Core callus: causes of appearance, structure, treatment

Calluses on the soles of the feet (corns) and core calluses are one of the most common foot problems. Hyperkeratotic areas and core calluses on the feet can occur on any part of the foot, and some people also develop core calluses on the hand.

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Why does core callus appear?

What are the causes of this type of callus?

Mechanical pressure, which develops into a factor that traumatizes the skin. The response to repeated compression to which the same area of the skin is exposed is increased proliferation of cells of its outer layer - keratinocytes, as well as activation of desmosomes that strengthen the intercellular space.

As a result, the stratum corneum of the epidermis becomes significantly thicker and denser, and this thickened area on the skin's surface, consisting of dead cells, serves as a "protective armor" for the deeper tissues. In essence, this process - both clinically and histologically - is hyperkeratosis.

Corns and calluses are usually localized on the foot - on the pad of the foot (in the projection of the heads of the metatarsal bones), at the base of the arch of the foot or on the heel. Very often, a callus forms on the toe, especially on the big toe (from the outer lateral or plantar side) and a callus on the little toe of the foot (from the side of the sole or from the side); there is a callus between the toes (along the first phalanges and on the sides of the joints).

A core callus on the palm is the result of activities (industrial, sports, etc.) that require repeated use of certain equipment or hand tools that exert physical pressure on the same areas of the skin.

Risk factors for core calluses

When determining risk factors, specialists first of all note wearing tight shoes and shoes with very high heels, which increases pressure on the anatomical structures of the foot. Therefore, as statistics show, core calluses are formed in women four times more often than in men.

Other risk factors for both corns and calluses include:

• flat feet (longitudinal and transverse) or too high arch of the plantar vault;
• injuries and deformations of the foot, as well as hammertoes;
• excess body weight, which increases the compression on the feet. For this reason (due to weight gain), a core callus may appear during pregnancy, as well as a core callus in an obese child;
• curvature of the spine and associated changes in gait with impaired redistribution of weight on the feet during movement;
• insufficient blood supply to the distal parts of the limbs;
• atrophy of the plantar adipose tissue, which softens the force of pressure on the metatarsal region, the tarsometatarsal joint, the heads of the metatarsal bones of the foot and the heel. Atrophy can be age-related, as well as associated with the shift and deformation of bones (congenital, traumatic or rheumatic origin) or severe contracture of the toes. By the way, this condition is aggravated by the same narrow shoes with high heels or very thin soles, as well as walking barefoot on hard surfaces.

Structure of the core callus

What does a core callus look like? A core root or internal callus looks like a limited area of a round shape with thickened rough skin of a whitish-yellow or gray-brown color. This is a cluster of keratinized cells - corneocytes, which gradually become denser due to cohesion (bonding) with ceramides. Over time, a cone-shaped keratin root of the core callus forms almost in the center of this area, penetrating or growing deep into the horny and Malpighian layers of the epidermis, and then into the dermis, causing tissue atrophy. At first, upon palpation, it feels like a hard grain, and with further development, a depression resembling a crater appears in the center of the keratinized spot.

Is a core callus contagious? No, this horny thickening of the skin is not contagious – unlike plantar warts, which are caused by the human papillomavirus.

A hard, dry core callus is typical for the ball of the foot area, a hard core callus most often occurs on the outer surface of the little toes or on the upper surface of the other toes, but can also be between the toes.

With a flat and painless callus, hyperkeratosis is diffuse and uniform in depth, but dermatologists consider its appearance as the first signs of the formation of a hard core callus, which can be completely painless. However, as it penetrates deeper into the skin, the core callus hurts when pressed.

Consequences and complications

If the core callus is inflamed, this is the result of its infection, which can cause such consequences and complications as ulceration with tissue necrosis and abscess. This is especially dangerous in thrombophlebitis of the lower extremities, peripheral neuropathy and diabetes.

It happens that the core callus bleeds and causes very severe pain (making it difficult to move), which is an indicator of the growth of the core callus below the papillary layer of the epidermis - to the dermis and its traumatic pressure on the vessels of the capillary network of the skin, venules, arterioles or glomus.

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Diagnostics

Which doctor should I see if I have a core callus or plantar wart on my foot?

First of all, this is a podiatrist, as well as a dermatologist or orthopedist. As a rule, diagnostics are carried out based on an examination of the patient's foot, taking into account the existing symptoms.

Instrumental diagnostics can also be performed - using dermatoscopy. And if there is a suspicion of foot deformation or problems with bone and joint structures, the orthopedist prescribes an X-ray of the foot. He also evaluates its mechanics.

Differential diagnostics should accurately determine what it is: keratoderma, core callus or wart (verruca plantaris). And the main difference between a wart and a core callus on the sole of the foot is determined by the absence of a skin pattern on the wart and by dark spots on its surface, observed after scraping (which does not happen with dry calluses with a core).

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How to remove or remove a core callus?

