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Burton J. Katzen, DPM
Treatment For Calluses
Metro Foot Care Centers
. http://www.marylandfootdoctor.com

Treatment For Calluses

Calluses are areas of skin that thicken in response to repeated pressure and friction. This callus formation is the body's defense mechanism to protect the foot against excessive pressure and friction that could cause injury to the structures beneath them. They form on the bottom of the foot underneath the metatarsal bones, which are the five long bones that connect to the bones of our toes. These bones are analogous to the knuckles of our hand. If you make a fist, the bumps that form the big knuckles are the metacarpal bones. The metatarsal bones are the “knuckles” of our feet, and they play a big role in bearing the weight of our bodies when we stand or walk.

Some calluses have a deep-seated center core known as a nucleation that is often confused with a wart. This particular type of callus can be especially painful in response to pressure when walking. This condition is often referred to as intractable plantar keratosis.

Calluses on the feet usually indicate a biomechanical problem, resulting in excessive pressure between the skin and the underlying metatarsal bone.

Calluses can develop under one or more of the five metatarsal heads for two reasons. Either one or more of the metatarsal heads is too low (dropped or plantar flexed metatarsal) or too long, causing it to bear more weight and pressure than the others; or one of the metatarsals is unstable, causing the adjacent metatarsal head to absorb more pressure. This is very common in people with bunions. The first metatarsal drifts upward, causing the second metatarsal to accept the extra weight.


There are numerous conservative and surgical ways to properly treat calluses. The doctor may carefully debride the callus and any deep-seated core and apply various pads to properly redistribute the weight and temporarily relieve the pressure. An effective orthotic or accommodative insole may transfer pressure away from the hot spots or high-pressure areas and allow the weight bearing to be more evenly distributed. The orthotics should be made with materials that absorb shock and shear (friction) forces and they must fit comfortably in a shoe.

For people who desire a permanent cure or for those where conservative therapy has produced a less than desired result, surgery is also an option. The surgery is an in-office procedure performed under local anesthesia with or without IV sedation that will either realign the metatarsals or remove bony prominences.

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