Patient Education for Calluses Due to Tight Shoes
The most important intervention for a patient with calluses due to tight shoes is to educate them about wearing properly fitting footwear that accommodates the shape of their feet. 1
Proper Footwear Selection
- The shoe should not be too tight or too loose
- Internal length should be 1-2 cm longer than the foot
- Internal width should equal the width of the foot at the metatarsal phalangeal joints (widest part)
- Height should allow enough room for all toes
- Evaluate fit with the patient in standing position, preferably at the end of the day 1
Daily Foot Care Instructions
Inspection and Hygiene
- Inspect feet daily, including areas between the toes
- Wash feet daily with water temperature below 37°C (98.6°F)
- Dry feet carefully, especially between the toes
- Use emollients to lubricate dry skin, but not between the toes 1
Protection
- Avoid walking barefoot, in socks only, or in thin-soled slippers, both indoors and outdoors
- Wear clean socks daily; choose seamless socks or wear with seams inside out
- Inspect inside of shoes daily before wearing them 1
Managing Calluses
- Do not use chemical agents or plasters to remove corns and calluses
- Do not attempt self-treatment with sharp objects
- Cut toenails straight across
- Seek professional treatment for callus removal 1, 2
Treatment of Calluses
For existing calluses, professional treatment is recommended:
- Gentle debridement of callus by a trained healthcare provider
- Consider padding to redistribute pressure
- For persistent calluses with foot deformities, consider prescribing therapeutic shoes, custom-made insoles, or toe orthoses 1, 3
Follow-up Care
- Schedule follow-up appointment to assess response to treatment
- Evaluate if new footwear is properly fitting
- Assess need for additional professional debridement 3
Common Pitfalls to Avoid
- Patients often continue wearing tight shoes despite discomfort
- Self-treatment with over-the-counter chemical callus removers can cause skin damage
- Patients may not realize that indoor footwear is just as important as outdoor footwear
- Calluses will recur if the mechanical stress (tight shoes) continues 2, 4
Calluses are a normal physiologic response to chronic excessive pressure or friction 2. Research shows that callus formation under metatarsal heads is associated with external forces during walking, and wearing improperly sized footwear significantly contributes to this problem 5. With proper education and footwear selection, most calluses will resolve once the causative mechanical forces are removed.