How are corns managed and treated?

Management and Treatment of Corns

Manual debridement or paring with a scalpel by a trained podiatrist is the primary treatment for corns, and patients must never attempt self-treatment with chemical corn removers or plasters due to high risk of infection and ulceration. 1, 2

First-Line Treatment: Professional Debridement

Professional removal is mandatory for effective corn treatment:

• A trained podiatrist should perform manual debridement or paring with a scalpel to remove the central keratin plug that causes the characteristic sharp pain 1, 3
• After debridement, apply emollients and non-adherent dressings to protect the debrided skin 1, 2
• The corn typically disappears once the causative mechanical forces are removed 4

Addressing Underlying Mechanical Causes

Footwear modification is essential to prevent recurrence:

• Properly fitting shoes with adequate toe box width and height (1-2 cm longer than the foot, width equal to the metatarsal phalangeal joints) reduce pressure and friction 5, 1
• For soft corns between toes (heloma molle), use toe separators or silicone orthotic devices to redistribute pressure 1, 2
• When foot deformity or pre-ulcerative signs are present, therapeutic shoes or custom-made insoles are mandatory 3, 5

High-Risk Patients Require Specialized Management

Diabetic patients and those with peripheral arterial disease need conservative debridement due to higher complication risk:

• Corns are pre-ulcerative lesions in patients with PAD and require aggressive preventive management 1, 3
• Referral to a foot care specialist for ongoing surveillance every 1-3 months is mandatory for high-risk patients 1, 3
• Chemical agents or plasters to remove corns must never be used in diabetic patients 5, 3

Prevention Strategy

Daily preventive measures reduce corn formation:

• Inspect feet daily, especially between toes, to identify early lesions 1, 2
• Wash feet daily with careful drying between toes to prevent moisture buildup 1, 2
• Never walk barefoot, in socks only, or in thin-soled slippers whether at home or outside 1, 3
• Apply emollients to dry skin but never between the toes to prevent maceration risk 1, 3

Critical Safety Warnings

Avoid these common pitfalls that lead to complications:

• Never allow patients to self-treat with chemical corn removers or plasters, as this increases infection and ulceration risk 1, 3
• Do not cut corns at home—professional care is essential 3
• Avoid applying moisturizers between toes, as this increases maceration risk 3

Role of Topical Agents

Salicylic acid may be used as adjunctive therapy after professional debridement:

• Salicylic acid 6% can be applied to the affected area at night after washing, with the medication washed off in the morning 6
• The skin should be hydrated for at least five minutes prior to application 6
• Excessive repeated application will not increase therapeutic benefit but could result in increased local intolerance and systemic adverse effects such as salicylism 6
• One study showed that tangential excision with topical cantharidin (1% cantharidin, 30% salicylic acid, 5% podophyllin) succeeded in 79.2% of patients in one session, though this requires professional application 7

Note: Glycolic acid is not appropriate for treating corns on the feet, as it is only studied and recommended for facial plane warts 1