Callosities & Corns

Calluses (callosities) and corns are areas of thickened, hard skin that form where the foot is under repeated pressure or friction. They are not dangerous, but they can be painful when walking or wearing shoes. Most are managed with footwear changes, padding and podiatry. Surgery is only considered when a foot deformity keeps causing them.

Hard skin builds up to protect areas that are repeatedly pressed or rubbed. On the foot, this often happens over a bony prominence, on the knuckles of bent toes, or under the ball of the foot. Corns and calluses are especially common in people with foot deformities, prominent bones or an unusual walking pattern. The NHS describes them as hard or thick areas of skin that can be painful but are not often serious.

What is the difference between a corn and a callus?

• Calluses are usually larger, flatter and more spread out.
• Corns are smaller and more defined. They may have a central core that presses into the deeper layers of skin, often over a bony prominence such as a toe joint.

A trial in the Journal of Foot and Ankle Research (Farndon and colleagues) noted that surveys have indicated that between 14% and 48% of people have corns.

What are the symptoms?

• Thick, hard or rough skin on the foot or toes
• Pain when pressure is applied
• A corn may feel like a small pebble under the skin
• Yellowish, grey or waxy skin over joints or pressure points

What causes corns and calluses?

• Tight, ill-fitting or high-heeled shoes
• Toe deformities such as hammer toes or claw toes
• Bony prominences from arthritis or differences in foot mechanics
• High-arched or flat feet
• Prolonged standing or walking barefoot

The NHS also lists losing fat on the bottom of the feet with age and not wearing socks with shoes. Bent toes can rub on shoes — on top of the toe, at the tip, or both — and hard skin on the sole or on the knuckles of the toes is known as a callosity or callus.

Who should not treat corns themselves?

The NHS advises: "If you have diabetes, problems with your circulation, a weakened immune system, or are an older person, do not try to treat corns and calluses yourself." It also advises everyone: "do not try to cut off corns or calluses yourself".

The NHS advises seeing a GP if you think you have a corn or callus and:

• "you have diabetes"
• "you have problems with your circulation or a weakened immune system"
• "it bleeds, or has any pus or discharge"
• "it has not improved after treating it at home for 3 weeks"
• "the pain is severe or stopping you doing your normal activities"

How are corns and calluses treated?

Treatment focuses on removing the hard skin safely and reducing the pressure that causes it:

• Regular podiatry to trim calluses safely and remove corn cores
• Wide, cushioned footwear with plenty of room for the toes
• Custom orthotics to redistribute pressure
• Protective pads or toe sleeves to reduce friction
• Urea-based moisturising creams to soften the skin and reduce build-up
• Physiotherapy or stretching where foot mechanics contribute

Corn plasters or scalpel?

A randomised trial of 202 adults in Sheffield (Farndon and colleagues) compared 40% salicylic acid corn plasters with standard scalpel treatment by a podiatrist. At three months, 34% of corns had completely resolved with plasters, compared with 21% with the scalpel. The time to corn recurrence was longer with plasters over 12 months. The authors concluded that, "used under supervision of a podiatrist on appropriate patients", corn plasters are an effective alternative to scalpel treatment. The trial excluded people with diabetes, poor circulation, rheumatoid arthritis or a history of foot ulcers, so its results do not apply to them.

When is surgery recommended?

Surgery is rarely needed for the corns or calluses themselves. It may be considered if a structural problem, such as a hammer toe, a bunion or a prominent metatarsal head, is causing repeated skin breakdown. Correcting the underlying deformity aims to reduce the pressure that causes the hard skin to form; the deformity can come back after toe surgery.

What is recovery like if surgery is needed?

• 0–2 weeks: rest with the foot elevated; protective dressing or post-operative shoe
• 2 weeks: wound review; stitches removed; light walking begins
• 2–6 weeks: increased walking; supportive footwear and offloading
• 6–8 weeks: return to daily activities; monitoring for recurrence
• 12+ weeks: long-term prevention with footwear advice and custom orthotics

How Mr Hester can help

Mr Hester is a dual fellowship-trained foot and ankle surgeon (FRCS Tr&Orth), trained at Guy's and St Thomas' and in Toronto and Calgary, and a member of BOFAS and EFAS. He sees patients privately at The London Clinic, Cromwell Hospital, King Edward VII's Hospital and HCA The Shard. His NHS practice is at King's College Hospital.

Insured patients need a GP referral and an authorisation code from their insurer. Self-pay patients are welcome. To book, call 020 7046 8004.

Frequently Asked Questions

Sources

1. Corns and calluses. NHS. https://www.nhs.uk/conditions/corns-and-calluses/
2. Farndon LJ, Vernon W, Walters SJ, et al. The effectiveness of salicylic acid plasters compared with "usual" scalpel debridement of corns: a randomised controlled trial. J Foot Ankle Res. 2013. PMID: 24063387. https://pubmed.ncbi.nlm.nih.gov/24063387/
3. Malhotra K, Davda K, Singh D. The pathology and management of lesser toe deformities. EFORT Open Rev. 2016;1(11):409–419. PMID: 28461920. https://pubmed.ncbi.nlm.nih.gov/28461920/