Callus, corns and warts are very common problems affecting the skin of the foot, and they each have different treatment requirements. Our cliniciansare trained to identify each of these problems and treat them accordingly. Let’s look at the general differences between them:
When a particular area of skin is constantly rubbing on something (eg: a shoe), it thickens and hardens to protect itself. Therefore, callus is the result of friction. Most callus is not painful, but if left untreated, may become uncomfortable. Many people have callus treated due to aesthetic concerns. Callus is generally nothing to worry about but it may indicate certain issues or abnormalities. For example, it may indicate biomechanical dysfunction, which is when the lower limbs are not functioning properly. It may also be the precursor to ulceration in a diabetic patient. Callus looks yellow, or white if it is dry, and may feel hard and not as flexible as the skin around it.
Not all callus results in corns, but all corns are callus. In other words, corns are a type of callus where friction, pressure or compression occurs over a much smaller surface area. This may indicate structural abnormality. A corn will generally be situated in the centre of an area of diffuse callus. This central portion, the nucleus, will be well circumscribed and it will feel like standing on a tiny stone, or having a tiny stone between two toes. They are often classified as hard corns (sole of the foot) or soft corns (between toes). The build up of skin/callus is pushed inward due to the pressure of bearing weight or of surrounding structures (eg: a protruding bone).There are many other types of corns with beautiful exotic names like heloma durum, heloma molle, heloma milliare, heloma neurofibrosis, heloma vasculare.
PLANTAR WARTS (Verruca Pedis)
Plantar warts are the result of infection with the human papilloma virus (HPV) which may be picked up in public areas such as washrooms, pools and change rooms or from direct contact with someone else. The virus enters the plantar aspect of the foot through a break in the skin, which may not even be visible to the eye. On the sole of the foot, the subsequent lesions are pushed inward due to the pressure of standing, unlike other parts of the body where warts protrude outward from the skin. On close inspection, they are well demarcated lesions that may contain tiny little black dots which are evidence of capillaries as the virus creates a blood supply to sustain itself. They have a cauliflower appearance and are often covered by a layer of callus. They may be of variable size and may be singular or multiple. Warts are often painful but may also go unnoticed.
Typical single wart with small black dots.