Callus

Calluses are a very common occurrence at any age, presenting as a firm patch of thickened skin on the feet. As they’re a direct result of pressure or friction (rubbing), most calluses are found:

• On the soles of your feet, particularly beneath the heels and the ball of the foot that bears a lot of weight during walking
• On the sides of the feet, often from rubbing against tight or narrow footwear
• Between the toes, typically from toes rubbing against one another, particularly if they’re being squeezed in a tight pair of shoes
• At the tips of the toes, typically from wearing shoes that are too small and hence the toes are constantly buttressing against the end of the shoe
• On tops of the toes at the joints, particularly where a toe deformity like claw toes or hammertoes means the top of the toe sits higher and so rubs against the top of the shoe

A callus starts off as healthy, supple skin and will gradually thicken over time. Depending on how dry or well moisturised the skin is, it may also become very hard. Unfortunately, once a callus builds up to a certain thickness, it can become uncomfortable and even painful, with many patients describing the feeling as walking on a pebble beneath their foot. Callus is dead skin with no nerve endings or blood supply, so removing it is typically painless - much like cutting your hair. You may have a callus if you notice:

• A distinct patch of skin that appears more ‘yellow’ than the surrounding skin
• A patch of thickened skin that feels harder than the surrounding skin
• The thickened skin will be distributed over a weight-bearing area or an area where rubbing occurs
• The thickened skin will have less sensation (feeling) than the surrounding skin
• Pain or discomfort upon walking may be present for thicker calluses, particularly when present on the soles of the feet during walking

When callus builds up excessively on the heels of the feet and then dries out, it can also cause cracked heels (fissuring), a frustrating and often painful condition. The risk with cracked heels is that it’s not just the dry callus that cracks, but the healthy skin beneath the callus can crack open too, leading to bleeding and putting you at risk of infection if bacteria enters the cracks and takes hold.

Calluses develop as part of a natural process by which your body attempts to protect the skin when it is exposed to repeated pressure, friction or rubbing. By having the skin thicken in response to the rubbing, the risk of the skin ‘breaking’ and becoming cracked, raw or exposed is minimised. This is your body’s goal - as any ‘open’ wounds are vulnerable to infection and further harm, which is the opposite of what your body wants.

As calluses develop in direct response to pressure or friction, the first thing you should do is identify any factors that are contributing to this rubbing and stop or minimise them. This typically involves discontinuing wearing shoes that:

• Have little support or cushioning at the soles of the feet, and instead feel hard or firm, as these place more pressure on the feet while walking
• Are narrow and are rubbing against the sides of your feet
• Have a small or tight toe box that is squeezing the toes together, or rubbing against the tops of the toes

Additionally:

• Start moisturising your feet daily with a thick emollient to help keep the skin hydrated and supple, while helping prevent it from drying out. Callus that dries out becomes even harder and more uncomfortable while being more prone to cracking.
• If your callus is mild and you have no existing medical conditions like diabetes, bleeding disorders or other high-risk conditions, you may try using a pumice stone, foot file, or a scrub to gently work on the calluses. Do this after soaking your feet for 10-15 minutes in warm soapy water, when the skin is softened. Avoid excessive rubbing, as it can cause irritation and damage.
• To help soften the skin at home, you may try using a natural skin-softener such as lemon, apple cider vinegar or pineapple. This includes soaking a cotton ball with the vinegar (or cutting a slice of the fruit) and placing it against the callus only (taking care to ensure it’s not in contact with the surrounding skin) and leaving it overnight. Note - this cannot be done if you have any cracks in your callus, or any of the skin is raw, open or has bled. It should only be done on completely intact calluses.

Here at Matt Raden Podiatry, our trusted and experienced podiatrists listen to the concerns, goals and needs of our patients with calluses and utilise evidence-based treatment methods to help you get the best outcome. 

The good thing about calluses is that it’s one of the simplest conditions for us to treat, and we’re able to reduce your calluses to a comfortable and manageable level in just one appointment using our medical-grade podiatric tools. Specifically, we will debride back the layers of the callus safely and painlessly, leaving only a small protective layer in the area to help your body support its original function - to protect your skin. This removes the ‘pebble’ many feel, and most of our patients walk out of their appointments with a fantastic feeling of relief and in much less pain or discomfort. In the case of cracked heels, we’ll reduce this callus too, and help smooth the skin to remove those sharp edges that tend to catch on socks and hosiery. 

With callus, it’s important to note that even after the callus is removed, if you don’t change the cause of the callus, then it will begin to regrow and build up again over time to the same uncomfortable level. That’s why your podiatrist will also discuss with you strategies to help prevent your callus from returning, based on your unique circumstances.