What is a Callus?
A callus is a hard, thickened area of built up layers of dead skin, which develops on areas of the foot that are exposed to an unusual amount of pressure or friction on a regular basis. They are usually found on the ball of the foot, the heel, and the outsides of the big and little toes. They are usually not painful.
What Causes Calluses?
- Improperly fitting shoes. Shoes that are too tight can cause calluses to develop on the outsides of the big and little toes. Open-backed shoes can cause calluses on the bottom or sides of the heel. Shoes that are too loose can cause calluses to form on the balls of the feet. In this case the callus develops when the foot consistently rides forward inside the shoe with each step.
- Structural deformities of the foot. If the foot has a high or low arch, calluses may result on the balls of the feet or just behind the toes. When one of the bones of the mid-foot (the metatarsals) "drops" and becomes out of alignment, it is subjected to excess stress when walking. A callus may develop to protect the bone or tissue under the skin from the extra weight they must carry when the bone is out of alignment. When one metatarsal bone is affected, the ligaments that hold the bones can become over-stretched, causing other bones to drop. This sometimes results in the entire arch collapsing. The condition can be very painful if very deep callus material develops under the ball of the foot. This condition is called intractable plantar keratosis (IPK).
What Should I Do if I Have Calluses?
There are very simple ways to prevent and treat the development of calluses.
- Buy proper fitting shoes... not too tight or too loose. Wear closed-healed shoes or socks with open-healed shoes if calluses are forming on your heels. If your feet slip inside your shoes, wear "anti-shearing" insoles.
- If the callus is on the ball of the foot, padding the callus with moleskin, foam, or gel callus pad may help. The principle behind padding is to spread the weight evenly over the entire ball of the foot.
- A callus can be filed down using a foot file or pumice until normal skin appears. Apply a good moisturizer to keep skin supple. Regular filing and moisturizing can keep most calluses manageable.
- Be extremely cautious if you use a commercial callus remover. These liquids, creams, and medicated pads contain salicylic acid that can burn health skin along with the callus and could cause ulceration. These must not be used by anyone with diabetes or circulatory impairment.
When Should I Get Professional Help?
- If you don't see well enough to safely file or pad your calluses.
- If you are physically unable to look after your calluses.
- If you don't have the right equipment or understanding of how to care for your calluses.
- If your calluses have developed to the point where you cannot reduce them adequately.
- If your calluses are likely due to a foot structural problem, custom-made orthotics or surgical correction may be an option you may want to discuss with your doctor or a podiatrist.