Corns can occur on various areas of the foot, and are quite common on the bottom of the toes because of pressure and friction from the ground reaction forces or contact with the ground when walking. A corn is a circular area of thickened skin known as hyperkeratosis which has a core or “nucleus.” A corn on the bottom of the toe is known as a hard corn or heloma durum. This type of corn is often mistaken for a wart and needs to be properly assessed and diagnosed to ensure effective treatment is achieved.
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Symptoms
Pain and discomfort are often felt with a hard corn on the bottom of the toe which can make walking and activities of daily living challenging at times. A hard corn may be round or irregular in shape and can vary in size. The area of thickened skin typically appears yellowish or brownish depending on a person’s skin tone. A hard corn will feel hard or firm in texture and may have flecks of red or brown which indicates bleeding in the tissue because of excessive pressure and friction. If left untreated, corns can begin to break down causing an opening in the skin. This can lead to infection and significant pain.
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Causes
Ill-fitting footwear that presses on toes or does not provide proper support may cause corns to occur. Shoes with narrow, shallow or pointed-toes will restrict natural movement of toes. Hammer toes and bunions may increase a person’s risk for developing these lesions as they tend to place more pressure and friction on particular areas. Wearing shoes without socks may result in more friction on toes. Some people have more of a genetic predisposition for these thickened areas of skin.
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Treatment
When a corn is painful, treatment by a medical footcare clinician is recommended. They will assess the area and provide treatment, which includes reducing the thickness of the corn. If there is a nucleus or core in the lesion, it may need to be removed. Wearing a silicone toe prop can be beneficial as it helps to straighten the toe when walking and prop it up off the ground. This can be an effective way of reducing the pressure causing the corn in the first place. This toe prop should be removed for personal hygiene routines and for sleeping. Also, consider a more permanent offloading solution, which is orthotics. Orthotics and footwear can be discussed with a BioPed Pedorthist.
