What is the treatment for corns on the feet?

Treatment of Corns on the Feet

Professional debridement by a trained podiatrist is the primary and most effective treatment for corns on the feet, and should be combined with footwear modifications and orthotic interventions to address the underlying mechanical causes. 1, 2

Immediate Treatment: Professional Debridement

• Manual paring with a scalpel by a trained podiatrist is the first-line treatment for removing the hard keratin plug that characterizes corns and causes the sharp, localized pain. 1, 2
• After debridement, apply emollients and non-adherent dressings to protect the treated area. 1, 2
• For severe or particularly thick corns, blade debridement under professional care is necessary when the area is too painful for standard paring. 1

Addressing Underlying Mechanical Causes

Treatment cannot stop at debridement alone—you must correct the biomechanical factors causing the corn, or it will rapidly recur. 2, 3

Footwear Modifications

• Prescribe properly fitting shoes with adequate toe box width and height to reduce pressure and friction. 1, 2
• For corns between toes (soft corns/heloma molle), ensure shoes provide sufficient space to prevent toe compression. 1

Orthotic Interventions

• Use toe separators or silicone orthotic devices to redistribute pressure between toes for interdigital corns. 1, 2
• Consider custom-made insoles or therapeutic footwear when foot deformities or pre-ulcerative signs are present. 2

Adjunctive Topical Treatment (Limited Role)

• Salicylic acid 6% can be used as a topical aid for excessive keratin removal in hyperkeratotic lesions, applied at night after hydration of the skin for at least 5 minutes. 4
• However, this is only an adjunct—professional debridement remains the primary treatment. 4
• Wash off the medication in the morning; excessive application does not increase benefit and may cause local irritation or systemic salicylism. 4

Special Considerations for High-Risk Patients

Diabetic Patients or Those with Peripheral Arterial Disease

• Use a more conservative debridement approach due to significantly higher complication risk. 2
• Corns are considered pre-ulcerative lesions in these patients and require aggressive preventive management. 5, 2
• Refer to a foot care specialist for ongoing preventive care and surveillance every 1-3 months. 5, 2
• Never allow these patients to use chemical corn removers or plasters—this dramatically increases infection and ulceration risk. 5, 2
• Therapeutic footwear is mandatory, not optional, for high-risk patients. 5, 2

Prevention Strategies

• Perform daily foot inspection, especially between toes, to identify corns early before they become symptomatic. 1, 2
• Wash feet daily with careful drying between toes to prevent moisture buildup that contributes to soft corns. 1, 2
• Apply emollients to lubricate dry skin, but never between the toes as this increases maceration risk. 2
• Never walk barefoot, in socks only, or in thin-soled slippers, whether at home or outside. 2

Critical Pitfalls to Avoid

• Never allow patients to self-treat with over-the-counter chemical corn removers or medicated plasters—these significantly increase the risk of skin breakdown, infection, and ulceration, especially in diabetic patients. 5, 2
• Do not treat corns in isolation without addressing the underlying biomechanical abnormality causing the pressure; this leads to rapid recurrence and continued pain. 2, 3
• Do not cut corns at home—professional care is essential for safe and effective removal. 2

Surgical Considerations

• For non-rigid hammertoes with recurrent corns on the toe apex that fail conservative treatment, consider digital flexor tendon tenotomy to normalize foot structure. 5
• Surgery should be specifically aimed at correcting the abnormal mechanical stresses causing the corn, not just removing the lesion itself. 6
• Surgical intervention is rarely indicated and reserved for cases where conservative management has failed and structural deformity is the primary cause. 6