MEDICAL FOOT CARE

Callus is the name given to regional skin thickenings. It is the presence of more dead skin in a skin area than it should be. This is actually the self-protection mechanism of the skin, which is exposed to a lot of pressure and trauma. Since it is constantly under pressure during the day, the skin thickens in that area to prevent the pressure from damaging the subcutaneous and bone tissues and to prevent unwanted wounds from opening in that area.

Congenital (pes planus, pes cavus, etc.) or acquired deformations in the feet or soles, posture and pressing disorders, orthopedic and neurological disorders, some skin diseases may cause calluses.

Calluses are usually found in the areas above the bone and in the foot region. The reason for this depends on the preference of high-heeled, narrow-toed shoes that are not suitable for the foot structure. It is due to the fact that shoes that are not suitable for the width of the foot and the foot number are not preferred in broad-footed structures.

Although we most often see calluses on the feet, calluses are seen on the knees and elbows of patients who have the habit of leaning their elbows and knees on the table, and on the back of the feet in patients sitting as cross-legged.

The stages of callus formation develop depending on the location and the intensity and duration of the pressure that the relevant area is exposed.

In the initial phase, a slight redness and pain are the first stimulations. At this stage, when the pressure is removed, the skin returns to normal in a short time, but as long as the pressure continues, an increase in the rate of dead skin and skin thickening begin to be seen in that area. Thickening skin tissue tends to increase gradually. This increase progresses both upward and inward from the skin surface over time. When it progresses from the skin surface to the inside, the callus begins to give pain and when this progress continues, the pain begins to give pain not only during the wearing of shoes, but also at rest and impair the quality of life of the person. If the pressure continues at this stage, it is observed that changes not only in the skin but also in the bone structure of the person begin. In the presence of severe pressure extending to the bone tissue, permanent damage is also observed in the structure of the bone and finger attachments. This situation is especially encountered in the toes. In patients with 2-3 toes longer than the big toe, if suitable shoes are not preferred and if the foot number is not preferred according to these fingers, the fingers are bent in the shoe and exposed to pressure on the joint. Prolonged exposure also results in flexion of the toes. In these patients, the expected result cannot be obtained only from the callus treatment. In this case, the fingers are supported with splints and the joint structure is tried to be corrected.

Is Callus and Wart the Same?

The best treatment for calluses is to make the differential diagnosis of diseases such as warts that can be confused with calluses. Warts are a skin infection caused by a virus called HPV and are contagious. Mostly, it can be as painful as calluses. However, since the treatment of both lesions is different, it is important to make a definitive differential diagnosis. Most of the time, we witness that both lesions are mixed with each other and wrong treatments are applied. If small bleeding foci are observed when your doctor scrapes the suspected lesion in the differential diagnosis, it is a wart. However, if there is no bleeding focus despite the scrubbing, and there is dead tissue that continues up to the deep layers of the skin, it is a callus.

How Should Callus be Treated?

Prioritized treatment of callus begins with the correct diagnosis. After making the differential diagnosis from skin lesions such as warts, the pressure exposure that causes calluses should be determined and the patient should be informed about the correct shoe selection. Broad-footed individuals should not choose narrow-toed shoes. Again, patients with 2-3 toes longer than the thumb should take the shoe size half a size larger than these toes.

Silicone or rubber pads, splints and insoles are recommended for callus areas to reduce pressure exposure. Since these preventive treatments are often ignored, we observe that the calluses of the patients recur after the callus treatments and they have to receive treatment frequently. I do not neglect to give information about foot care, shoe selection and preventive treatments to my patients whom I treat their calluses.

Our priority in callus treatments is curettage of the callous tissue. This process is done by your doctor with sharp instruments called scalpels or with the help of cutters that scrape the tissue without damaging the tissue in medical foot care devices. In our clinic, we offer the necessary protective measures after the callus treatment using medical foot care devices. After the callus scraping treatment, long-term care of the callous area with tissue regeneration creams is also important within the scope of protective measures. The reason is that while tissue regeneration continues in that area, keeping the skin moist and soft, which is accustomed to healing itself as thick tissue, positively affects the quality of the new-produced tissue. It prevents the production of thick and callous tissue again. In particular, after-bath care and moisturizing and restorative creams that are applied after soaking in warm water from time to time will reduce the risk of recurrence of complaints.

In callus treatments, callus band and acid pickling processes are risky. The acid in these bands, which contain intense acid, will be difficult to absorb from the hard and bony tissue, and because this acid will burn the surrounding normal skin, both calluses will remain as they are, and wounds and sometimes infections will develop in normal skin due to acid burns. Attention should be paid to these risky applications if they are not used carefully.

From time to time, we witness that surgical treatments are applied to calluses, which patients claim that they do not heal in callus treatments. There is no possibility of healing with or without surgery for any callus of which cause is not eliminated. These surgeries, which are performed regardless of the removal of the exposure, can cause difficulties for the patients in difficult-to-heal areas such as the soles of the feet, and they often recur. In fact, surgery may not be a good option for situations that we can eliminate with simple interventions.