What is the most common area for callus formation on the foot anatomy?

From the Guidelines

The most common area for callus formation on the foot is the plantar surface, particularly under the metatarsal heads (the ball of the foot). Calluses frequently develop in this location because it bears significant weight during walking and standing, creating repeated pressure and friction. Other common sites include the heel, the outer edge of the big toe, and the outer side of the fifth toe. Calluses form as a protective response by the skin, which thickens in areas of repeated pressure or friction. The body produces extra layers of keratin, a tough protein found in skin cells, creating a hardened, yellowish or grayish, sometimes painful patch of skin. People with certain foot structures, such as flat feet or high arches, may be more prone to developing calluses due to uneven weight distribution. Wearing ill-fitting shoes, going barefoot regularly, or participating in activities that put pressure on specific areas of the foot can also contribute to callus formation in these common locations. According to the most recent evidence 1, the presence of erythema, warmth, or callus formation may indicate areas of tissue damage with impending breakdown, highlighting the importance of regular foot examinations to identify high-risk foot conditions.

Key Factors Contributing to Callus Formation

• Uneven weight distribution due to certain foot structures, such as flat feet or high arches
• Wearing ill-fitting shoes
• Going barefoot regularly
• Participating in activities that put pressure on specific areas of the foot
• Presence of erythema, warmth, or callus formation, which may indicate areas of tissue damage with impending breakdown 1

Management of Callus Formation

• Well-fitted walking shoes or athletic shoes that cushion the feet and redistribute pressure can help manage callus formation 1
• Callus can be debrided with a scalpel by a foot care specialist or other health professional with experience and training in foot care 1
• People with bony deformities, such as hammertoes, prominent metatarsal heads, or bunions, may need custom-molded shoes 1

From the Research

Callus Formation on the Foot Anatomy

The most common areas for callus formation on the foot anatomy are:

• Under the first metatarsal head (MTH) 2, 3
• Under the second MTH 2, 4
• Under the fifth MTH 2, 4
• On the lesser digits, particularly the toes 5

Factors Contributing to Callus Formation

Some factors that contribute to callus formation in these areas include:

• High external forces, such as pressure and shear stress, during walking 2, 3, 4
• Abnormal gait patterns, such as small flexion of the knee joint and large ankle pronation motion 2
• Wearing ill-fitting shoes, including those that are too long or too narrow 2, 4
• High heel heights, which can alter the distribution of external forces on the foot 6

Prevention of Callus Formation

Preventing callus formation can be achieved by:

• Wearing suitable size and width of shoes 4
• Using rocker sole shoes to reduce peak pressure under the first MTH 3
• Debridement and custom molded digital orthoses to reduce digital plantar pressure 5
• Avoiding high heel heights or selecting shoes with a moderate heel height 6