Corn is a tall annual cereal grass (Zea mays) that is widely grown for its large elongated ears of starchy seeds.
No not that type of corn ! Not the kind you eat !
Medical corns – yes corns with a S ( plural ) meaning there or more than one kind !
A corn, also known as a “clavus,” “heloma,” or “focal intractable plantar hyperkeratosis,” is a type of callosity.
Wow that is a mouthful!
What does that mean?
Simply that it is a thickened hardened part of skin.
Now you may think to yourself – this sounds very much like a callous.
You would not be wrong! That is exactly what a callous is.
So, is there a difference between a callous and a corn? And if so, what is the difference?
Corns are uncomfortable, thickened skin lesions that result from repeated mechanical trauma due to pressure forces.
Callouses are the same but mostly caused by friction.
So the difference is pressure versus friction. Corns have a hardened central core, whereas calluses do not.
Why not look at my previous post about calluses – https://dessiefhp.com/2023/08/04/callus/
For now – let’s focus on corns.
Who gets corns?
In short anyone can get a corn. It is often seen in:
- Athletes,
- People who do certain activities,
- People with pressure forces caused by footwear or gait problems
- People with foot deformities
- Older adults that have bony prominences. The repeated pressure of the skin overlying the bony prominences leads to a hyperkeratotic thickness resulting in corn formation. This corn is a protective body reaction that produces an excess of the horny epithelial layer to prevent skin ulceration
- The elderly are subject to loss of the protective fat pad cushioning, called fat pad atrophy
Different types of corns:
- Hard corns
- Soft corns
- Seed Corns
- Subungual corns
- Vascular corns
Hard Corns
Hard corns can be seen as a callus with a deep hard centre.
Soft Corns
They are soft, white and rubbery
Seed corns
Seed corns are associated with dry skin (anhidrosis)
Subungual Corns
Are corns under the nail
Vascular Corns
Corns that has a vascular involvement (it has both a blood supply and nerves in them)
Treatment /Management
The treatment aims to reduce the pain and discomfort resulting from corns.
- Management begins with prevention. Patients should avoid ill-fitting shoes and mechanical trauma to the affected area.
- Any biomechanical abnormalities and/or deformities should be managed with appropriate conservative treatment. This involves proper footwear, orthotics, and soft cushions (silicon sheet, sheepskin), which reduce friction and improve comfort.
Hard Corns – once the overlying callous has been removed with a scalpel the centre needs to be cut out (enucleated), this may leave a little hole in the foot but it will in time fill with healthy tissue. Some larger corns or corns in difficult areas could be seen as a chronic corn and this may need regular 6-8 weekly appointments.
Soft Corns – Soft corns are white and rubbery because the skin is damp from sweat or from not drying properly, they are found between toes and are caused by pressure from footwear. The macerated, dead tissue is removed with a scalpel. Aftercare would be to advice a toe separator – a device that holds toes apart allowing the sweat to evaporate and to stop the toes rubbing together. It is also advised to pay special attention to drying toes and web spaces, in additional it is recommend to use Surgical spirit, when it is put on the skin and allowed to evaporate it dries out the skin cells as well as sterilising the area.
Seed Corns – they are associated with dry skin, treatment would be to remove the little corns with a scalpel and to apply an emollient cream that contains urea. Seed corns usually presents as multiple little corns and thus a regular review appointment is required to make sure all the corns were removed and does not reoccur.
Subungual Corns– Corns that occur under the toe nails are very difficult to treat. It is impossible to get to the corn with the nail still in place. Therefore, to get to the corn, the nail (either in part or in full) needs to be removed. Once removed the corn is cut back, Ideal treatment would be clearance of the keratin plug and a dressing if needed. However, this is not always possible, in such cases clinical explanation and paring down should be attempted the patient should be reviewed every 3-4 weeks to make sure the corn is cut back and that the nails grows back in the correct manner.
Neurovascular corns – have nerves and blood vessels in them they can be sensitive painful to treat and they can bleed if removed. Most corns have only dead tissue in them. If they are too painful to be treated by a FHP they would normally refer you to a podiatrists to be removed under local anaesthetic. Fortunately, they are rare.
With expert treatment most corns can be adequately managed. If you are suffering with painful corns , please contact me on :
WhatsApp: 07856577897
Email: contactme@dessiefhp.com
Website: https://dessiefhp.com