Topical Salicylic Acid for Corn on Toe
For treating corns on the toe, use 40% salicylic acid plasters applied directly to the corn after paring down the hyperkeratotic tissue, changed every few days until resolution. 1, 2
Recommended Concentration and Formulation
- 40% salicylic acid plasters are the most effective formulation for corns, demonstrating superior outcomes compared to standard scalpel debridement alone 1, 2
- Alternative concentrations include 50% salicylic acid ointments, though plasters are more commonly used and studied 1
- Lower concentrations (10-26% paints) are available but are primarily studied for viral warts rather than corns 1
Application Method
- Pare down or abrade the hyperkeratotic corn tissue before application to enhance penetration 1
- Apply the 40% salicylic acid plaster directly to the corn lesion 1, 2
- Keep the area occluded with a dressing for approximately 5 days, then remove and reassess 3
- Repeat application as needed until complete resolution 3, 2
Expected Outcomes
The evidence strongly supports salicylic acid plasters for corns:
- 79% of corn patients achieved complete resolution with one treatment session using a combination product containing 30% salicylic acid 3
- 34% complete corn resolution at 3 months with 40% salicylic acid plasters versus 21% with scalpel debridement alone 2
- 83% reduction in corn size at 3 months with plasters versus 56% with scalpel alone 2
- Time to corn recurrence was significantly longer with salicylic acid plaster treatment 2
- Pain reduction was significantly greater with plaster treatment at 3 months 2
Important Safety Considerations
- Do not apply to more than 20% of body surface area to avoid systemic salicylate toxicity 1, 4
- Avoid combining with oral salicylate medications (aspirin, NSAIDs) due to additive systemic effects 1, 4
- Exercise caution in patients with impaired hepatic or renal function, as systemic absorption can occur 1, 4
- Contraindicated in children under 2 years of age due to increased risk of systemic toxicity 4
Clinical Pitfalls to Avoid
- Do not abrade surrounding normal skin during paring, as this may spread infection or cause unnecessary irritation 1
- Avoid application to inflamed or infected tissue 1
- The treatment requires patient compliance with repeated applications; set realistic expectations that multiple sessions may be needed 1, 3
- Monitor for excessive irritation, erythema, or scaling and reduce frequency if these occur 1
Cost-Effectiveness
Salicylic acid plasters are cost-effective compared to repeated scalpel debridement sessions, with better long-term outcomes and patient satisfaction 2