What is the treatment for corns between the toes?

Treatment for Corns Between the Toes

The primary treatment for corns between the toes involves professional debridement by a podiatrist, along with addressing the underlying cause through proper footwear and cushioning devices to reduce friction and pressure.

Understanding Corns Between Toes

• Corns (helomas) are localized areas of hyperkeratosis with a hard, yellow nucleus or plug of keratin that extends downward in a cone-shaped point, causing notable pain and discomfort 1
• They develop due to persistent pressure or friction, particularly between toes where there is insufficient soft tissue between skin and bone 2
• Patients often describe the sensation as walking on a small stone or pebble 1
• Corns between toes (soft corns or heloma molle) differ from hard corns (heloma durum) on weight-bearing surfaces 1

Treatment Algorithm

First-Line Treatment: Professional Care

1. Professional debridement

   • Manual debridement or paring of the corn by a trained podiatrist is the primary treatment 1
   • If the area is too painful or thick, blade or scalpel debridement by a podiatrist is recommended 1
   • After debridement, emollients and non-adherent dressings should be applied to protect the skin 1

2. Self-management options (for minor cases)

   • Gentle filing with an emery board after softening the corn in warm water 1
   • Application of cornflour between toes to control moisture and reduce friction 1
   • CAUTION: Chemical agents or medicated corn plasters should be used with care, especially in diabetic patients or those with poor circulation 1

Second-Line Treatment: Addressing Underlying Causes

1. Footwear modifications

   • Wear properly fitting shoes with adequate toe box width and height 1
   • Avoid tight shoes or those with rough edges and uneven seams 1
   • Consider open-toed shoes or sandals to reduce pressure between toes 3

2. Orthotic interventions

   • Use toe separators or silicone orthotic devices between affected toes 1
   • Consider cushioning insoles to redistribute pressure 1
   • For recurrent cases, custom orthotics may be necessary 3

3. Topical treatments

   • For hyperkeratotic tissue, salicylic acid preparations may be used cautiously 4
   • Apply by covering the treated area at night after washing and hydrating the skin for at least five minutes 4
   • Wash off in the morning; if excessive drying occurs, apply a bland cream 4

Special Considerations

For Diabetic Patients

• More conservative approach is essential due to higher risk of complications 1
• Never use chemical agents or plasters to remove corns 1
• Regular podiatric care is crucial for prevention and management 1
• Any corn treatment should be performed by a healthcare provider, not by the patient 1

Surgical Options (Rarely Indicated)

• Surgery is rarely indicated and should only be considered when conservative measures fail 5
• In cases of recurrent corns due to underlying bone deformity, surgical correction of the deformity may be necessary 3
• For severe recurrent cases, split-thickness sole skin grafting after corn excision has been reported as effective 6

Prevention Strategies

• Daily inspection of feet, especially between toes 1
• Regular washing and careful drying, especially between toes 1
• Use of appropriate socks (preferably without seams) 1
• Avoid barefoot walking 1
• Regular moisturizing of dry skin (but avoid between toes) 1

Common Pitfalls to Avoid

• Overdebridement: Can make underlying skin susceptible to increased blistering and tenderness 1
• Self-treatment: Attempting to cut corns without proper training can lead to injury or infection 1
• Ignoring underlying causes: Treating only the corn without addressing the cause will lead to recurrence 5
• Using medicated corn plasters inappropriately: Particularly dangerous in patients with diabetes or poor circulation 1