Corns

Corns

SKIN – Corns

Excuses are the nails used in the house of failure,’ is a popular saying. Likewise, corns – nails of foot or hands – are made from excuses of constant disturbances or pressure. A corn is a small, hard, thickened growth of skin or a toughening of the outer layers of the skin inhands or feet. They are cone-shaped, projecting inward which is referred as the root or nail or core or seed.

Corns are white or grey or yellow or brown in colour, depending on the place of the skin. Corns occur commonly on the feet, where the bone presses the sole in weight points, and between the toes. The pressure on the corn gives a feeling of having a pebble in the shoe all the time.

Corns are very painful when they are inflamed. Even small corns are very much annoying. Initially, friction or abrasions cause blister. If rubbing or friction continues everyday, it may form callosity or corn.

The thickening of the skin is a protective reaction to safeguard the skin. For example – in the hands of farmers or rowers, the thickening of skin is formed at the base of the fingers and feet to prevent blister formation during friction. This rough, thickened patch of skin is called callosity. It has even thickness and occurs most commonly on the heels and balls of the feet, knees and palms. They don’t pain unless otherwise pressure is applied sideward. The callosities are usually superficial and larger than corns and have undefined margin.

The thickened hyperkeratotic lesion often invade deeper and become corn. Corns generally are found in soles and toes which rub one another. Whenever pressure is applied directly on corn, a sharp pain occurs. Basic pathology, symptoms and predisposing factors are one and the same for corns and callosities.

Causes: The main cause for formation of corn is abnormal and constant mechanical stress on the skin. Relieving pressure on high-risk areas of the feet not only stops corns from forming but also prevents their recurrence. Neither corns nor callosities are serious conditions. In lean elderly people, corn formation is commonly seen because there will be lack of supportive cushion tissue on the bottom of the foot.

The causative factors can be classified as follows:
Intrinsic factors

1) Bony prominences
2) Faulty gait i.e. walking foot mechanism
3) Deformed toes
Hammer toes – it is an abnormal second toe which overrides on the big toe. This overriding elevates the joint, which often rub with shoes and become the commonest site for formation of corn.

Bunion- it is an abnormally displaced prominent big toe. People with bunions often develop callosity over the bunion due to constant rubbing against the shoe.

Extrinsic factors

Shoes – Hard leather shoes with tight fitting or ill-fitting high heels
Occupational – Any continuous pressure which arises during occupation will mark in the body as corns
Athletes suffer from constant friction and trauma
Guitar players’ fingertips are common sites of callosities due to playing sharp strings frequently
Abnormality of gait – Due to
Surgery done in the lower extremities
Due to pain while walking
Walking down a hill
Standing on a hard surface for a long time

Occurrence: The condition is more prevalent in females since their skin is smooth in texture. Common sites of corn’s formation are:
On the sole, over the metatarsal arch – the ball of the foot
On the outside border of the fifth toe, where it rubs against the shoe
Between the 4th and 5th toe, since both of them often rub with each other in a slanting manner

Symptoms:
Pain and swelling in and around the corn
Sensation of walking on pebbles
Discomfort and pain with direct pressure, since root gets pressed

Types: Corns may look different, according to the size and location. They are divided into two main types, depending upon the texture of the inner core either soft or hard.

Soft corn – A soft corn is a small, inflamed patch of skin with a smooth centre. It is found commonly in between the fourth and fifth toe. Soft corn results from the absorption of moisture due to sweat, and it is noticed by its white, macerated boggy appearance. Women are more prone to this type of corn, since they work more in water. Perspiration also causes soft corns to break down and become extremely tender. They don’t appear at sites of pressure points. It becomes an extremely painful lesion when the opposing toe moves against it, causing friction.

