What are the treatment options for heloma (foot corn)?

From the Guidelines

To treat a foot corn, it is recommended to start by soaking your foot in warm water for 5-10 minutes to soften the hardened skin, followed by the application of a corn pad containing 40% salicylic acid, and for persistent or painful corns, consult a podiatrist who can safely remove the corn and address underlying causes, as suggested by the most recent evidence 1. When treating foot corns, it is essential to prioritize methods that reduce pressure and friction on the affected area. The use of corn pads with salicylic acid can help dissolve the hardened skin, and soaking the foot in warm water can aid in softening the corn.

Key Considerations

• Soaking the foot in warm water for 5-10 minutes to soften the hardened skin
• Applying a corn pad containing 40% salicylic acid directly over the corn
• Replacing the pad every 48 hours after soaking the foot again
• Gently filing down the softened corn with a pumice stone or foot file after 1-2 weeks of treatment
• Preventing recurrence by wearing properly fitting shoes, using silicone toe separators, and cushioning pressure points with moleskin pads

Podiatric Management

For patients with persistent or painful corns, especially those with underlying conditions such as diabetes or circulation problems, consulting a podiatrist is crucial. Podiatrists can safely remove the corn and address the underlying causes, as highlighted in the evidence-based guideline for foot care in epidermolysis bullosa 1.

Additional Recommendations

• Assessment and correction of weight distribution, with cushioning to reduce hyperkeratosis build-up 1
• The use of EB-specific assessment tools to evaluate the distribution of pressure on the skin leading to hyperkeratosis and to manage the condition effectively 1

From the FDA Drug Label

Urea is useful for the treatment of hyperkeratotic conditions such as ... corns and calluses... The answer to the question of foot corn treatment is that urea (TOP) can be used for the treatment of corns 2.

• Urea (TOP) is indicated for the treatment of hyperkeratotic conditions, including corns.
• No information is provided about the use of salicylic acid (TOP) for foot corn treatment in the given drug label.

From the Research

Foot Corn Treatment Options

• Conservative management: Proper footwear, orthoses, and regular paring can help manage most lesions, and the lesions usually disappear when the causative mechanical forces are removed 3
• Tangential excision with topical cantharidin: A study found that this treatment method was simple, minimally invasive, and reliable for calluses, with a success rate of 79.2% after one session 4
• Salicylic acid plasters: Compared to 'usual' scalpel debridement, salicylic acid plasters were found to be more effective in resolving corns, reducing pain, and improving health-related quality of life 5
• Combination urea and salicylic acid ointment: This treatment was used to achieve painless nonsurgical avulsion of a nondystrophic nail, but its effectiveness for foot corns is not directly stated 6

Treatment Effectiveness

• The study on salicylic acid plasters found that 34% of corns had completely resolved after 3 months, and 83% had reduced in size 5
• The study on tangential excision with topical cantharidin found that only one recurrence (1.4%) was seen after a follow-up of at least 1 year 4
• The economic analysis of the salicylic acid plaster study indicated that this treatment was cost-effective 5

Treatment Considerations

• Surgery is rarely indicated for foot corns and should be specifically aimed at correcting abnormal mechanical stresses 3
• The treatment method should be chosen based on the individual patient's needs and the severity of the corn 4, 5