Why do corns develop?
The skin on our feet is exposed to a myriad of stresses on a daily basis from the ground, our body weight, hosiery and our footwear. These stresses are often well tolerated by our feet but as soon as it goes beyond the threshold level then pathological changes occur. Corns are one such pathology. Medically known as helomata (shown in the image below), corns become so hard that one feels as though you are stepping on a pebble.
Typical hard corn (heloma durum) on the bottom of the foot.
HOW DOES A CORN DEVELOP?
Our skin has mainly two layers. The outer layer called the epidermis and a deeper layer called the dermis. The epidermis is covered with a layer of keratinised dead cells that form a protective layer and sheds frequently and is just as frequently replaced. These cells originate in the deeper layers of the skin and slowly migrate to the surface over a 30-day period known as epidermal transit time. They then undergo a process of keratinisation to convert them into keratinised dead cells forming the protective layer of on the outermost part of our skin. If compression, tensile, shearing and torsional stresses pass the threshold level then blood flow to the area increases (hyperaemia). This then stimulates the cells to stick together tighter than before and decreases the rate of natural shedding. The result is a build-up of cells which appear as hard skin. This is a very beneficial process since it adds a layer of extra skin protection when needed. However, as the stresses continue the process continues and the build-up then leads to a very hard, cone-like nucleus that feels a lot like stepping on a pebble.
Different types of stresses that lead to corn development
What foot corn treatment is available?
Successful corn treatment requires identifying which stress is at work. It can often times be a combination of stresses. The stress could arise from a shoe that may not be appropriate for the foot-type of the wearer. It could also be due in an acquired misalignment in the bones and joints of the foot leading to uneven weight-bearing which causes the mechanical stress.
Foot corn removal is painless and is done with a surgical blade, without any local anaesthetic. This gives immediate relieve but the corn will reoccur if the mechanical stresses are still present and so this needs to be addressed too.
Correct diagnosis is extremely important since corns are often times incorrectly surgically excised under local anaesthetic. The corn reappears after a few weeks with the added complication of a scar which becomes very painful. Proper diagnosis is achieved by a detailed clinical examination.
Speak to our Singapore clinic to learn more.