Foot Problems:
Corns, Calluses, Plantar Warts, and Black Toes

Many athletes experience foot problems. Surprisingly, however, common problems are often related to skin and nail disorders. These conditions affect many people, not just athletes, and can cause serious pain and discomfort.

What are calluses and corns?
A callus, or callosity, is a thickened, hard build-up of skin that forms because of excessive rubbing or pressure on a bony prominence, such as the outside of the foot at the base of the little toe. It is usually caused by improper footwear and found in areas where the skin is soft. Calluses can also form as a result of structural abnormalities, such as hammer toe and mallet toe, in which the balance of weight bearing is shifted to thinner portions of the foot, creating a focal point of pressure.

A corn is also a thickened, hard build-up of skin that usually forms as a result of repeated friction or pressure from ill-fitting shoes. Corns are normally found on and between toes. They can become inflamed and even infected in crevices where the skin is moist.

But Doc, my toes are killing me!!!!
Not to worry! A donut pad made from protective foam can relieve pressure on the affected area. In some extreme cases where all other measures have failed, the thickened skin or the bony prominence may be removed surgically to relieve pain.

What is a plantar wart?
Plantar warts are hard, whitish, small growths caused by a viral infection and found on the plantar (bottom) surface of the foot. These are usually quite tender and extremely sensitive to pressure. Although they are often confused with calluses and corns, plantar warts have a visible central core and root with skin built up around it. For treatment, your physician will trim the thickened skin around the wart and use a salicylic acid, such as Compound WT, on the viral infection. The wart will eventually die and the skin will return to its normal state.

What is black toe?
Black toe, or black nail, is a condition frequently seen in athletes (especially runners) when a shoe is too short or too tight. As a result, the toe repeatedly hits the end of the shoe, causing pain and bleeding under the toenail. The nail becomes discolored, giving the appearance of a black toe. If enough pressure builds beneath the nail, it can become quite painful, requiring your physician to drill a hole into the nail to relieve the pressure.

What is the treatment of choice?
Prevention is the treatment of choice for most foot problems. Take care of your feet by wearing properly fitted and comfortable shoes that are made for your daily walking, running, and standing needs. Also, remember that washing your feet daily will help prevent viral infection.

Stephen C. Hunter, M.D.
Columbus, Georgia