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 on the heels, 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 bottom of the feet can be diffuse or cover a large area or can be more pinpointed and localised. 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 such as tissue and bone underneath the skin.
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Causes
Callus forms when the foot and the ground move in opposite directions, creating a shearing force. The heel is usually the first part of the foot to make contact with the ground when walking. It encounters a considerable amount of pressure and stress. Shoes that are the wrong size and not wearing socks, can cause unnecessary friction to occur. Callus can also be caused by a repetitive movement experienced at work or in life. If joints are misaligned or more prominent than they should be, they will be more susceptible to pressure and friction when walking.
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Treatment
If you are healthy and the callus is not bothersome, treatment is not necessarily required. Using a foot file and a rich emollient on a regular basis, will keep callus soft and can prevent cracks in the skin from forming. Thick callus on the heels is at risk of cracking which can lead to infection. BioPed’s medical footcare clinicians can safely remove callus during a foot care appointment. Wearing custom foot orthotics from a Canadian Certified Pedorthist or off-the-shelf insoles are useful in offloading high pressure areas on the foot and correcting gait to reduce the amount of callus that forms in the first place. Well-fitting footwear is imperative to support and cushion bottoms of the feet.
