From the Guidelines
Corns can be effectively treated through a combination of debridement, assessment and correction of weight distribution, and the use of emollients and nonadherent dressings, as recommended by the most recent evidence 1. When treating corns, it is essential to consider the underlying cause of the condition, which is often related to repeated friction and pressure on the skin.
- Debridement of the lesions is a procedure that can be performed regularly by podiatrists using manual debridement or paring of hyperkeratosis, with a quality evidence level of 2+ 1.
- Assessment and correction of weight distribution, with cushioning to try to reduce hyperkeratosis build-up, is also recommended, with a quality evidence level ranging from 2 to 2+ 1.
- The use of emollients and nonadherent dressings after debridement can help to protect the debrided skin and promote healing 1. It is also important to note that overdebridement can make the underlying skin susceptible to increased blistering and tenderness, particularly in patients with epidermolysis bullosa (EB) 1. In terms of specific treatment options, the use of a validated tool to assess hyperkeratosis can help to monitor, evaluate, and manage the condition, with a strength of recommendation grade of B 2.
- Pressure redistribution and cushioning are also helpful in preventing the development of hyperkeratosis, with a quality evidence level of 2 2. Overall, a comprehensive approach to treating corns should include a combination of debridement, assessment and correction of weight distribution, and the use of emollients and nonadherent dressings, as well as consideration of the underlying cause of the condition and the use of validated assessment tools.
From the FDA Drug Label
Indications and Usage For debridement and promotion of normal healing of hyperkeratotic surface lesions, particularly where healing is retarded by local infection, necrotic tissue, fibrinous or purulent debris or eschar. Urea is useful for the treatment of hyperkeratotic conditions such as dry, rough skin, dermatitis, psoriasis, xerosis, ichthyosis, eczema, keratosis pilaris, keratosis palmaris, keratoderma, corns and calluses, as well as damaged, ingrown and devitalized nails.
- Urea (TOP) can be used for the treatment of corns.
- The drug is indicated for debridement and promotion of normal healing of hyperkeratotic surface lesions, including corns 3.
From the Research
Treatment Options for Corns
- Salicylic acid plasters have been shown to be an effective treatment for corns, with a higher proportion of resolved corns and a prolonged time to corn recurrence compared to scalpel debridement 4
- The use of salicylic acid plasters has also been associated with less pain and reduced corn size over the first 6 months of treatment 4
- A study analyzing the long-term effectiveness of salicylic acid plasters found that treatment was not significantly related to time to corn recurrence when analyzed over the full 12-month follow-up period 5
Comparison of Treatments
- A randomized controlled trial compared the effectiveness of salicylic acid plasters with scalpel debridement and found that the salicylic acid plasters were a cost-effective intervention 4
- Another study compared the keratolytic effect of 5% salicylic acid and 10% urea ointment with 12% ammonium lactate lotion and found that both treatments resulted in a reduction in the severity of xerosis after 4 weeks of therapy 6
Mechanism of Action
- Salicylic acid and urea have been shown to have a keratolytic effect, with salicylic acid increasing the skin material on tape strips and urea not having a significant influence 7
- The distribution and absorption of salicylic acid and urea in human skin have been studied using a tape stripping technique, which provides a useful tool to evaluate the binding forces within the stratum corneum in relation to absorption of topically applied substances 7
Other Uses of Salicylic Acid
- Salicylic acid has been used to treat other skin conditions, such as acanthosis nigricans, and has been shown to be effective in reducing hyperpigmentation associated with the condition 8
- A study comparing the efficacy and safety profiles of 10% salicylic acid and 10% urea creams in treating acanthosis nigricans in adolescents found that both treatments had similar efficacy and safety profiles 8