Pain At Base Of Ankle Top Of Foot Weight Gain Callus Removal From Feet: Myths and Facts

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Callus Removal From Feet: Myths and Facts

Corns under the feet are common sources of pain and frustration. This article will discuss what can actually be done to provide treatment, and dispel some of the myths about its treatment.

Calluses on the bottom of the foot are from a natural process designed to protect the foot skin from excessive pressure. This excessive pressure can come from several sources. Externally, pressure can come from simply walking or standing on the ground, whether one is wearing shoes or not. The shoe itself can be a source of external pressure, although this is usually seen as a result in corns on the top of the toes (which is the same type of condition as a callus). Internally, pressure can come from the bones that lie under the skin. If the bones are abnormally prominent due to an abnormality of the foot structure (such as a bunion or flat feet), or if the skin and padding under the bone is abnormally thin, then the pressure on the overlying skin will increase. The skin is usually irritated by both internal and external sources of pressure at the same time, where external pressure from walking combined with internal pressure from prominent bones or thin skin create a reaction in the skin tissue. This reaction causes the skin to form a thickening of the outer layer of keratin-based cells, which fuse together to form multiple layers.

Over time, a callus (also known as hyperkeratosis) develops when the skin becomes too thick at the site of pressure. This callus, if thick enough, can be painful because the original normal skin layer at the bottom of the callus is damaged by the pressure of the layer that covers it. What was once a simple protective measure by the skin can become a source of pain and damage to the skin if growth progresses far enough. Sometimes the callus grows inward to the base layer of the skin, leading to the formation of a thick, hard core that tunnels inward (but does not break the skin). This is also called an intractable plantar keratosis, and is often mistaken for a wart. Eventually, sweat and other skin glands can fill with keratin material, forming a small pinpoint callus called a porokeratosis. This type of callus does not need to have prominent bone underneath to form, and is usually not painful.

Callus treatment is often misunderstood, and in reality can be somewhat complicated. The most common form of treatment is simple shaving of the callus by yourself, a pedicurist or a podiatrist. The act of shedding the hard skin will make it more comfortable to walk on, and will reduce pain. However, the cause of the callus will still exist, and the callus will eventually return in a month or two. This causes great confusion for some people, who simply associate a callus with a temporary skin growth, and not something directly linked to their foot structure and activity. Using special shoe padding or foot support to reduce pressure on the bottom of the foot can help limit the growth of a callus, when used in conjunction with callus shaving and well-fitting shoes. Unfortunately, these will not eliminate the callus permanently, and will only serve to reduce the overall thickness of the callus as it grows back. Even prescription shoe inserts (orthotics) will not permanently reduce calluses, although they de-weight the callused area better than store-bought inserts by being custom-made to a mold of the foot.

It should be noted that diabetics should never try to manage their calluses on their own. Due to bad feelings of diabetes, diabetics trim their own calluses or having an inadequate family member try this at home can lead to a wound and an infection from an accidental cut in normal skin.

Some people assume that a callus can be burned off, like a wart or other skin growth. The use of chemicals, lasers, cold treatment and electricity to destroy skin growths is very common, and often effective for other types of skin disorders. Unfortunately, these techniques do not work so well on callus tissue, because the growth of the callus is continuous, and not based on the simple presence of abnormal skin cells that can be removed. Callus tissue is normal tissue, and any destructive procedure against this tissue will only be temporarily successful until skin growth starts again, and the callus reforms. The only exception to this is a porokeratosis, which can be removed if the underlying gland and gland duct is destroyed.

Surgical treatment is the next level of callus care. This is another area where there is great confusion, and treatment myths abound. In short, calluses cannot be excised or otherwise surgically removed, with the expectation that the callus will not return. The new skin that grows after the operation will continue to form a callus, and combined with a surgical scar, it can be even more painful than the original callus. The only exception is again the porokeratosis, which can be successfully removed with an operation. The only way to get rid of a callus permanently is to get rid of the underlying bony prominence, and to make sure shoes fit well and are properly constructed to account for any skin and tissue that thins over these bones. There are a multitude of bones in the foot that can cause enough prominence to irritate the skin, and so many ways to relieve the pressure through bone surgery. Procedures may include lifting bones that protrude too far toward the bottom of the foot, removing extra bones that form naturally during development (very common), shaving or removing bone spurs or loose bone fragments, or even complete removal of the part of the bone causing the pressure. Procedures to correct the general deformity that caused the pressure, such as a bunion, or arch abnormality, may be necessary. Healing times will vary, and depends on whether the bone was simply sheared or pulled out, or whether the bone position was moved. These procedures are generally successful in eliminating callus formation if done properly, although there is a risk for the pressure point of the foot to simply transfer to the next bone. Orthotics are often used after surgery to prevent this.

As one can see, callus care is not simply about shaving or cutting out the hard tissue. In reality, this myth does not work well, and bone surgery is necessary to keep callus care from becoming an exercise in regular skin maintenance through regular shaving and shoe inserts. This can provide complete relief for some. For others, surgery is needed to break the ongoing pain cycle.

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