Corn

Overview of Corn

It is thicker than a callosity and causes more concern to the patient. This occurs at the site of friction and often spontaneously disappears when the causing factor is removed.

Often corns are multiple and bilateral. Corn can be commonly hard in the sole or rarely soft corn do can occur between 4th and 5th toes due to friction of bases of adjacent proximal phalanges.[2]

Location: It is common in soles, tips of toes.

Causes of Corn

Generally, Corns are caused by friction and pressure from repeated actions. Some sources of this friction and pressure i.e.:

Wearing ill-fitting shoes and socks-

• Tight shoes and high heels can squeeze areas of the feet.
• If your shoes are loose, your foot may repeatedly slide and rub against the shoe.
• Your foot may also rub against a seam or stitch inside the shoe. Socks that don’t fit right can also be a problem.

Skipping socks-

• Wearing shoes and sandals without socks can cause friction on your feet.

Playing instruments or using hand tools-

• Corn on the hands may result from the repeated pressure of activities such as playing instruments and using hand tools or even a pen.

Inheriting a tendency to develop corns-

• The type of corn that forms on non-weight-bearing areas, such as the soles and palms (i.e. keratosis punctata), might be caused by genetics.

Risk factor of Corn

• Bunions
• Gait abnormalities
• Abnormalities in the anatomy of the toes
• Poor-fitting shoes
• Occupations such as garden workers also farmers.[5]

Pathophysiology of Corn 

• The repeated friction and pressure of the skin overlying the bony prominences leads to a hyperkeratotic thickness.
• Corn consists of severe keratoses with central degenerated dead cells and cholesterol.[3]
• This latter is a protective body reaction that produces an excess of horny epithelial layer to prevent skin ulceration.
• This explains the preferential location of corns next to the condyles of the metatarsals and phalanges as well as the occurrence of corns in patients with a foot deformity.[5]

Classification of Corn

Two Types of corn:

Firstly, Hard corn:

• It is localized area of thickening over a bony projections like heads of metatarsals.
• Histologically it differs from callosity by having severe keratoses with a central core of degenerated cells and cholesterol.
• It presses over the adjacent nerves causing pain. It can get infected causing severe pain and tenderness with inability to walk.

Secondly, Soft corn:

• Soft Corn It usually occurs between 4th and 5thtoes due to friction of bases of adjacent proximal phalanges.[3]

Sign & Symptoms of Corn

• A thick, rough area of skin
• A hardened, raised bump
• Tenderness or pain under the skin
• Flaky, dry or waxy skin [3]

Diagnosis of Corn

• Your health care provider will likely diagnose corns by examining your feet.
• This exam helps rule out other causes of thickened skin, such as warts and cysts.
• Your health care provider might confirm the diagnosis by paring away a bit of hardened skin if it bleeds or reveals black points (dried blood), it’s a wart, not a corn.[4]

Differential Diagnosis of Corn

• Plantar wart
• Poroma
• Warty dyskeratoma
• Calcinosis cutis
• Gout and pseudo gout
• Hypertrophic lichen planus
• Interdigital neuroma
• Lichen simplex Chronicus
• Palmoplantar keratoderma
• Keratosis punctata of palmar creases
• Porokeratosis plantaris discrete
• Porokeratosis palmoplantar et disseminate [5]

Treatment of Corn

It involves avoiding the repetitive actions that caused them to form. Wearing shoes that fit and using protective pads can help.

If a corn persists or becomes painful despite your self-care efforts, medical treatments can provide relief:

Trimming away excess skin:

• Your health care provider can pare down thickened skin or trim a large corn with a scalpel.
• This can be done during an office visit.
• Don’t try this yourself because it could lead to an infection.

Medicated patches:

• Your health care provider may also apply a patch containing 40% salicylic acid.
• Such patches are sold without a prescription.
• Your health care provider will let you know how often you need to replace this patch.
• Try thinning the thickened skin with a pumice stone, nail file or emery board before applying a new patch.
• If you need to treat a larger area, try non-prescription salicylic acid in gel (e.g. Compound W, Keralyt) or liquid (e.g. Compound W, Duo film) form.

Shoe inserts:

• If you have an underlying foot deformity, your health care provider may prescribe custom-made padded shoe inserts (in other words, orthotics) to prevent recurring corns or calluses.