How to remove a core callus and is it painful to remove? It should be borne in mind that it is unlikely to be successful in one go, and all attempts to pick it out with improvised sharp objects can end in tissue damage with pain and inflammation.

Podiatrists, dermatologists and pedicure specialists know what remedies should be used for core calluses. Appropriate and rather long-term treatment of the core callus is necessary. And hot soap and soda foot baths should become a mandatory daily procedure. And after steaming the keratinized skin and removing some of it with regular pumice, you can use:

• plasters,
• liquids,
• ointments and creams,
• folk remedies.

In order for a corn plaster for core corns to provide the necessary keratolytic effect, it must contain salicylic acid or urea. If the corn has not yet grown in deeply, two or three times the application of the plaster (which is applied for at least a day) can eliminate this problem.

Thus, the Salipod patch softens the keratinized skin due to salicylic acid and sulfur. Salicylic acid is contained in the Urgokor patch, the Compid patch for core calluses (but you should use Compid intensive).

Anti-callus liquids are represented by Duofilm (with lactic and salicylic acid) and the alkali solution Superchistotel.

Ointments and creams for core calluses include:

• 5-10% salicylic and sulfur-salicylic ointment;
• Unna ointment with resorcinol and salicylic acid;
• ointments Super Antimozolin, Hemosol (with salicylic acid);
• ointment with lactic and salicylic acids Kerasal;
• combination ointment Nemozol for removing core calluses and corns (consisting of medical petroleum jelly, paraffin, sulfur and salicylic acid);
• Keratolan lactic acid cream;
• Basalmed cream-balm, AntiMozolin balm (Krok Med), etc.

Read also –

• Ointments for corns
• Creams for corns
• Ointments and creams for corns

The aerosol Cryopharma containing methoxymethane and propane is not used: this product is used to remove papillomas and warts.

How to get rid of core callus at home - folk remedies

Traditional medicine uses natural remedies such as:

• lemon juice (apply a tampon soaked in lemon juice to the callus overnight and secure with adhesive tape; long-term treatment);
• table vinegar (lotions with 9% vinegar - twice a day for 3-4 hours for a week, securing the tampon with adhesive tape);
• vinegar essence (wet the surface of the callus every day for three days and cover with a regular plaster);
• warm castor oil (compresses on the keratinized areas of the skin - twice a day);
• raw grated garlic - but not garlic marinated in vinegar - is applied to the callus (at night), covered with a napkin, and washed off with warm water in the morning;
• a mixture of mustard powder and ground turmeric (1:1) - prepare a thick paste in water and make a compress every day (keep for two to three hours).

How to remove a core callus (shallow) using an onion? Grate it, mix with vinegar (2:1) and apply it to the callus overnight (cover with a PE film on top). They assure that such procedures over several days help soften the core, and its removal will be easy and painless.

But it is unlikely that you will be able to remove a core callus with propolis: despite its unique biochemical composition, bee glue does not have a keratolytic effect on dry hard calluses, but it can relieve inflammation in ordinary calluses. Herbal treatment involves applying a paste of dried licorice root ground into powder (tablespoon) and mustard oil (half a teaspoon). Apply as in the recipes described above.

Instead of a callus liquid, you can use celandine, or more precisely, the juice of this plant, which contains citric and malic oxyacids, which help reduce the density of keratinized skin cells. It is enough to lubricate the callus with celandine juice three times a day for 7-8 days.

Removal of core callus: hardware, surgical

Surgical treatment of core calluses by excision is an extreme measure, which is now rarely resorted to. Their hardware removal is easier and more comfortable.

When cauterization of the core callus with electric current or electrocoagulation of the core callus (under local anesthesia) is used, the keratinized tissue throughout the depth of the root of the callus is destroyed, and under the resulting scab, regeneration of healthy cells of all layers of the epidermis occurs.

A similar result is achieved by removing the core callus with a laser, which is also performed with an anesthetic injection.

The removal of the core callus with liquid nitrogen, freezing or cryodestruction (which separates within a few days after the procedure) is quick and painless.

Removal of core calluses in salons is removal with the help of a pedicure (several sessions of softening and grinding of calluses). Medical hardware pedicure is also offered, which involves drilling out the core callus.

This manipulation requires local anesthesia and a special tool - a pedicure cutter for core callus, the size of which is selected in accordance with the area and depth of the core internal callus. It should be borne in mind that with a very deep callus, several such procedures may be required.

Some complain that after removing the core callus, a hole remains, but this phenomenon is temporary, since the damaged tissues are repaired due to the growth cells of the basal and spinous layers of the epidermis.

Prevention

Prevention of the appearance of core calluses and corns is the right footwear and constant foot care.

In addition, experts recommend monitoring your weight (and if you have extra pounds, be sure to lose them) and using corrective orthopedic insoles and shoe inserts that will redistribute pressure on the foot when walking.

Forecast

Corns on the foot can be a chronic problem if you constantly wear the wrong shoes. But even with the right shoes, there are many factors that provoke the appearance of this problem.