So you observed at the side of your little toe what appears to be a second toenail? Looks weird, doesn’t it? And you’ve tried to pick it off, and then, it reappeared?
Corns occur when there is an excess amount of pressure or friction, usually from shoes, on an area of the foot or toes. The foot will try to compensate for this friction by creating an extra layer of skin to protect itself. That works out fine for a while, then more and more skin becomes a bump on your foot. Now we have a different type of problem.
Though not a serious foot ailment, corns can be both unsightly, and painful at times. When you’re putting on your favourite shoes, your corn will make you do a little hop and skip. Corns can become infected from rubbing from shoes.
If you have a hard, thick, bump on the outside or inside of your toe, or what looks like an oddly shaped toenail, it’s likely a Lister’s corn. It is often described by the patient as having a ‘second toe nail’ on the toe. This ‘second toe nail’ is actually hard callus that resembles a nail. Pain is described with direct pressure to the corn, by shoes.
Symptoms include focal pain adjacent to the 5th toe nail, and or a split nail, or secondary toe nail. It is unique because they can form because of the usual shoe pressure, or even without it. Where do they come from if not from shoes? Do they spontaneously appear? No, they don’t actually come from pressure on the toe, but from the toe itself. Many people have little toes that roll outward, so the corn forms since the toe is constantly rubbing against the ground. However they form, they’re not nice.
What should I do about them?
Choose shoes with a roomy toe box, that allows your toe to lie flat, and where the material of the shoe won’t rub against the corn. Cover the corn with toe sleeves, which is something that we provide. If the corn developed because you have a problem with your toe rolling outward, a podiatrist may suggest custom-fit orthotics to help take pressure off the toe.
How do I avoid them?
If your problem comes from a toe that rolls outward or inward naturally, then you might not be able to avoid them. If that’s not the problem, then it’s up to you. Remember what we said about shoes with roomy toe boxes, where your toes can easily lie flat? That’s how you can avoid them. Therefore, essentially, the basic position is don’t wear silly shoes; be sensible!
Lister corns can be prevented by wearing a shoe or sneaker with a wider, more rounded toe box, in order to reduce the pressure being applied to the lesion. Periodic trimming of the callus is helpful to relieve pain, and callus cream is helpful to soften the corn prior to trimming. Padding of a Lister corn can be accomplished in a number of different ways: these include the use of foam and gel sleeves, or cut out pads.
For stubbornly recurrent Lister corns, that do not respond to conservative treatment, they can be treated surgically. Depending on their location, a surgeon can perform a terminal Symes procedure, by either removing the distal phalanx, a small portion of the last bone in the toe. Or, a surgeon can relieve pressure by doing a condylectomy, by simply filing the bone spur often found underlying such a lesion. This relieves pressure from the bone that’s sometimes rubbing on the ground. The incision for such a procedure is very small, and is typically tolerated very well. The procedure can be completed in a matter of minutes, and requires only mild sedation and the use of a local anaesthetic. Following such a procedure, most patients are able to return to normal activity and regular shoes within 1-2 weeks.
Your feet mirror your general health . . . cherish them!