Surgery:

• Your health care provider may suggest surgery to correct the alignment of a bone causing friction. In brief, This type of surgery can be done without an overnight hospital stay.[4]

Complication of Corn

• Ulceration
• Tenia pedis
• Septic arthritis
• Osteomyelitis [5]

Prevention of Corn

• Wear shoes that give your toes plenty of room- If you can’t wiggle your toes, your shoes are too tight. Have a shoe shop stretch your shoes at any point that rubs or pinches. Shop for shoes when your feet are most swollen, usually at the end of the day. If you use orthotics and inserts, be sure to have them on while fitting your shoes at the store.
• Use protective coverings- Wear felt pads, nonmedicated corn pads or bandages over areas that rub against your footwear. You can also try to separators or some lamb’s wool between your toes.
• Wear padded gloves when using hand tools- try padding your tool handles with cloth tape or covers.[4]

Homeopathic Treatment of Corn

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Corn:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy. potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Medicines:

Antim Crudum:

• Presence of large, horny corns on feet which may or may not be inflamed.
• Antimonium Crudum is also one of the best medicines for corns where the corns are very tender.
• Pain is felt in the corns while walking.
• This homeopathy medicine can help when the feet are covered with too many corns which make walking difficult.
• Also, it is the best medicine to treat corns that are too pointed and hard to touch.
• Further, it also helps those patients who are overweight which may cause pressure due to which these corns may erupt.

Silicea:

• Silicea is another of the top-grade medicines for corns.
• Excellent results in patients with soft corns with the use of Silicea, which is natural and therefore, safe.
• Soft corns mainly appear between the toes.
• Silicea is one of the most effective.
• The characteristic symptoms – corns between the toes may be sore and painful.
• Patients may also feel burning or tearing pain in these corns.
• Silicea also works wonders in cases of corns between toes that tend to suppurate (discharge pus).
• Excessive sweat with an offensive odours may be present on the foot where the corn is located.

Hepar Sulph:

• Hepar Sulph is one of the best choices of medicines for corns that tend to suppurate (have pus formation).
• I have seen many corn cases with pus formation heal magnificently well with the use of Hepar Sulph.
• The kind of corns for which Hepar Sulph would be the most suitable prescription are corns infected with pus formation and pricking pains.
• Burning, stinging pains may also be experienced in cases where Hepar Sulph would be one of the ideal medicines for corns.
• Such corns may also be highly sensitive to touch.

Sulphur:

• When there is a burning pain that the patient experiences in the soles and the corns, then this condition can be treated with the help of Sulphur which also ensures that the hard coating of corn quickly yields from the very first dose or application.
• This also helps those patients who find their feet sweating excessively due to the development of these corns.

Nitric Acid:

• Nitric Acid is best medicines for corns that are very painful.
• The guiding feature for prescribing Nitric Acid as the most suitable among medicines for corns is the presence of corns with either splinter-like or sticking pains.
• In cases where the most prominent symptoms are thick, indurated (in other words, hardened) corns on the feet with pressing, tearing, aching and drawing pains.

Lycopodium:

• When walking around with the corn causes a dull pain and persistent ache, then the patient can use this medicine.
• This medicine also helps in treating symptoms like pain in the heels when the patient steps on something hard.
• Lycopodium is also one of the best medicines for corns which are inflamed and result in sore, stinging, burning pains.[6]

Thuja:

• Thuja is specifically, deep acting medicine.
• Moreover, Thuja is indicated in very fleshy persons with dark complexion, black hair and unhealthy skin.
• Thuja personality have tendency for overgrowth of tissues also hyperkeratosis.
• Additionally, People with recurrent tendency of corns responds well to Thuja.
• Besides this, Aggravation from damp weather.
• Lastly, Perspiration is oily and sweet smelling or sometimes offensive.[6]

Diet & Regimen of Corn

• Soak your hands or feet
• Moisturize your skin
• Wear comfortable shoes and socks. [4]

Frequently Asked Questions

What is Corn?

Corn is a localized, smaller, deeper lesion with palpable tender nodule having a yellow white core of cornified dead skin in the center.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Corn?

• Antim Crudum
• Silicea
• Hepar Sulph
• Sulphur
• Nitric Acid
• Lycopodium
• Thuja

What causes Corn?

• Wearing ill-fitting shoes and socks
• Skipping socks
• Playing instruments or using hand tools
• Inheriting a tendency to develop corns

What are the symptoms of Corn?

• A thick, rough area of skin
• A hardened, raised bump
• Tenderness or pain under the skin
• Flaky, dry or waxy skin

Give the types of Corn?

• Hard corn
• Soft corn