What are the treatment options for foot corns?

Treatment Options for Foot Corns

Professional debridement by a trained podiatrist is the primary and most effective treatment for corns, and patients should never attempt self-removal with chemical agents or plasters. 1, 2

First-Line Treatment: Professional Debridement

• Manual paring or scalpel debridement by a podiatrist removes the central keratin plug that causes the characteristic sharp pain of corns. 1, 2 This is the gold standard recommended by the American Podiatric Medical Association.
• 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. 1

Second-Line Treatment: Topical Keratolytics (After Professional Debridement)

• Salicylic acid 15-26% applied daily after removing the thick keratin layer, with occlusion if possible, for 3-4 months provides optimal effect. 2 This is the evidence-based topical agent recommended by the British Journal of Dermatology.
• Alternative keratolytic options include:
  • Cantharidin 0.7% solution applied every 3 weeks up to four times 2
  • Trichloroacetic acid 50-80% solution applied weekly for up to 8 weeks 2
  • Combination therapy with 1% cantharidin, 30% salicylic acid, and 5% podophyllin (Canthacur-PS) achieved success in 79.2% of patients with one session 3
• Urea-containing products are FDA-approved for hyperkeratotic conditions including corns and calluses, promoting debridement and normal healing. 4

Addressing Underlying Mechanical Causes

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

Emerging Treatment Option

• Hyaluronic acid gel injections for digital and interdigital corns in non-weight bearing areas showed considerable improvement without adverse reactions in case reports, though this remains investigational. 6, 7

Critical Safety Warnings

• Never allow patients to use chemical corn removers or plasters at home—this significantly increases infection and ulceration risk. 5, 2
• Patients should never cut corns themselves; professional care is mandatory. 2
• Avoid applying moisturizers between toes as this increases maceration risk. 2

Special Considerations for High-Risk Patients

Diabetic Patients or Those with Peripheral Artery Disease

• These patients require a more conservative debridement approach due to higher complication risk, as corns are considered pre-ulcerative lesions. 2
• Referral to a foot care specialist for ongoing preventive care and surveillance every 1-3 months is mandatory. 2
• Therapeutic footwear is required, not optional, for these patients. 2
• More aggressive preventive management is needed given the ulceration risk. 2

Prevention Strategies

• Daily foot inspection, especially between toes, to identify corns early. 1, 2
• Daily washing 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. 5, 2
• Apply emollients to lubricate dry skin, but not between the toes. 2
• Cut toenails straight across to prevent ingrown nails that can contribute to corn formation. 5