Calluses

WHEN TO SEE YOUR DOCTOR

* Your callus is painful.

* You have diabetes or circulatory problems and need to have your callus pared down.

* A callused area is red and hot.

* Your callus splits open or cracks and bleeds.

* Your callus has a bluish color.

What Your Symptom Is Telling You

A callus is your skin's self-generated shield, a way to defend itself from too much pressure. And that shield does a good job, says Ellen Cohen-Sobel, D.P.M., Ph.D., associate professor of podiatric orthopedics at the New York College of Podiatric Medicine in New York City. Think of how the fingertips of a professional guitar player or the palms of an Olympic gymnast would feel if they weren't guarded by thick calluses. They'd hurt. In fact, they'd probably bleed.

Similarly, a few thin, well-placed calluses on your feet can offer a little bit of protection when you're walking barefoot on the beach. But those calluses aren't only caused by pressure on your feet. You have your parents to blame.

"The underlying cause of callused feet is hereditary," says Mark D. Sussman, D.P.M., a podiatrist in private practice in Wheaton, Maryland, and coauthor of The Family Foot-Care Book. Parents pass on instabilities in the feet, he explains. "If you inherit poor foot mechanics, your foot moves around instead of being stable when it hits the ground." That constant friction causes calluses.

Calluses like those on the feet that cover a wide area are sometimes irritating but rarely painful, says Dr. Cohen-Sobel. The major exception tends to be a smaller, deeper callus with precisely defined edges (a plantar keratosis), which is usually painful. It often has a deep, white area in its center with a clear area around it that looks almost like a moat, says Dr. Cohen-Sobel.

Symptom Relief

If you've been living with your calluses for many years and they don't bother you, don't do anything to them," says Dr. Cohen-Sobel. Thin calluses spread over the bottoms of the feet are not a health problem, says Howard Dananberg, D.P.M., a podiatrist and medical director of The Walking Clinic in Bedford, New Hampshire. "When calluses become focused at one site, that's a different story, especially if they become painful," Dr. Dananberg says. The body tries to protect the site by making yet more hard, protective skin. To break this cycle, the callus has to go. Here's what to do.

Sand it. You can keep calluses under control at home by carefully sanding them down, says Dr. Sussman. First, wash your feet. Then soak them for 20 minutes in a basin of clean, warm water with two tablespoons mild dishwashing liquid added. Then rub the callus with cooking oil until it feels moist and soft, usually about one minute. Finally, sand the callus with a pumice stone, fine sandpaper, sandstone or a callus file. "Stop sanding before the area becomes tender—one to two minutes," says Dr. Cohen-Sobel.

Protect it. To take pressure off callus-prone areas, cut a slightly-larger-than-callus-size hole in a piece of adhesive moleskin, which is available at pharmacies. Position the doughnut-shaped pad around the filed callus and fill the hole with petroleum jelly, says Dr. Sussman. Then cover the area with gauze. Just make sure your podiatrist knows you're using this method and approves.

Avoid acids. "Over-the-counter callus removers contain acids that can burn your skin," says Dr. Dananberg. Dr. Sussman agrees, warning that they can also cause infections.

If the shoe fits, wear it. Poorly fitting shoes don't cause calluses, but they can aggravate them, says Dr. Sussman. "Feet get larger as you get older, especially in women who've had children," he explains. "So don't just squeeze into the size you wore last year. And if the shoes hurt after wearing them at home for a few hours, return them."

Put your feet in a doctor's hands. The only person who should remove or trim your calluses with a sharp instrument is a podiatrist—not you and not a beautician—says Dr. Cohen-Sobel. Never take a razor or scissors to a callus, she warns. "You can easily cause an infection or worse."

A severe callus—such as a plantar keratosis—might need monthly or bimonthly medical attention. In many cases, the doctor may arrange to see you less often by fitting you with an in-shoe device that redistributes your weight, says Dr. Sussman. As a last resort, severe calluses can be corrected surgically. Be sure to get a second opinion before having this done, he adds.