What is a Corn?

• Hard corn (heloma durum) - firm, dome-shaped papule with a translucent central core; found on the dorsal (top) and lateral aspects of toes
• Soft corn (heloma molle) - painful, macerated keratosis found in the interdigital (between-toe) web spaces

Treatment

1. At-Home Softening and Filing

• Soak the affected area in warm water for 10-15 minutes to soften the skin
• After soaking, gently rub the corn with a pumice stone or emery board to file down the thickened skin
• Do this regularly but avoid over-filing, which can break skin and cause infection

2. Topical Keratolytic Agents

• Salicylic acid (OTC pads, gels, or plasters - typically 17-40%) - the most commonly used agent; it chemically breaks down the thickened keratin
• Urea cream (20-40%) - softens and loosens the hyperkeratotic tissue
• Apply these only to the corn itself, not the surrounding healthy skin; protect surrounding skin with petroleum jelly

3. Cushioning and Padding

• Use silicone pads, sheepskin, or foam cushions to reduce friction and pressure on the corn
• Donut-shaped corn pads (with a hole in the center) take pressure off the lesion directly
• These provide comfort and prevent the corn from worsening

4. Footwear Modification

• Wear properly fitting shoes - ill-fitting footwear is the #1 cause of corns
• Choose shoes with a wide toe box, soft lining, and adequate cushioning
• Avoid high heels and narrow, pointed shoes that compress the toes

5. Orthotics

• Custom or OTC orthotics can redistribute pressure away from bony prominences and corn sites
• Particularly helpful for recurrent corns related to structural foot issues

6. Professional (Podiatric) Treatment

• A podiatrist or physician can pare (debride) the callus and surgically remove the corn's central core - this provides the most prompt relief
• Curettage or cryotherapy may be used by some clinicians
• If these measures all fail, an X-ray should be taken to look for exostoses (bony spurs), and referral to orthopedic surgery may be warranted

Distinguishing Corn from Wart (Important!)

When to See a Doctor

• You have diabetes, peripheral neuropathy, or poor circulation - never self-treat in these cases; risk of serious infection is high
• The corn is infected (red, warm, draining, or very painful)
• Home treatment has failed after several weeks
• You suspect an underlying bony deformity