Caring for calluses and corns is an essential part of foot care, especially for individuals who are at risk of complications, such as those with diabetes, poor circulation, or mobility issues. A foot care nurse works to remove the thickened skin caused by pressure or friction, while also educating the patient on preventive measures to reduce recurrence. Below is an outline of how a foot care nurse typically cares for calluses and corns.

1. Initial Assessment

• • Patient History: The nurse will begin by asking the patient about their symptoms (pain, discomfort, or any changes in the appearance of the skin) and whether the calluses or corns have been causing any difficulty walking or discomfort in shoes.
  • Foot Examination: The nurse will carefully inspect the feet, assessing the size, location, and condition of the calluses and corns. They will check for any signs of infection, open skin, or pressure points that might have led to the formation of the thickened skin.

2. Differentiating Between Calluses and Corns

• • Calluses: These are larger, thickened areas of skin that form on the soles of the feet, typically due to friction or pressure from walking, ill-fitting shoes, or standing for long periods. Calluses are usually painless but may become uncomfortable if they become too thick.
  • Corns: Corns are smaller, circular, often painful areas of thickened skin that typically develop on the tops or sides of toes due to pressure from footwear or abnormal toe positioning. Corns may have a hard center and can cause sharp pain when pressure is applied.

3. Soaking the Feet

• • Warm Water Soak: The nurse will often recommend soaking the feet in warm water to soften the calluses or corns, which makes them easier to treat. The soak may last about 10–15 minutes. Sometimes, a mild antiseptic solution or Epsom salts are added to the water to help clean the feet and soften the skin further.
  • Antiseptic Soak (optional): If there are signs of infection or if the skin is broken, an antiseptic solution may be used to prevent infection while softening the calluses or corns.

4. Removing or Reducing the Callus or Corn

• • Gentle Debridement: After soaking, the nurse will use a pumice stone, callus file, or foot rasp to gently file down the callus or corn. The goal is to remove the thickened skin gradually without causing damage to the healthy skin underneath. The nurse will take care not to remove too much skin, as this could cause injury or expose the sensitive tissue below.
  • Scalpel (in severe cases): If the callus or corn is very thick, the nurse may use a sterile scalpel or dermatome to carefully trim the hardened skin. This is typically done under sterile conditions to minimize the risk of infection.
  • Avoiding the Sensitive Skin: When dealing with corns, which are often more concentrated in a small area, the nurse will be particularly careful not to cut into healthy skin around the corn, as corns are typically raised and harder to treat.

5. Moisturizing the Skin

• • Hydration: After the thickened skin is reduced, the nurse may apply a moisturizing lotion or foot cream to keep the skin hydrated. Dry, cracked skin can lead to infections or more severe skin problems.
  • Specialized Foot Creams: In cases of severe calluses or corns, the nurse might recommend a foot cream containing urea or salicylic acid, which helps to break down thickened skin over time. However, this will be done with caution, especially in high-risk patients (e.g., those with diabetes).

6. Caring for the Surrounding Skin

• • Protection: If any of the skin around the corn or callus is irritated, inflamed, or broken, the nurse may apply an antiseptic ointment or antibiotic ointment to prevent infection.
  • Padding or Cushioning: If the patient has a recurring corn or callus in the same location, the nurse may recommend using cushioning pads or gel toe protectors to protect the area from further pressure. This is particularly helpful for people who have deformities (like hammertoes) that cause continued pressure on certain areas of the foot.

7. Addressing the Underlying Cause

• • Footwear Education: A common cause of calluses and corns is improper footwear. The nurse will educate the patient about the importance of wearing well-fitting shoes that provide adequate room for the toes and do not cause excessive pressure on certain areas of the foot. Shoes that are too tight or too loose can exacerbate the formation of calluses and corns.
  • Footwear Modifications: For patients with foot deformities (e.g., bunions, hammertoes), the nurse may recommend custom orthotics or insoles to redistribute pressure and reduce friction on vulnerable areas of the foot.
  • Changing Habits: The nurse may suggest changes in walking or standing habits if prolonged pressure or friction is contributing to the problem, such as frequent breaks or avoiding prolonged standing in one position.

8. Preventive Measures

• • Daily Foot Inspection: The nurse will encourage the patient to perform daily foot checks, especially if they are at high risk for complications (e.g., diabetic patients). This helps catch any developing calluses, corns, or other issues before they become problematic.
  • Regular Foot Care: The nurse may suggest regular foot care appointments, especially for individuals with chronic or recurrent calluses and corns, to ensure the condition is managed and the risk of complications is minimized.
  • Hydration and Moisturization: The nurse will stress the importance of daily foot care at home, including moisturizing the feet regularly to prevent dry, cracked skin, which can lead to further irritation and the formation of calluses or corns.

9. Special Considerations for High-Risk Patients

• • Diabetic Patients: Diabetic patients may have reduced circulation and neuropathy, which means they may not feel pain or notice problems like calluses and corns until they become severe. For these patients, the nurse will be extra cautious when performing debridement, avoiding aggressive trimming to prevent skin injury and possible infection.
  • Elderly or Immobile Patients: Elderly or less mobile patients may have difficulty reaching or caring for their feet, so the nurse will provide instructions on how to manage calluses and corns at home. In some cases, the nurse may offer regular foot care services to ensure the feet remain healthy.

10. Referral to a Podiatrist

• • If the corn or callus is recurrent, unusually painful, or doesn’t improve with conservative care, the nurse may refer the patient to a podiatrist. Podiatrists can offer more specialized treatments, such as surgical intervention for severe deformities or conditions that require more advanced care.

By addressing the immediate concerns of calluses and corns while also providing education and preventive strategies, a foot care nurse helps to maintain foot health, alleviate discomfort, and prevent complications that could arise from untreated calluses or corns. Regular monitoring and ongoing care are essential, especially for individuals with underlying health conditions.