From the Guidelines
Treatment for a callus on the plantar surface of the foot should prioritize addressing the underlying cause, such as increased plantar pressure, and may involve a combination of self-care measures and professional care, including debridement by a foot care specialist and the use of well-fitted walking shoes or athletic shoes that cushion the feet and redistribute pressure 1.
Key Considerations
- The most recent and highest quality study, published in 2022, recommends that people with neuropathy or evidence of increased plantar pressures may be adequately managed with well-fitted walking shoes or athletic shoes that cushion the feet and redistribute pressure 1.
- Calluses can be debrided with a scalpel by a foot care specialist or other health professional with experience and training in foot care, as recommended in a 2015 study 1.
- Custom-molded shoes may be required for people with bony deformities, including Charcot foot, who cannot be accommodated with commercial therapeutic footwear 1.
Treatment Options
- Self-care measures, such as soaking the foot in warm water and gently filing down the thickened skin using a pumice stone, foot file, or emery board, can help soften the callus.
- Over-the-counter salicylic acid patches can be applied directly to the callus for 1-2 days, followed by gentle filing of the softened skin.
- Wearing properly fitting shoes with adequate cushioning and using padded insoles or orthotic devices can relieve pressure on the affected area.
- Donut-shaped pads placed around the callus can redistribute pressure away from the thickened skin.
Professional Care
- For persistent or painful calluses, a podiatrist can safely trim the thickened skin and may recommend custom orthotics to address biomechanical issues causing abnormal pressure.
- A thorough workup should be performed when patients with neuropathy present with the acute onset of a red, hot, swollen foot or ankle, and Charcot neuroarthropathy should be excluded 1.
From the FDA Drug Label
For Podiatric Use: Salicylic Acid 6% is a topical aid in the removal of excessive keratin on dorsal and plantar hyperkeratotic lesions. 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.
The treatment for a callus on the plantar surface of the foot includes:
- Salicylic Acid 6% for the removal of excessive keratin on plantar hyperkeratotic lesions 2
- Urea for the treatment of hyperkeratotic conditions such as calluses 3 Key points:
- Salicylic acid and urea are used to treat hyperkeratotic conditions
- These treatments can be used on the plantar surface of the foot
- They aid in the removal of excessive keratin and promote normal healing of hyperkeratotic surface lesions.
From the Research
Treatment Options for Callus on the Plantar Surface of the Foot
- Over-the-counter (OTC) topical salicylic acid has short-term benefits for treating calluses, as stated in the study 4
- Pads and inserts that redistribute contact forces can provide long-term benefits for patients with calluses, according to the study 4
- Debridement of callus by a trained specialist is considered the 'gold standard' of treatment, as mentioned in the study 5
- Home treatments such as potassium hydroxide (KOH) and trichloroacetic acid (TCA) can also be effective in treating calluses, although to a lesser extent than podiatry treatment, as found in the study 5
Use of Orthotic Devices
- Custom molded digital orthoses can significantly reduce digital plantar pressure, as shown in the study 6
- Rigid orthotic devices can reduce callus grade in people with diabetes by lowering and redistributing abnormal foot pressures, according to the study 7
- Foot orthoses provided by the CAD-CAM and foam impression methods can decrease peak pressure and maximum force in the heel region and redistribute pressure to the medial arch region, as found in the study 8