What is a callus?
A callus is a section of skin that has become toughened and thick because of friction, pressure, or irritation. They often happen on the feet, but they can occur on the hands, elbows, or knees.
Calluses are yellowish or pale in color. They feel lumpy to the touch, but, as the skin is thick, it may be less sensitive to touch compared with the skin around it. However, calluses can become painful if not removed.
How do calluses form?
Plantar calluses are formed as a result of excessive pressure and friction. There are a few factors that directly impact levels of pressure. Foot and bone structure can play a massive role in the development of callus on the foot. People with well defined bony prominences such as prominent metatarsal heads can often develop plantar callus due to a lack of skin between the bone and ground which leads to increased pressure within the area. Weight bearing for long periods of time typically develop calluses and may need offloading or shoe inserts in the long run. Hard callus forms over the top of these prominences due to the consistent force going through a particular area. Another factor for callus is the mechanism of gait, we all have a particular walking and running style. All individuals have different areas of plantar pressures whilst walking and running, if the pressure in the areas becomes too great then we see the formation of plantar callus. Footwear can also increase friction at sites. Ill fitting shoes where the shoe is too big and therefore too much movement occurs within the shoe can result in high areas of friction and the formation of plantar callus. Likewise shoes that are too tight on a particular area, such as a bunion within the toe box are also at risk of developing hard skin.
For example; if you have calluses that form on the tips of your toes, this may be a result of your shoes being too small or that you have hammertoes (clawed toes) causing increased pressure in that area.
Moreover, if you have calluses forming on the bottom of your big toe, this may be the cause of you putting too much pressure on that toe when you are walking. Or if you play sports like netball or basketball, it may be the foot that you land on or pivot with during the game.
Another example is callus forming on the littles toes. This is a classic example of shoes being too narrow causing rubbing of the little toe on the side of the shoe. Wearing a wider shoe would prevent this callus from returning.
Where can calluses form?
Calluses can form typically over the bony area just under the toes, heels and areas of skin that take the person’s weight when they are walking. They are more common among people who wear ill-fitting shoes, have sweaty feet, and those who stand for long periods each day.
Do I have to remove a callus?
It is recommended that calluses are removed as they can become painful. In worst case scenarios especially in people who are diabetic, calluses can result in hard-to-treat wounds. Callus removal is not painful as the skin is already classified as “dead skin.”
How to remove calluses:
It is recommended that calluses are removed in a safe and sterile environment by a qualified Podiatrist. Podiatrists use a scalpel blade to gently remove any callus on the feet as well as educate on how to prevent calluses from returning. Ways to prevent calluses from returning can include:
- Orthotics to help redistribute pressure
- Change in footwear
- Foot intrinsic exercises to aid in pressure redistribution
- Offloading the calluses through padding the area
Home remedies for callus removal:
It is not recommended to remove callus at home by yourself, however, there are some home remedies that can help in between appointments with your Podiatrist.
A pumice stone can be especially handy when you have a callus on the bottom of your feet or on your elbows, where it’s hard to see. After soaking your callus thoroughly, apply the pressure of the pumice stone to your callus and rub in a circular motion.
Moisturising the bottom of your feet every day is a good way to keep not just the skin well hydrated, but to also aid in the callus not becoming too hard and painful. Keeping the feet well hydrated and soft also prevents any fissures (cracks) forming in the skin which can also become quite painful when the cracks are deep in the skin. The Podiatrists at Foot Centre Group recommend a moisturiser with urea in it as this helps hydrates and exfoliate the skin. Walker’s Pedicream Plus is the moisturiser we use at the clinic as it has 15% urea and is also not greasy on the feet.
What to avoid when treating callus at home:
Avoid removing the callus yourself:
It is highly recommended to not remove the callus at home, especially with something sharp as this usually results in going too deep into the skin, leading to infection and the area becoming more painful. Please make an appointment with a qualified Podiatrist as they are trained in how much callus to remove and how to remove it without causing further damage.
Avoid harsh chemicals or peels:
Strong, chemical foot callus removers and peels which contain high concentrations of caustic ingredients such as salicylic acid and potassium hydroxide can cause irritation and even chemical burns on fragile skin. These chemicals are also present in offloading pads at the chemist.
Calluses in people with diabetes
Foot callus and diabetes are a potentially dangerous combination. When plantar callus is left untreated it can begin to break down and open up which results in foot ulcers. These ulcers pose a great risk as these can be tricky to heal and could become infected resulting in ulceration. Diabetes also adds another element due to the effects that poorly controlled blood sugar levels can have on both the blood supply and the nerves within the feet and legs. Poor diabetic management can lead to a reduced blood supply to the feet which can result in the body having a decreased chance to heal a potential skin tear or ulceration that can arise due to plantar callus breaking down. Another result of poorly controlled diabetes is a loss of protective sensation which means a reduced feeling under the foot. How does this impact plantar callus? If an individual is unable to feel an area of callus they will continue to leave it untreated and this can lead to a breakdown in the callus and potentially lead to an ulcer. It’s very important for diabetics to check their feet daily. Diabetics with callus should never look to remove it themselves as they are most likely to do more harm than good. It is very easy to harm yourself and it would not be performed in a sterile fashion which opens up the door to possible infections and self harm. At Foot Centre Group you may be able to see our podiatrists under Medicare.
Need an assessment?
When in doubt, ask your podiatrist. We are always here to help diagnose, treat and prevent all kinds of nail and skin related issues!
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