Heloma or corns
A plantar corn is a skin that looks like a bump of hard skin. It may feel like walking on a small pebble or cause a burning sensation when located between your toes. Corns tend to form on areas of your skin that experience too much pressure and/or friction. Most often, corns form on the sole of the foot, the outer side of the little toe, between toes and, occasionally, on the top or side of a hammertoe.
Signs and symptoms of plantar corn
- Painful bump on a toe or the bottom of your foot
- Pain worsens if direct pressure is applied
- Presence of a darker core
- Damp, tender skin between your toes
- Feels like walking on a pebble
- Burning sensation between the toes
What is the cause of plantar callus
Plantar corns happen when your skin wants to protect itself from excessive pressure and friction. Skin responds to stress by thickening and prolonged stress can cause the skin to become so thick that it forms a painful bump called a “corn.” This hard skin gets pushed down in your skin in the shape of a cone or inverted pyramid and thus, makes you feel like there is a pebble in your shoe.
What causes excessive stress on skin?
- Gait anomalies resulting in excessive pressure under certain parts of your feet (flat feet, hyperpronation, hallux limitus, bunions)
- Poor bone alignment (bones that are too long, too short, too mobile, etc.)
- Toe deformities (hammertoes, etc.)
- Foot deformities (bunions, bumps, flat feet, high arches, etc.)
- Shoes that are too narrow at the toe box
- Poorly fitting shoes (too big or too small)
- High-heeled shoes (putting excessive pressure on the ball of the foot)
- Certain sports’ footwear (skates, dance shoes, soccer cleats, cycling shoes, rock climbing shoes, etc.)
- Steel-toe boots
- Wearing shoes without socks
IMPORTANT! Very painful corns are common among smokers—another good reason to quit!
Progression and consequences of plantar corn
Left untreated, plantar corns tend to get bigger, deeper and more painful, to the point where they can interfere with everyday life. On top of that, painful corns can make you change your gait without even realizing it. This can trigger additional pain elsewhere as your body tries to compensate.
If the stress on your skin isn’t alleviated, blisters or even ulcers may form. This heightens the risk of infection, which is especially worrying for patients with diabetes or vascular disease.
How to relieve a plantar corn pain at home
First and foremost, choose footwear that’s appropriate for the length and width of your feet. If you suffer from a foot deformity, it may be helpful to get your shoes adjusted by your shoemaker.
Book an appointment with your podiatrist. In the meantime, you can try to reduce the thickness of the corn with a pumice stone. The corn won’t go away completely, but reducing its thickness will help alleviate your pain.
In some cases, pharmacy-bought insoles may help temporarily reduce the pressure and friction under your feet. However, insoles aren’t a long-term solution because they aren’t designed to treat your specific foot deformity.
Gel toe pads can protect toes from excessive friction, but this won’t address the source of the problem. A corn will continue to be painful until it is removed. Gel pads are more effective as a preventive measure. Make sure they don’t make your shoes too tight as it can make the problem worse by increasing the amount of pressure on your toes.
We don’t recommend using commercially available corn remover liquid. It can burn the surrounding healthy skin and doesn’t completely remove the corn. Your corn will still hurt, and you’ll be at risk of infection.
Diagnostic of plantar callus
A healthcare professional will be able to provide a diagnosis after inspecting your corn and removing a few layers of skin tissue. In very rare cases, a skin biopsy may be taken.
What can my podiatrist do about plantar corn?
First, your podiatrist will assess the lesion and try to identify the cause. Then your podiatrist will carefully remove the entire corn using a special scalpel. Your podiatrist may also need to apply medication to reduce the size of the lesion, delay or prevent recurrence.
Next, your podiatrist will recommend ways to try to treat the underlying cause. He or she may recommend a biomechanical exam if it seems likely that the corn was caused by a foot deformity or gait abnormality. In such cases, plantar orthotics are a preferred solution because they improve the distribution of pressure on the bottom of your feet.
Your podiatrist may also recommend custom-fit silicone toe separators made for your specific toe deformity.
How to prevent plantar callus?
- Wear adequate footwear
- Wear socks with your shoes
- Address any foot deformities or gait disturbances
- Wear your plantar orthotics
- Remove excess layers of dead skin on your feet
- Obtain professional footcare on a regular basis to address calluses
- Wear gel tubes or toe spreaders/separators
- Get your shoes specially adjusted for you by a shoemaker
“To prevent a corn from coming back, you have to remove its root.”
A corn doesn't have a “root” like a plant. Corns are nothing more than an accumulation of thickened skin that sinks deeper in your foot from outside pressure. To relieve the pain, this central and deeper core must be removed. Moreover, preventing recurrence is not as simple as “pulling out a weed.” To prevent a corn from coming back, it is the source of the pressure or friction that must be addressed.
“I've never had corns before, so this one can't be caused by the way I walk.”
Your feet change over the course of your lifetime. The ligaments that hold the bones together can loosen, which can cause your feet to become flatter, wider and longer. This can cause the loss of uniformity in your plantar pressure points and lead to the formation of plantar corns. Also, some foot deformities worsen with time, such as bunions and hammertoes.
And if it was not plantar callus?
Different conditions may have similar appearance or symptoms:
- Plantar warts
- Foreign body
- Internal pain (caused by a cyst, bursitis, capsulitis, etc.)
- Molluscum contagiosum
- Athlete’s foot (between the toes)
- Plantar fibroma
- Seborrheic keratosis
- Basal cell carcinoma
- Amelanotic melanoma