The skin is the body’s first line of defense against various factors such as environmental irritants and disease-causing microorganisms. As a result, the skin suffers from various conditions and lesions. One of the most common skin lesions known is calluses.
Calluses are hard, thickened and rough areas of skin that may appear yellow.
The usual areas these develop are in the palms of the hands, the feet, and knuckles.
These thickened areas of skin develop when it tries to protect itself against pressure and friction. Also known as tyloma, the callus is painless but can be hard to touch.
Calluses are typically larger than corns and do not have defined edges. The skin where the callus forms become thick and less sensitive to touch. These develop when the skin rubs against the shoes or a bone.
The feet play a major role in helping people move around. They carry the burden of the body weight. When there is too much pressure placed on the foot, there will be an imbalance, leading to friction on some parts of the foot. As a result, the skin in those areas thickens. These thickened areas are called calluses.
Calluses develop when the skin rub against a bone, the ground or a constrictive shoe.
They often form over the ball of the foot because this area is where most of the weight is placed when you’re walking or standing.
When people engage in activities that put extra and repeated pressure on the foot, these may lead to callus formation. The other causes of callus formation including having dry skin, regularly holding objects like pencils, hammers or rackets, and reduced fatty padding or cushion in the body, particularly in older adults.
Calluses develop in response to pressure or friction. When there is a repetitive injury to a certain part of the body, the keratinocytes or basal epidermal cells increase in number, leading to a thicker layer of skin. The most common sites are in the feet and hands, particularly the side of the foot, a ball of the foot, palms or knuckles.
A person has a callus if he notices:
- A hardened, thickened and raised bump on the skin
- A rough area
- Painless bump or thickened area on the skin
- Thickening of the skin without borders or edges
- Most commonly seen on the feet and hands, especially those over bony prominences
- Painless or just tender
- May throb a little
- May form fissures or cracks
Calluses and corns are not the same things. Calluses are painless and they develop on the palms, the knees and the soles of the feet. On the other hand, corns are much smaller than calluses. They are painful and tender. Moreover, they have a hard center surrounded by swollen skin.
Some people are predisposed to having calluses because of certain factors such as:
Having other foot problems – Having bunions, hammertoes, and other foot deformities may increase the risk of developing calluses. These are particularly seen in the areas of the skin that rub to other parts of the foot and footwear.
Not protecting the hands – Some hand tools like hammers can cause too much friction. Also, bodybuilders who hold barbels often may have increased risks of having calluses on their palms.
Age – Older people may be at a higher risk of having calluses because the feet widen and flatten. Moreover, the fat padding on the joints and sole of the feet lessens and wears down, leading to more pressure and friction.
Gender – Women are at a higher risk of developing calluses on their feet because they often use high-heeled shoes and narrow shoes.
Weight gain – Gaining weight places extra stress on the feet and can lead to foot problems and skin problems, including corns and calluses.
The complications of calluses are rare. However, for people with diabetes, they are more susceptible to ulcers and infections. They should regularly examine their feet to detect skin problems earlier because such food injuries and lesions need immediate medical attention.
Calluses occur more often in people with diabetes as a result of high-pressure on the sole. When these calluses are not treated or trimmed, may break down and turn into open ulcers or sores. When you have diabetes, wound healing is impaired and as a result, simple wounds could be dangerous.
Never cut calluses on your own because it could also lead to infection and ulcers.
When there are open sores on the feet, these could interfere with one’s activities.
The doctor will usually diagnose calluses based on a physical examination and assessing the feet. This will also rule out other causes of thickened skin like cysts and warts. Diagnosis is often made by a physical examination of the callus. However, the doctor can still recommend a biopsy wherein a tissue sample is taken and examined under the microscope.
Moreover, the doctor can take X-rays of the feet or hands to visualize the underlying bony structures. These structures may lead to the development of the calluses. In some cases, the doctor may observe your gait and how you walk to determine if the calluses have interfered with daily activities.
The calluses can be differentiated from plantar warts by paring away the thickened skin. Sometimes, a wart, which is a skin infection caused by a virus, may look like calluses. Hence, it is important to seek the medical attention of a doctor to determine if it’s a callus or wart.
If it’s a callus, it shows smooth translucent skin, while a wart appears circumcised and with central black dots. Usually, plantar warts require treatment, while calluses are mostly corrected by simple measures such as trimming of the calluses, change of shoes and surgery.
Most calluses gradually disappear when the pressure or friction that causes those stops. The treatment for calluses typically involves preventing the repetitive actions that caused them in the first place. This can be resolved by changing the footwear, doing self-care measures and using protective pads.
The other treatments include:
Callus-removing medicines – The doctor can prescribe medicines that can remove the calluses, by applying a patch that contains 40 percent salicylic acid. These patches are available over-the-counter but you need to consult with your doctor on the dosage or how often you need to use them.
Trimming the calluses – Trimming away the excess skin can be done by a doctor.
He can pare down the thickened skin. However, this procedure should be done by a doctor because there is an increased risk of infection when you do it yourself.
Using shoe inserts – For a patient with an underlying foot deformity, the doctor may recommend padded shoe inserts or orthotics. These will prevent recurring calluses.
Surgery – In rare occasions, the doctor may also recommend surgery to correct the alignment of the bone. If the friction lessens, the callus will resolve on its own. You may consider surgery when these interfere with daily activities. However, there are no guarantees that the callus will not return or recur. Keep the feet always dry and free from fiction.
Manual removal – Calluses can be removed naturally through a nail file or pumice stone after bathing. It can manually remove hyperkeratotic tissue.
Moisturizing creams – Moisturizers may help soften the skin and soften the calluses. Apply these creams on the calluses and cover them overnight with a sock or plastic bag. After covering the area, rub off much of the callus with a soft brush or a pumice stone.
There are many ways to prevent calluses, including:
- Apply a moisturizing foot cream, instead of a lotion, after drying your feet and cleaning it with a warm shower.
- Use a pumice stone to file regularly to gently eradicate the hard skin. Make sure the stone or nail file is dry and it does not have bacteria.
- Wear shoes that give the toes plenty of room and space for the toes. Make sure you can wiggle your toes. Choose comfortable footwear that fits properly. Also, do not wear heels as they increase the pressure on the front of the feet.
- Use protective coverings such as felt pads or bandages over the areas that rub against the shoes or socks. There are various toe separators between the toes.
- Avoid calluses on the feet by having them fitted professionally at the shoe store to make sure the footwear is comfortable and properly-fitted.
- Make sure the shoes’ length and width are appropriate for each foot since they may have different sizes. Ascertain that there is a half-inch between the longest toe and the front of the shoe.
- Buy shoes in the afternoon when the feet are most swollen. This way you’ll not buy shoes that will become tight at the end of the day.
- Avoid using shoes that have narrow or pointed tips to make room for the toes to move. Avoid using high-heeled shoes that put pressure on the feet when standing or walking.
- Calluses can happen on the hands, too. Make sure you wear protective gloves if you use certain tools. If you have hammertoes, make sure the toes are buckled under and the shape of the shoes offer plenty of space to accommodate them.