Overview

A callus is a common skin condition characterized by a thickened and hardened area of skin that develops in response to repeated friction, pressure, or irritation. Calluses typically form on the hands, feet, or areas subject to frequent rubbing. They serve as a natural protective mechanism to prevent skin injury, but when excessive, they can cause discomfort, pain, and cosmetic concerns. Calluses are usually harmless but may require treatment if they become painful, cracked, or infected, especially in individuals with diabetes or circulation problems.

Causes

Calluses form as a result of the skin’s protective response to chronic mechanical stress. Common causes include:

• Repeated friction: Activities such as walking, running, or manual labor can lead to constant rubbing against shoes or tools, causing skin thickening.
• Excessive pressure: Standing for long periods or wearing poorly fitting footwear can create pressure points on the feet.
• Improper footwear: Tight shoes, high heels, or sandals without support can lead to callus formation.
• High-activity lifestyle: Athletes and individuals involved in physical labor are more prone to developing calluses.
• Foot deformities: Conditions like bunions, hammertoes, or flat feet can cause abnormal foot mechanics, increasing pressure on certain areas.
• Manual work: Frequent use of hands in activities like gardening, construction, or playing musical instruments can cause calluses on the palms or fingers.

Symptoms

The symptoms of a callus are generally easy to identify. Typical signs include:

• Thickened skin: A rough, hardened area of skin that feels thicker than the surrounding skin.
• Yellowish or gray color: Calluses often appear discolored compared to normal skin.
• Reduced sensitivity: The thick skin may feel numb or less sensitive to touch.
• Pain or tenderness: While most calluses are painless, they can cause discomfort, especially under pressure.
• Cracking: In severe cases, calluses can crack, leading to pain and potential infection.
• Common locations: Calluses frequently develop on the soles of the feet (heel, ball of foot), toes, palms, and fingers.

Diagnosis

Diagnosis of calluses is straightforward and usually based on physical examination:

• Clinical examination: A healthcare provider examines the affected area, noting skin thickness, location, and any signs of irritation.
• Patient history: Information about daily activities, footwear habits, or repetitive tasks helps identify contributing factors.
• Differentiation from corns: Calluses are distinguished from corns, which are smaller, more localized, and often painful.
• Assessment for complications: In individuals with diabetes or poor circulation, providers check for signs of skin breakdown or infection.
• No special tests: Generally, no laboratory or imaging tests are required unless complications are suspected.

Treatment

Treatment for calluses focuses on reducing skin thickening, relieving discomfort, and addressing the underlying cause:

• Footwear adjustments: Switching to properly fitting shoes with cushioning reduces friction and pressure.
• Padding: Use of protective pads or insoles to redistribute pressure and prevent further callus formation.
• Soaking and exfoliation: Regular soaking in warm water followed by gentle exfoliation with a pumice stone can soften and reduce callus thickness.
• Moisturizing creams: Urea-based or salicylic acid creams help soften thickened skin and prevent cracking.
• Professional removal: A podiatrist or dermatologist can safely trim or shave thick calluses to relieve discomfort.
• Treating underlying conditions: Correcting foot deformities or gait abnormalities with orthotics may prevent recurrence.
• Avoiding self-surgery: Patients should avoid cutting calluses at home, especially if they have diabetes or circulation problems, to prevent infections.

Prognosis

The prognosis for calluses is excellent when properly managed:

• Good outcome with care: Most calluses improve significantly with conservative treatment and proper foot care.
• Chronic recurrence: Calluses may return if the underlying causes, such as poor footwear or repetitive activities, are not addressed.
• Preventable condition: Regular foot care, appropriate footwear, and avoidance of repetitive friction can prevent callus formation.
• Risk of complications: In people with diabetes or poor circulation, calluses may lead to ulcers or infections if neglected.
• Long-term management: For some individuals, routine maintenance by a healthcare professional may be necessary to keep calluses under control.

With consistent care and preventive measures, most people can manage calluses effectively and maintain healthy skin.