The conical core in a corn, which is a thickening of the stratum corneum, is a protective response to the mechanical trauma. Plantar corns are more sensitive to direct pressure of the lesion, while a plantar wart is more sensitive on lateral compression of the lesion.7Sharp debridement and a palliative course of treatment for both warts and calluses can define the underlying etiology of the lesion as being either mechanical or viral. Over-the-counter products that contain salicylic acid should be avoided because they may damage surrounding normal tissues, especially in neuropathic and immunocompromised patients.4PADDINGTherapeutic padding can alleviate the patient's symptoms by reducing the amount of mechanical irritation to the site of the corn or callus. For hard corns, foam pads or silicone toe sleeves offer the cushioning and protection needed after adequate debridement of the corn.


In young persons who have a fixed deformity, conservative measures will produce better results than surgery.
A crest pad is an easily fabricated, two-inch cotton roll (dental roll) that is placed under the interphalangeal joints of the lesser toes, on the plantar aspect.
In a nonreducible hammertoe, the crest pad can cause further discomfort for the patient by accentuating the deformity; these deformities may respond to a gel-filled corn pad placed over the offending interphalangeal joint. Patients should be advised to wear low-heeled shoes with a soft upper portion and a roomy toebox.1 Patients with hammertoe deformities may need a shoe with an extra depth to accommodate hard corns that often occur on the top of the deformed toe.


Patients with soft or hard corns on the fifth toe may benefit from a shoe that has extra width. The goal of surgical correction of a hammertoe deformity, claw toe deformity, or mallet toe deformity is to reestablish a rectus alignment of a toe that is also free of painful lesions.9 Hard corns on the fifth toe and soft interdigital corns can be treated by resection of the prominent condyles or excision arthroplasty of the proximal phalanx of the fifth toe.



Shoes for heel pain relief
Sore toes after swimming


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