Hard corns – A hard corn is a firm, dry and tender lesion with a shiny polished surface.
Hard corns usually occur over the bony part, on the lateral aspect of the fifth toe. They are hard to touch and may feel like a small stone in the shoe while walking. Though always found single, it may be found in several different areas on the same foot. The hard corn is the most common type and it has a hard central core. This central core distinguishes it from warts. The major points to differentiate it from warts are, they do not have roots and they are contagious. Palpation of the lesion can also help to differentiate the plantar wart from the corn. Corns are more sensitive to direct pressure, while a plantar wart is more sensitive on lateral compression of the lesion. Warts are a dry crusty surface lesion which appears in clusters.

Further corns are differentiated as:

Age corn – These can be noticed on the feet of aged people. Here prevalence of corns increases with increasing age due to thinning of muscles against bony prominence.

Seed corn – This is the least common type of corn which occurs only in the heel or ball of the foot with a seed (circular stiff skin surrounding a plug of cholesterol).

Prevention: Most corns and callosities disappear within a month after relieving the pressure that causes them. They tend to recur if the pressure returns.

For prevention,

Avoid -

Stress to hands or feet by using gloves and shoes
Shoes for a while, or avoid hard leather-bottom shoes
High heels

Wear -

Thick socks for cushioning effect
Gloves during work to avoid frictions
Shoes with soft cushioned soles

Don’t -

Rub corns since it may become ulcerated
Use acids, it may damage surrounding normal tissues also

Do’s -Cushioning to reduce the amount of mechanical irritation on the site of the corn formation
Soak feet or hands in warm water for sometime to make it soften

Treatment - should be given as soon as the abnormality is noticed. The first step is to identify and eliminate the inducing factor, i.e. pressure and friction points. There are different varieties of treatment available in the market, that too attractively, as

1) Giving symptomatic relief by pain killers and antibiotic

2) Corn plaster – a plaster with central opening to disperse weight

3) Corn paint – This application has acids which make hard tissue, soft. Salicylic acid is used in different forms as applicators, drops, pads, and plasters. Corns may take a few weeks to resolve with this method of salicylic acid treatment

4) Align gait, including cushioning and removal of constant pressure points

5) Surgery for corns is rarely necessary. When necessary, it involves shaving the underlying bone also which presses the skin, to reduce the pressure.

6) Enucleation – to let out the nucleus i.e. root or nail or seed as patient prefers

7) Electro surgery – removal of the corn as whole, under local anesthesia

Precaution should be taken when you have

Diabetes
Hypersensitivity
Poor circulatory disorders
Autoimmune disorders
Peripheral neuralgic disorders

Complications
Bursitis – infection of sheath which avoids friction while moving the joint. Here you will get sudden sharp pain that spreads quickly in palm and soles.
Development of an ulcer occurs when infected with bacteria or fungus. It is common in diabetic patients.

The homeopathic approach is a natural way to help the body by supporting the body’s own process of healing. It involves the use of extremely diluted substances to heal the body through the release of vital energy. The rule in Homeopathy is that ‘like treats like’. The early you treat, the speedier and more complete the cure. In all a natural way of healing where the immune power is increased against that disease, so that recurrences are avoided. When the cure is not in the proper way, the disease recurs.

Treating skin disorders is very tough since it is outer most part of the body and also often exposed to irritants or pollutants or friction which hinder the action of drugs. Also recurrence is common in skin disorders, with no exception for corns. Some may go for surgical removal. Here also recurrence occurs with permanent scarring.

External application or treating externally with any other means usually suppresses the condition and is prone to skin thickening again. In Allopathy, they can’t treat corn with internal medicines since they cannot find disease or bacteria or virus in corns. Corn is a surgical complaint in Allopathy, so simply they go with surgical management. But in Homeopathy, corns can be treated with internal medicines after eliminating pressure or frictions, and you will be surprised when they are expelled automatically.

First of all, the causative factor should be removed (if found). Then medicines should be taken as per the direction of the Homeopath. There are many drugs in Homeopathy to relieve pain and to expel corns. These medicines not only relieve the pain but also treat the condition permanently. The most common medicines used are Anti-crud, Thuja, Radium brom, Ranunculus bulbosis, Pulsatilla, Sulphur, Natrum Mur, Nitric acid, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com  / www.drcheena.in

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)