Advice on Foot Care

A corn is a buildup of dead skin on the top of a toe, at the end of a toe or in between the toes. Corns develop as a result of excess pressure, either pressure from shoes or from the other toes. The most common place for a corn to develop is on the top of a hammertoe. Unequal pull from the tendons in the foot and leg can cause hammertoes to develop. This unequal pull is usually the result of an abnormal foot position or abnormal motion in the foot. As the toes pull up and the tips of the toes curl down, this creates an unusual toe position and results in excessive rub on the toes. The excess rub and irritation is most common on the top of the toes, but also occurs at the tips of the toes. Corns can develop on the sides of the toes and this is generally at the little toes, especially when the little toe is rotated and rubbed by the shoes. When the toes are forced together, the area between the toes is irritated. The body’s response to the excess rub and irritation is to buildup the outer layers of the skin. This creates a hard layer of skin and protects the area from the rubbing. In between the toes, the skin becomes moist, soft and takes on a whitish appearance and becomes very tender. Corns on the top of the toes and in between the toes can become red and swollen because of excess rubbing and irritation. When combined with excess moisture, for example in a pair of boots in the winter or with sweating from sporting activities, a blister can develop under the corn, creating a very painful, swollen toe.

The first step in treatment is figuring out why the problem started. To truly assess why the corns have developed, a podiatrist should evaluate the mechanics of your feet. By doing this, any abnormal motion or abnormal foot position can be addressed. But, there are certainly steps you can take without going to the doctor.

• Shoes: The shoes could be too narrow at the toes or have little depth. For those with hammertoes, depth in the toe area of a shoe is important. Look inside the shoe at the stitching. Is the threading unraveling or are there areas of the shoe material which are peeling off? Both of these problems are common in older shoes and could be the reason for the excess rubbing on the toes.
• Hammertoes: For those with flexible hammertoes, special padding can help reduce the defomity. A flexible hammertoe can be manually straightened. This means that you can take the toe and straighten it, or when you step down, the toes partially or completely straighten. Trying a hammertoe buttress pad, hammertoe cushion or other hammertoe corrective device will help keep the toes in this position and prevent rubbing and friction which contributes to the development of the corns.
• Padding: For corns on the top of the toes, donut hole pads can be placed over the top of the corn to help distribute pressure, alleviating pain. Medicated pads are generally not recommended as they can take off not only the corn, but also the surrounding skin. This type of padding can be used for corns on both flexible and rigid hammertoes. Rigid hammertoes are toes that are in a fixed, curled position. Rigid hammertoes generally don’t respond as well to corrective hammertoe pads, as described above. For in between toe corns, a toe separator usually works the best. The goal with any type of padding is to take pressure off of the corn. This will reduce the buildup of tissue and eventually decrease the pain.

When these home treatments don’t work, the next best step is to visit your doctor for a full evaluation. Your doctor may simply trim the corn or may recommend corrective orthotics, different types of padding or recommend shoes specifically for your feet. For those with severe hammertoe deformities which cause painful corns, blisters, ulcers or infection, your doctor may even recommend surgery.

More information and images on corns.

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