Callus is an area of thickened skin, also known as hyperkeratosis. Callus forms in the outer layers of the skin known as the stratum corneum, which as a protective layer, is susceptible to pressure and friction when walking and moving around day-to-day. The stratum corneum contains a protein called keratin that helps keep skin healthy and strong. The body will attempt to protect itself by thickening the skin when it is subjected to repetitive pressure and friction.
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Symptoms
Keratin in the skin contains melanin, which is the part of the skin that gives it colour. When callus forms, the area of thickened skin will appear darker or more pronounced in colour. Depending on skin tone, callus can look yellow or brown. It can feel rough, lumpy or smooth and may have patches of white, dry skin overtop. Callus on the bottoms or underside of the toes typically covers the area that endures friction from the ground. If pressure is significant, bleeding can occur, visible within the callus on the toe. Callus that is thick and untreated will likely cause pain and discomfort as it places pressure on the structures underneath the skin.
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Causes
Callus forms when the foot and the ground move in opposite directions, creating a shearing force. In addition, high heels, shoes that are the wrong size or too narrow and shallow and not wearing socks, can all cause undue friction to occur. Callus can also be caused by a repetitive movement experienced at work or in life. If toes are bent or curved, such as hammertoes, the underside of the toes will be more susceptible to pressure and friction when walking.
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Treatment
If callus is not bothersome, treatment is not necessarily required. The thickness of callus can be reduced using a foot file on a regular basis. Moisturising the skin with a rich emollient will keep callus soft and prevent cracks in the skin from forming. If at-home treatment is not effective, BioPed’s medical footcare clinicians can safely remove callus using a scalpel blade or electric file. Silicone toe sleeves can be worn to act as a buffer between the skin and ground/shoe. Wearing custom foot orthotics or off-the-shelf insoles are useful in offloading high pressure areas of the foot and reducing the amount of callus that forms in the first place. Well-fitting footwear is imperative to support and cushion the toes and feet. BioPed Canadian Certified Pedorthists and Registered Chiropodists are well-trained to assess areas of high pressure.
