Callus Fundamentals
Calluses are a build-up of hard skin and are generally found beneath the weight bearing surfaces on the bottom of the foot. Some degree of callus formation on the sole of the foot of an active person is normal and generally does not cause any problems for a patient. Callus formation can also occur around the periphery of the heels, which can lead to fissuring of the callus, which can become quite painful. Some people use the terms “corns” and “calluses” interchangeably.
How is this caused?
Calluses are generally caused by an uneven distribution of weight, generally on the bottom of the forefoot or heel that leads to a build-up of hard skin. Calluses can be caused by wearing improperly fitted shoes and, in rare instances, an abnormality of the skin causing a build-up of callus tissue. When calluses become too thick, they become painful.
How is this treated?
Properly fitted, supportive shoes with good shock-absorbing soles can help to alleviate pressures on the bottom of the foot which can eventually lead to the build-up of callus. People who have problems with calluses should definitely avoid hard soled or leather soled shoes that do not cushion the bottom of the foot. The use of over-the-counter cushion pads or insoles can also be helpful to eliminate pressure points that can lead to a painful callus. At times, more expensive, custom-made insoles may be necessary. You should also limit the amount of time spent barefoot, since walking barefoot can also cause a build-up of calluses.
Calluses are generally treated conservatively by scraping and/or trimming the build-up of hard tissue and some attempt to re-distribute weight bearing forces away from the callused area.
You should never use sharp objects to cut calluses since injuries can occur and are particularly dangerous in patients with diabetes. This “bathroom surgery” is strongly discouraged and can lead to serious problems. People with calluses are encouraged to soak their feet in lukewarm, soapy water for 10-15 minutes, followed by using a pumice stone to gently file away the build-up of hard tissue. Certain medicated creams and lotions are also helpful in breaking down callus tissue and keeping the skin soft and pliable. When conservative treatment for calluses is not successful, special custom-made inserts are used to even out weight bearing forces on the bottom of the foot to prevent abnormal callusing. In rare instances, surgical procedures may also be performed in order to change the position of the bone so that callusing ceases.
What are the risks of treatment?
Risks include nerve injury, infection, and stiffness of the joints, and onset of a new callus in a different area of the foot.
What do I need to do the day of surgery?
- If you currently take any medications, take them the day of your surgery with just a sip of water.
- Refrain from taking diabetic pills or insulin on the morning of surgery.
- Do not wear any jewelry, body piercings, makeup, nail polish, hairpins or contacts.
- Leave valuables and money at home.
- Wear loose-fitting, comfortable clothing.
Rehab after surgery
Foot and ankle surgery rehabilitation can be done at home, or, may require formal physical therapy.