arch support and cushioning to distribute pressure evenly across the foot
• Replace worn-out shoes that have lost their cushioning or have developed uneven wear patterns

Protective Measures

Beyond proper footwear, several additional measures can help prevent calluses and corns:

Always wear socks with closed-toe shoes. Socks provide a protective barrier that reduces friction between your skin and the shoe. Choose moisture-wicking socks to keep feet dry and prevent soft corns from developing between toes.

Use protective padding on areas prone to friction. Adhesive moleskin, corn pads, or gel inserts can be placed over pressure points before calluses develop. For people who already have foot deformities, wearing toe caps or spacers can prevent corns from forming.

Maintain foot hygiene by washing and thoroughly drying your feet daily, especially between the toes. Apply moisturizer to keep skin supple and less prone to cracking and callus formation. However, avoid applying moisturizer between the toes, as this can create excess moisture that leads to soft corns.

For Hands

To prevent calluses on the hands from manual labor, sports, or musical instruments:

• Wear gloves when using tools, doing yard work, or lifting weights
• Use padded grips on tools, exercise equipment, and musical instruments
• Apply moisturizer regularly to keep skin soft and flexible
• Take breaks during repetitive activities to reduce continuous friction

Why Are Calluses and Corns Dangerous for People with Diabetes?

People with diabetes face significantly higher risks from calluses and corns due to reduced sensation (neuropathy), poor circulation, and impaired wound healing. What starts as a simple callus can progress to an open wound, infection, and in severe cases, may lead to amputation. Diabetics should never attempt self-treatment and should see a podiatrist regularly.

Foot complications are one of the most serious consequences of diabetes, and calluses and corns play a significant role in their development. Understanding why these seemingly minor skin conditions pose such a threat to people with diabetes is crucial for preventing serious complications.

The Diabetes-Foot Problem Connection

Peripheral neuropathy affects up to 50% of people with diabetes. This nerve damage reduces or eliminates sensation in the feet, meaning a person may not feel pain from a developing callus, corn, or blister. Without pain signals alerting them to a problem, foot injuries can go unnoticed and untreated.

Poor circulation from peripheral vascular disease reduces blood flow to the feet. This impairs the body's ability to deliver oxygen and nutrients needed for healing and to fight infection. Even minor wounds can become serious because the body cannot mount an effective healing response.

Impaired immune function in people with poorly controlled diabetes makes them more susceptible to infections and less able to fight them off once they develop. Bacteria can quickly multiply in wounds that would heal normally in someone without diabetes.

How Calluses Lead to Ulcers

The progression from callus to foot ulcer typically follows a predictable pattern. First, a callus forms due to pressure or friction. Without proper treatment, the callus continues to thicken. Pressure on the thick callus causes the tissue underneath to break down, creating a cavity beneath the callus that fills with fluid or blood. Eventually, the callus ruptures, exposing the damaged tissue below and creating an open wound - a diabetic foot ulcer.

Diabetic foot ulcers are notoriously difficult to heal and carry a high risk of infection. According to the American Diabetes Association, approximately 15% of people with diabetes will develop a foot ulcer during their lifetime, and about 14-24% of those with foot ulcers will require amputation.

When Should You See a Doctor?

See a healthcare provider if you have diabetes or circulation problems (before any self-treatment), if the callus or corn becomes painful or inflamed, if there are signs of infection, if home treatment doesn't improve the condition after 2-3 weeks, or if you're unsure whether you have a corn or another condition like a wart.

While most calluses and corns can be safely treated at home, certain situations require professional medical attention. Knowing when to seek help can prevent complications and ensure proper treatment.

Immediate Medical Attention

Seek prompt medical care if you experience:

• Signs of infection: increasing redness spreading beyond the callus, warmth, swelling, pus or drainage, red streaks extending from the area, or fever
• Severe pain that prevents normal walking or activities
• Bleeding from a callus or corn
• Development of an open wound or ulcer
• Numbness or tingling in the feet (may indicate nerve damage)

Scheduled Medical Evaluation

Make an appointment with a healthcare provider if:

• You have diabetes, poor circulation, or peripheral neuropathy
• Home treatment hasn't improved the condition after 2-3 weeks
• The callus or corn keeps returning despite preventive measures
• You're unsure whether you have a corn, wart, or other skin condition
• You have multiple corns or calluses that interfere with daily activities
• You notice changes in foot structure (bunions, hammertoes) that seem to be causing the problem

What to Expect at Your Appointment

When you see a healthcare provider for calluses or corns, they will examine your feet and ask about your symptoms, footwear, and activities. They may examine your gait and foot mechanics to identify underlying causes. The provider may safely pare down the thickened skin, recommend appropriate treatments, and advise on prevention strategies. For recurring problems, they may refer you to a podiatrist or recommend custom orthotics.