Calluses  i.e.  locally intensified keratinization, are caused by too much pressure applied on one place on the feet. As a result, the accumulation of keratinocytes makes the skin there get visibly tougher and thicker. Repeated pressure and friction cause hard cells to press deeper in  to form the callus core, which in turn, presses against neural endings inflicting intense pain.

The deeper the core gets, the more severe the pain becomes as eventually it can irritate periosteum.

Factors predisposing for calluses:

  • tight and hard shoes (high heels) 
  • (metatarsal) midfoot joint arthritis, instability and dysfunction (toes, hallux valgus, flat feet (platypodia)
  • sutures without proper post-surgical protection
  • wrong foot care: frequent peeling can lead to callosity and finally to calluses
  • ignoring the indications for orthotic insoles and orthoses

Photo gallery of  cases :

Patient 1. – Patient with a callus on his right midfoot.

The patient used a selection of home methods of calluses removal, ranging from cutters and pumers to callus cushions. All the means relieved the discomfort only temporarily, what’s more, the improper treatment resulted in the callosity around the callus which kept reoccurring. The callus was properly processed with the milling machine so that the tough skin was removed and the skin surface was neatly polished. The suitable orthosis helped to reduce the pain altogether.

Before treatment:

After treatment:

Patient 2. A young female with callosity under the head of the bone of her big toe that she tried to remove with a razor blade, which eventually led to a callus on her sole.

Both the callosity and the callus were removed from the inside lateral part of her midfoot. The area which was pressure-prone due to metatarsal deformity was fitted with adequate protection.

photo. 1.Before treatment,  photo. 2. After treatment

Patient 3.

photo. 1.Before treatment,  photo. 2. After treatment

Patient 4.

photo. 1.Before treatment,  photo. 2. After treatment

Patient 5. 68-year-old patient with a callous skin change on the 5th toe of her right foot. The large callus lead to walking problems and spinal pain.

A large, hard callus pressed against periosteum and nerves causing great pain. Additionally,callosity was formed around the callus. Narrow footwear led to 90 degree rotation of the toe. Such a location of a callus is very common, especially when people wear tight and narrow shoes and when women have worn high heels for many years.

photo. 1.Before treatment,  photo. 2. After treatment

After the callus removal, the next therapeutic steps included gradual eradication of the callosity and skinimmunisation. The patient was also taught appropriate massage and instructed to wear the orthosis on a daily basis to prevent the callus recurrence. Proper shoe types were indicated as a long term prevention measure.


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