Calluses: Treatment for when they become Painful

Hi Dr. Blake,


I have come to see you in the past at the Sports Center for an ankle sprain. I have a question unrelated to the sprain and would like your advise. When I sprained my ankle I was training for my first half marathon. I started to get a callus on the ball of my left foot and that has now developed a corn on top of it. At first it would not bother me too much but as I continued to train it got worse and worse. Now after my training is over and, I admit, wearing not cushioned enough shoes it has gotten MUCH worse and has become very painful. For the past four weeks I have tried self medicating it with those pad treatments from the drugstore. I think Ive tried them all at this point, the Dr Scholls brands, and it is still there and still painful. Now even with no pressure on it, there is still a lingering pain. Is there anything else I could do/try myself or is it time to come in?

I appreciate your time,

Jessica

Dear Jessica, Thanks for your email.

Usually calluses and corns only become painful when they have grown too deep into your foot and are now irritating the soft tissue under the skin. It is the corn on top of the callus which is usually the most painful and bores deep into the skin, normally called "seed corns".

As the picture above notes, these calluses can be like "gluing rocks to your foot", and can be multi-layered with variable depths with each layer. The hardness of the corn irritates the soft tissue under the skin which contains a rich supply of nerves. You can get a deep blister, very painful, underneath the callus, and so deep that it is difficult to reduce. But the blister part is irritated with massage, even gentle massage with a pumice stone.

 It is best to approach these very sore calluses with softening creams (ask the pharmacist for a great hydrator) three times a day, avoid skin irritants like the Dr Scholl's plasters with acid, lay the sore area on an reusable ice pack 15 minutes 3 times daily to reduce soft tissue swelling, try 1 session of 30 minutes cool water soak  daily (the longer the better), and gentle removal with a callus scraper (like Ped-Egg) daily for 2-3 minutes to gradually reduce the callus.

A trip to a Podiatrist would help make the diagnosis of callus, blister, or wart (since many of these painful calluses are actually warts under the callus), and speed up the callus removal by weeks since they can use very sharp instruments, plus place appropriate padding in your athletic shoes to off-weight the painful area.

No matter what, the callus has become something else, since calluses do not hurt. It is how the skin around them reacts that produces the pain. Or is there a wart or deep blister needing other treatments.

I hope this helps. Rich