Nails, corns and callus


A question many of our patients have is why do I get hard skin on my feet. Well to simplify this answer, it all comes down to the high localised areas of pressure going through your feet as a direct cause of either poor choice of footwear, foot shape or foot/ lower limb function.

Essentially any area of friction caused to a certain part of your feet (mainly bony areas) will result in your body producing hard skin or callous as a defensive mechanism to stop the deeper layers of your natural skin from breaking down.

Callus is thickened skin in a discreet area. It is caused by an increase in cell production (hyper proliferation ) leading to increased layers of stratum corneum (hyperkeratosis).


Corn is a localised area with a deep centre nucleus. It usually occurs when the subcutaneous tissue is highly disrupted, which results in the stratum corneum to become thickened and form a nucleus of the corn.

The sharp cone shaped nucleus can often feel like a sharp pin digging into the foot. It often forms on the sole of the feet or even resides under the toenail.

There are many different types of corns:

Heloma Durum- hard corn, tense lesion found on exposed site of direct pressure.

Heloma Milliare- seed corn, found on the sole of the foot. It is hard and very small and found in clusters and can be very painful.

Heloma Molle- Soft corn, found in between toes. It is usually ring shaped with maceration. Outer edge is has a rubbery sensation.

Heloma Neurovasculare- neurovascular corn embedded with small blood vessels or nerves. Appears as tiny dots usually red or yellow. Tends to be painful and usually bleeds when removed.

Treatment of corns are by a method of enucleation (removal of nucleus) using a scalpel blade. We then address the mechanics of the foot to redistribute the pressure away from the corn with padding or insoles.

We do not recommend the usage of medicated corn plasters as this can cause damage to healthy skin tissue surrounding the corn, ulceration and infections.

Treatment Options

Callus is treated by a technique called debridement using a scalpel blade. As callus is just hyper formation of dead skin, this procedure is pain free.

The likely hood of the same lesions re appearing is moderately high due to the mechanics of your feet. The next treatment option is pressure relieving orthotics. These are devices that fit into your shoes and help with alleviating pressure from the affected area.

Nail Cutting Service

Nail pathologies can be very difficult to treat at home. The most common nail pathologies we see are:

Onychauxic nail – Thickened nail plate caused by trauma, fungal infection, age or poor circulation. These factors cause a change to the nail matrix resulting in hypertrophy.

Onychogryphotic nail – Thickened nail plate with distorted direction of growth. Usually caused by trauma, neglect and genetics.

Onychomycotic nail- Fungal infection of the nail bed and plate. Caused by poor health, trauma, warm climate, immunosuppression and occlusive footwear.

Onychocryptotic nail- known as ingrowing toe nail. Nail becomes pierced into the epidermis of sulcus to the dermis. Common symptoms are pain, inflammation, exudate, malodour and hyper granulation tissue. The main causes of ingrowing toe nail are hyperhidrosis, poor nail cutting, trauma and involuted nails. Can be solved without nail surgery, but to prevent future reoccurrence nail surgery is the most promising.

Involuted nail – Curved nail. Caused by hyperhidrosis, trauma, local pressure, footwear or hereditary.

We also offer general foot care treatment for routine check up and nail cutting.


  • Onychauxic nails (Thickened Nails) – caused my micro-trauma over the years.
  • Onychogryphosis nails (Grossly thickened and deformed nails) – usually caused by macro trauma and microtrauma/genetics.
  • Onychomycosis nails (fungal nails) – caused by airborne fungus. Very stubborn and difficult to remedy. We have treatment options however that reap superior results than most. Call us for a free discussion regarding this.
  • Onychocryptosis nails (ingrowing toe nails) – can many times be solved without nail surgery, but nail surgery is the sure fire way to remedy this condition and to stop it from re-occuring.

To find out more about The Foot Clinic or to make a booking please call

020 8445 8528