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What are Corns?
Corns are thickened areas of skin. They typically occur in areas of pressure on the toes or the ball of the foot. Examples include the pressure from a shoe on the top of the toes or the pressure between the toes.
Corns Symptoms and Anatomy
There are 2 main types of corns. Hard corns are thicker, waxy appearance that are found on the top of the toes or the ball of the foot. Soft corns are between the toes and remain softer due to the increased moisture between the toes. Both types can be painful particularly with shoe wear.
The major cause of corns is increased pressure and friction. Examples include:
- Tight fitting shoes may squeeze the toes bones together and rubbing on the top on the toes.
- Loose shoes may cause the foot to slide within the shoe and lead to rubbing and increased friction.
- High heel shoes tend to be narrow, squeezing the toes while also putting excessive pressure on the ball of the foot leading to corns under the metatarsal bones.
- Wearing closed toed shoes without socks puts increased pressure on the bones of the foot without the sock for cushion as well as increased moisture between toes.
- Toe deformities can cause increased rubbing at the apex of the deformity, typically the knuckle on the top of the toe in hammer toes or between the toes in curly toes.
The best treatment solution is to minimize the pressure and friction. This is possible with properly fitting shoes. A wide toe box with a soft upper can accommodate some mild to moderate toe deformities. A corn cushion on the top of your toe or lambs wool between the toes may help relieve pressure. The corn maybe softened with mechanical exfoliation like a pumice stone or medical exfoliation (salicylic acid or urea cream). Care should be taken with medical exfoliation, especially in diabetics, as it may cause skin irritation and infection. The corns will often return if the increased pressure is not addressed.
Occasionally, surgery is necessary to correct the toe deformity. We recommend surgery when there is a deformity that cannot be accommodated with wide toe box shoes and there is pain that affects activities of daily living. Surgery may also be warranted if an ulcer or infection occurs secondary to the corn.