Hard Skin Removal
Hard skin can form for several reasons, including excessive amounts of sheering forces or pressure on the foot caused by poorly fitting footwear, abnormal foot biomechanics, abnormal gait patterns, foot deformity, or as a consequence of a particular activity (e.g. foot stamping in Judo or ballet).
There are two main “hard skin issues” that people present with when visiting a podiatry clinic: callus and corns. Callus arises from sheer forces which are a combination of pressure and friction. Callus is a diffuse area of hard, thickened, often yellowish skin that can either be filed off or removed by sharp debridement. Callus is protective in that it protects the tissues beneath it from undue stress but can build up to excessive levels if allowed to accumulate. This can lead to pain and discomfort, and in vulnerable individuals, can lead to ulceration. Corns are rather different. There are a few different types of corns, the most common being heloma durum (“corns”), heloma mille (“seed corns”), heloma molle (“soft corns”) and subungual heloma (corns under the nails). Corns are usually hard, often round or cone shaped pieces of hard skin that is often painful when pressure is applied when walking or by footwear. Seed corns often form as a result of friction, while heloma durum and soft corns arise as a result of excessive direct pressure over a bony prominence. Subungual heloma are corns that are found underneath the nail plate. Commonly, these form at the outside edges of the nail but can appear in more central positions. These corns can be very difficult to remove and may involve removing some or all of the nail in order to expose the corn so that it can be removed.
Our therapists use a sterile, single-use scalpel blade to remove excess hard skin, followed by a thorough filing with a hand-file. The process of removing the skin is painless…some people even find it quite relaxing. Corns are best removed by a qualified podiatrist using sharp debridement techniques. Corns are also removed using a scalpel. The overlying and surrounding callus is removed, and the nucleus of the corn is excised. In most instances, this is also a largely painless process, although in some cases there may be a little discomfort experienced during removal, especially if the corn is very deep or in a sensitive area. Denucleation with a scalpel is the preferred and most effective method that podiatrists use.