First, to quickly review, corns and calluses are very different from each other in location, size, appearance, and pain level. Corns are very painful lesions that usually develop on non-weightbearing areas of the foot, such as the top of the toes or in between the toes. Their appearance is very different from calluses in that they are usually red, small, and have hard center. A callus is usually found in areas of weightbearing on the foot, such as the heel or ball of the foot. Calluses are large and the entire lesion is rough and hard. Both corns and calluses develop due to friction from either not wearing shoes or poorly fitting shoes that rub on the feet. Corns are usually much more painful than calluses, so many patients seek any type of relief they can find; however, beware that the advertised over-the-counter pre-medicated corn pads are dangerous.
What is in a pre-medicated corn pad that makes it dangerous?
To simplify, salicylic acid is a chemical that works to get rid of the corn by “melting” or “burning” the thick and hard skin. This is extremely dangerous for patients who have peripheral neuropathy. Peripheral neuropathy causes a loss of sensation in the feet. Patients who usually suffer from peripheral neuropathy include:
• Diabetics-at least 50% of all patients with diabetes
• Autoimmune diseases, such as lupus, rheumatoid arthritis, and Guillain-Barre syndrome
• Patient undergoing chemotherapy treatment
• Lyme disease
• Hepatitis C
• Charcot-Marie-Tooth Disease
• Vitamin B deficiencies
• Kidney disease
• Liver disease
If you are patient who has one of these diseases you should not use pre-medicated corn pads. The reasoning for not using these pre-medicated corn pads is that you may be unaware, due to the decreased sensation caused by the peripheral neuropathy, that the corn pad is melting/burning your skin too much. If the pre-medicated corn pad melts/burns too much of the skin, you will have an ulcer. Additionally, with many of the diseases listed above, the ability for ulcers to heal is decreased. So something that you used to get rid of a simple corn will now have you in a larger problem. With an ulcer, there is the opportunity for infection to get into the skin and spread to bone. Once bone is infected, your need for an amputation is extremely high as the infection usually cannot be gotten rid of by using antibiotics.
So what do you do if you have a corn and you shouldn’t use pre-medicated corn pads?
The answer is schedule an appointment with a podiatrist.
Treating a corn is a simple fix for the podiatrists; the podiatrist at your appointment is specially trained to use a sterile blade to debride, which means to trim down and get rid of all the hardened skin that is causing the pain. It is a non-surgical treatment that takes less than 5 minutes and is usually pain free. You will also most likely have immediate relief from the painful corn. However, since the corn is due to rubbing on your toes or your toes rubbing together, it will most likely return, but it usually takes about 3 months before it becomes painful again, which at that point you can return for another debridement. Prevent major complications by visiting Boulder County Foot and Ankle rather than trying your own pre-medicated corn pad.
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American Academy of Podiatric Sports Medicine