From the Guidelines
To treat helomas (corns) on the feet, debridement of the lesions is recommended, which can be performed by a podiatrist using manual debridement or paring of hyperkeratosis, or by the patient using an emery board or nailfile for self-management 1. When treating corns, it is essential to consider the underlying cause of the hyperkeratosis, which is often related to friction and pressure on the skin.
- Debridement is a crucial step in managing corns, as it helps to remove the thickened skin and reduce pressure on the affected area.
- After debridement, using emollients and nonadherent dressings can help to protect the debrided skin and promote healing 1.
- Assessment and correction of weight distribution, with cushioning to try to reduce hyperkeratosis build-up, is also an important aspect of treating corns, as it can help to prevent further irritation and pressure on the skin 1.
- In some cases, custom orthotics or therapeutic footwear may be necessary to redistribute pressure and prevent further corn formation, especially for individuals with high-risk foot conditions such as diabetes or poor circulation 1. It is crucial to approach debridement with caution, especially in patients with underlying conditions such as epidermolysis bullosa, as overdebridement can lead to increased blistering and tenderness 1.
- A thorough assessment of the patient's foot health and underlying conditions is necessary to determine the best course of treatment.
- Patients should be educated on proper foot care and self-management techniques to prevent future corn formation and promote overall foot health.
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. The treatment for helomas (corns) on the feet is urea (TOP), which is useful for the treatment of hyperkeratotic conditions such as corns and calluses 2.
From the Research
Treatment Options for Helomas (Corns) on the Feet
- Conservative management is often the first line of treatment, which includes proper footwear, orthoses, and regular paring of the lesion 3
- Relieving the cause of pressure or friction is crucial in treating corns, and this can be achieved with properly fitting shoes and corn/callus pads 4
- Other treatment options include:
- Injectable silicone to cushion corns, which has shown good to excellent results in 77% of cases after an average follow-up period of six years 5
- Microwave energy treatment, which has demonstrated effectiveness in clearing recalcitrant plantar warts and reducing pain associated with corns 6
- Surgical treatment is rarely indicated and should be specifically aimed at correcting the abnormal mechanical stresses 3, 7
Important Considerations
- Corns can be differentiated from plantar warts by gentle paring with a scalpel, which will reveal soft, granular, elongated mounds of dermis projecting up into the epidermis if the abnormality is a wart 4
- Foot deformation is a common cause of calluses and corns, and treating the underlying condition is essential for effective management 7