Calluses and Corns
Calluses and corns are areas of hard, thick skin that form due to pressure and friction over a prominent bone. When this hard skin forms on a toe, it is called a corn, and when it forms on the bottom of the foot it is called a callus.
Corns can develop on the top of the toe, the end of the toe, or between the toes. This is due to pressure from the shoe rubbing on a toe that is not straight. A rotated or contracted toe is a hammertoe. Treatment is aimed at either changing the pressure point with padding, or correcting the hammertoe deformity with surgery.
Calluses tend to form under the bottom of the foot. The most pressure from weight bearing is at the metatarsal head, or ball of the foot. Sometimes the metatarsal bones are slightly out of alignment and will cause increased pressure and callus in that area. The callus can form as a small, deep area of hard skin, or a large diffuse callus can develop. Both forms of calluses can cause pain, adding more pressure as they thicken. Treatment is aimed at reducing the pressure on the bone. Your foot doctor can skillfully reduce the hard skin to relieve pain immediately. Permanent correction would require offloading the area of pressure with padding or orthotics, however, sometimes the metatarsal needs to be surgically realigned.
It is important to consult with a foot specialist if you have painful corns or calluses. Those with diabetes, heart disease or poor circulation should never use store-bought corn remover medications. These are acids that can further damage the delicate skin surrounding the corn or callus, resulting in infection.
Athlete’s Foot (tinea pedis)
Athlete’s foot is a highly contagious, persistent infection of the skin caused by the overgrowth of a fungal microorganism. It is commonly between the toes but can extend throughout the bottom and up the sides of the foot. It thrives in moist , dark places, such as the inside of shoes. The warmth and humidity in pool areas, locker rooms, and public showers provide an optimum environment for fungus to thrive. The term “athlete’s foot” originated because the fungal infection was common in athletes who frequented these facilities. The signs of athlete’s foot can vary depending on the type of fungal organism present. The skin may be red and itchy with blisters that break and spread the infection, or the feet may have a dry, chalky appearance that doesn't improve with moisturizing cream.
Fungal infections of the skin can spread to the toenails and other parts of the body, including the underarms, the groin, and the scalp. Athlete’s foot can mimic other skin disorders such as psoriasis, excema, lichen planus, and allergic skin reactions. It is important to seek a proper diagnosis from your foot specialist so that you receive the appropriate treatment.
Warts are growths on the skin caused by the invasion of the human papilloma virus through a small cut or break in the skin. Warts on the bottom of the foot are referred to as plantar warts. Plantar warts are described by the location on the plantar (bottom) surface of the foot. It is the same virus that causes warts on other parts of the body.
A wart is the change in the skin due to an immune response to the virus. The wart or bump (that you can see) is the body’s reaction to the virus (that you cannot see). Hard skin may form in a circular pattern, which is why a wart is often mistaken for a corn or callus.
Small dark spots can also be present on a wart. These are small broken capillaries due to pressure, and are part of the immune response. The wart does not have a root; it cannot invade deeper than your skin.
It is important to treat warts when they are painful, multiplying, or getting larger. There are many types of treatments including acid creams, antiviral creams, laser treatment, and, less often, surgical excision. There are other types of bumps that can look like a wart but are sometimes cancerous. It is important to check with your foot care specialist for the proper diagnosis and to provide the best treatment option for you.
If you have a problem with changes in the appearance of your nails or are unsure how to care for them, please contact us for an appointment.
Ingrown toenails occur when the edges of the nail penetrate the surrounding skin of the toe. These are common in children and adults. An ingrown toenail is red and swollen, and is often accompanied by tenderness that can progress when a bacterial infection develops. Ingrown toenails can be very painful, and can cause limb-threatening infections in those with diabetes or poor circulation.
Ingrown toenails can be caused by pressure from the shape of the toenail, or the misalignment of the toe. Irritation to the toes can also occur through rubbing in tight shoes, and during sports activities. Swelling of the legs and feet are also common sources of ingrown toenails.
Treatment for ingrown toenails is relatively painless. With very refined instruments, your foot specialist can trim away a portion of the nail edge to provide immediate relief. Sometimes, freezing the toe by injection with a local anesthetic is necessary. Due to extensive training in these procedures, your podiatrist will have the skill and technique to minimize any discomfort. Once the toe is numb, the nail edge can be removed, and a chemical is applied to prevent future growth of that nail edge. When the numbness wears off, there is rarely a need for pain medication. Work and athletic activity can be resumed the next day.
Discoloured or Thickened Toenails
The most common cause of discoloured or thickened toenails is a fungal infection. The same fungal microorganism that causes athlete’s foot can also invade the toenail. This type of fungus can infect skin and nails, but cannot invade the body. Fungal infections, however, are not the only cause of discoloured or thickened nails. Any injury to the nail can cause a change in its appearance. Pressure from shoes, athletic activity, and even cold exposure can damage the nail. Poor circulation, medications, certain diseases, bone spurs, and bone tumors in the toes can also cause changes in the nail.
If you have a concern about changes in the appearance of your toenails, it is important to contact your foot specialists at the Associated Foot Clinic.