Corns

Presented by: Dr. John Brandeisky

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Corns are hyperkeratoses of the skin. This a a thickening of the surface layer of the skin in response to pressure. Corns usually form on the toes, where the bone is prominent and presses the skin against the shoe, ground, or other bones. As corn become thick the tissues under the corn are subject to increased irritation. There may be a deep seated nucleation, this is like a core where the corn is thickest and most painful. As corns become inflamed, there is pain and sometimes swelling and redness. Common places where corns form are; the top surface of the toe, at the tip of the toe, and between the toes.

Symptoms

• A hard growth on the skin of the toes
• Pain on direct pressure against the corn
• Sometimes redness and swelling around the corn, with severe discomfort
• Increased discomfort in tight fitting shoes
• More common in women than men

• Tight fitting shoes
• Deformed and crooked toes
• Tight socks and stockings
• Seam or stitch inside the shoe which rubs against the toe
• Sometimes a shoe which is too loose, with the foot sliding forward with each step.
• Prolonged walking on a downward slope

• Avoid shoes which are to tight or too loose
• Buy shoes with an extra depth toe box (the part of the shoe over the toes)
• Do not apply socks or stockings tightly around the toes
• Use a pumice stone or other abrasive to reduce the thickness of the corn
• Apply non-medicated pads around the corn to relieve pressure
• Use extreme caution if you choose corn removing solutions. They contain acid and sometimes increase discomfort. They should NEVER be used by diabetics and those with diminished circulation.

What the doctor may do

• Carefully debride (pare down) the corn and any deep seated core it may have. It should be stressed that this provides only temporary relief, if the pressure continues after treatment.
• Apply various pads and devices to the toes to relieve pressure.
• Recommend appropriate shoes.
• Surgically straighten crooked or deformed toes, or remove bony prominences.

Complications that can result from corns

• Development of a bursitis - the formation of a painful inflamed fluid-filled sac beneath the corn
• Infection
• Development of an ulcer. An open area that forms within the corn. This may even extend down to bone.
• Because of the serious consequences of infection, diabetics and those with diminished circulation should always seek professional help.

Other conditions which can resemble corns

• Verruca (warts)
• Various tumors of the skin and subcutaneous (below the skin) tissues
• Reaction to a foreign body (eg. sliver or animal hair)

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