From the Guidelines
To treat a corn, it is essential to start by relieving pressure and friction, as hyperkeratosis is a protective response to repeated irritation, and this approach is supported by evidence from a study on foot care in epidermolysis bullosa 1. When managing corns, it's crucial to understand that they can be painful and may lead to further complications if not addressed properly. The use of a validated tool to assess hyperkeratosis, as recommended in the study 1, can help in monitoring and managing the condition effectively.
- Key aspects of treating corns include:
- Soaking the foot in warm water to soften the hardened skin
- Gently filing the corn with a pumice stone or foot file to remove the thickened skin
- Applying a corn pad or cushion around the corn to relieve pressure, as pressure redistribution and cushioning are helpful in preventing the development of hyperkeratosis 1
- Using over-the-counter salicylic acid products, typically at a 17% concentration, directly on the corn following package instructions
- It's also important to wear properly fitting, comfortable shoes that don't compress the toes, as this can help eliminate the source of irritation and prevent recurrence.
- If the corn is painful or doesn't improve with home treatment, consulting a podiatrist is recommended, as they can safely remove the corn and address any underlying foot issues, especially considering that hyperkeratosis may lead to blisters and painful cracks in conditions like epidermolysis bullosa 1.
From the FDA Drug Label
Urea is useful for the treatment of hyperkeratotic conditions such as ... corns and calluses... The treatment for corns is urea, as it is useful for the treatment of hyperkeratotic conditions, including corns and calluses 2.
- Key points:
- Urea is used for debridement and promotion of normal healing of hyperkeratotic surface lesions
- Urea is useful for the treatment of hyperkeratotic conditions such as corns and calluses
- No information is provided about the use of salicylic acid for the treatment of corns in the provided drug label 3
From the Research
Treatment Methods for Corns
- Salicylic acid plasters: This method has been shown to be effective in treating corns, with a higher proportion of resolved corns and a prolonged time to corn recurrence compared to scalpel debridement 4.
- Scalpel debridement: This is a common treatment method for corns, but it has been found to be less effective than salicylic acid plasters in some studies 4, 5.
- Split-thickness sole skin graft (STSSG): This is a surgical method that involves harvesting a skin graft from the arch of the sole and using it to reconstruct the wound after corn excision. It has been shown to be an effective alternative treatment for recurrent palmoplantar hyperkeratosis 6.
Effectiveness of Treatment Methods
- Salicylic acid plasters have been found to be more effective than scalpel debridement in terms of clinical, economic, and patient-centred outcomes 4.
- The use of salicylic acid plasters has been associated with a higher proportion of resolved corns, a prolonged time to corn recurrence, less pain, and reduced corn size over the first 6 months of treatment 4.
- The effectiveness of salicylic acid plasters may vary depending on the type of corn, with dorsal/interdigital corns showing better resolution than plantar corns 5.
Quality of Life and Foot-Related Disability
- Treatment with salicylic acid plasters has been found to improve quality of life and reduce foot-related disability in the short term, but the effect may decrease over time 5.
- The use of salicylic acid plasters has been associated with a quadratic trend in quality of life and foot-related disability scores, with an initial improvement followed by a gradual decrease 5.