Corns on toes: throw the kitchen sink at them

foot corns

Corns on the toes are common and they are painful. They are probably one of the most common reasons why people visit a podiatrist. Corns can also be called a hyperkeratosis, or a hard corn or even by their Latin name of heloma durum. Corns are a more discrete localized thickening of the skin with a ‘core’ compared to the more diffuse type of thickening on the skin that occurs in a plantar callus. Pathologically corns and callus’s are essentially same thing but are different based on the definition of the corn being more localized and discrete and the callus more diffuse or spread out. The pathological process that underpins them both is the accumulation of skin cells so that the skin becomes thicker. As the skin becomes thicker, it can become painful.

What causes corns on the toes?

Corns and callus are only caused by one thing: too much pressure on the area. The skin responds to the higher pressures by becoming thicker to protect itself. Eventually the skin gets so thick that it becomes painful. If the higher pressure is more spread out, especially under the ball of the foot, you tend to get a plantar callus or if that higher pressure is from say a hammer toe and the shoe, then that focused pressure in a smaller area results in a corn on the toe that has a deeper ‘core to it’ (the ‘nucleus’). If that higher pressure is next to the nail on the little toe, then that gets called a Durlacher corn.

A common analogy that I often use is the ‘chopping wood analogy’. If you do things with your hands such as chopping a lot of wood, then you tend to develop calluses on your hand. The skin thickens to protect itself and this is a natural, normal process. Once you stop chopping wood, the callus tends to go away. The same thing happens with corns on the toe. The thickening of the skin is a normal and natural process that the skin does to protect itself. If that pressure continues on the toe, the skin will keep on getting thicker and thicker until it hurts. The corn will not go away unless the cause of the higher pressure (like in the wood chopping analogy) is stopped.

What causes the higher pressure that causes the corns on the toe?
Any number of things can cause higher pressure on the toe. For example, hammer or claw toes commonly result in pressure on part of the toe from the shoe. A hammer toe can also cause higher pressure between the end of the toe and the ground. Poorly fitting shoes can cause the higher pressures. There also could be an anomaly with the shape of the done in the toe that results in higher pressures under that particular spot.

Does a corn on the toe have roots that they grow back from?

No, corns do not have roots that they grow from or grow back from after being removed. This is a myth that just will not go away. A podiatrist can meticulously and skillfully debride a corn to get rid of it. However, that corn will highly likely just come back again (eg it may take 6 weeks, 6 months or 6 years) unless something is done about the higher pressures that caused it in the first place. The corn comes back as the cause is still there, not because the Podiatrist did not take out the root or did a bad job treating it.

What are the consequences of corns on the toes?

If you get a corn on the toe, it will eventually hurt as the skin becomes thicker. That is telling you that something is wrong and that you need to do something about it. If you don’t the body will eventually try and do something about it and the tissues can breakdown and ulcerate. That can become infected and get even more painful. Those with things like diabetes or poor circulation at greater risk and this is potentially serious for them.

Treatment for a corn on the toes

To treat a corn you have to do two things:
1. Relieve the pain
2. Remove the cause

Relieve the pain:
This is best done by having a Podiatrist skillfully and meticulously debride the accumulated skin that makes up the corn. This will give an almost instant relief of the pain. Different medicaments may be applied after to help reduce the inflammation in the area.

Other ways to relief the pain is the use of padding to get pressure off the corn and protect the toe. Padding over the corn will not necessarily help, but padding, for example that is oval with a hole or cavity in the middle that goes over the corn can get pressure off it. Toe straighteners or correctors that change the toe alignment can also help. Pads between the toes can help relieve the pain if that is where the corn is.

Remove the cause:
This is the most important part. It does not matter what you do to relieve the pain and how good that is, the corn on the toe is just going to come back again unless the cause of that higher pressure is reduced or eliminated. There are many ways to do this and the most appropriate way will depend on what the reason for that higher pressure is.

Approaches:

  • Footwear: This has to fit properly and have no pressure areas, especially from any seams over the toes. The shoes should be deep enough and wide enough so that they do not cause any area of excessive pressure that might result in corns (or bunions or other foot problems).
  • Footwear stretching: In some cases the footwear can be stretched to accommodate a higher pressure area.
  • Padding: various types of pads can be used to get pressure off areas or spots of higher pressure. There are various felt pads, silicon gel and foam pads that can go over toes, between toes or be thicker around the area of the corn.
  • Toe correctors: If there are problems like hammer toes or similar conditions, there are various toe corrector or alignment devices that can be used to try and correct the toe’s alignment.
  • Surgery: Surgery can be used to fix the alignment of toes to reduce the pressure. It can also be done to remove a piece of bone from underneath where the corn is so that the pressure from the footwear is not going to be an issue in the area.

What about the corn removal pads?

Corn cures or corn removal pads probably should not be used. They contain an acid that is supposed to ‘eat’ or remove the corn. The acid does not know what is corn and what is normal skin, so will eat or dissolve whatever you put it on and it will not stop when its got the corn (even it it does get the corn!). This can be really dangerous if you have poor circulation or diabetes. It also has the potential to facilitate an infection. Corn pads will also do nothing about removing the cause of the corn, so if they do help, it will only be a temporary fix until it recurs as the cause of the corn is still there.

Forum discussions on corns

Are corns curable? (Podiatry Arena)
Corn removal treatment?? (Foot Health Forum)
How to treat a corn that won’t go away ? (Podiatry Experts)

Personal opinion on corns on the toes

Corns are easy to remove and help the pain, but not so easy to stop coming back. Corns are relatively easy to get rid off. All you need to do is get rid of what is causing them. It is important that people with corns understand this. It all about knowing what the cause of the higher pressure is and doing something about that to get rid of that higher pressure. In a number of cases, the person with the corn can work this out and fix it themselves, other times a Podiatrist may be needed to help do that properly.

Oh, and certainly don’t use any of the medicated corn pads.

Author

Leave a Reply

Your email address will not be published. Required fields are marked *