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Plagued by interdigital corns?

By Foot Health with Leana

From time to time persons call, or come to the clinic in discomfort because of interdigital corns. These basically are corns in-between the toes, which occur when adjacent toes rub together. It is called an interdigital corn because it’s between two digits (two toes). However, it is also known as a helomamolle, which is a soft corn.
Dancers and women in particular are amongst the persons at risk for developing these corns, because of their footwear. While it’s nice to be fashionable, we have to be careful about the type of footwear choices we make, as there can be unintended long-term consequences which may not be so nice after all. With dancers, the most common location is between the 4th and 5th toes. The 5th toe usually curls and abuts against the 4th toe.

What causes interdigital corns?
These corns are more prevalent where the feet are squeezed into pointed tip or narrow shoes, or if the toes are overlapping. Since the skin in-between the toe is relatively thin and sensitive, corns that develop there have the potential to cause significant discomfort.
Interdigital skin is delicate, so it is not uncommon for corns to exhibit necrotic breakdown/ulceration in the layers below the corn. On occasions an infection may develop, contributing to an even greater level of discomfort.
As to why these are called ‘soft corns’, it is simply that the area between the toes is difficult to keep dry from both showering and the production of sweat. Just the same way that your thumbs will go white and wrinkly when you are in the bath too long, so will the corn. It will often appear to be a very white lump in the interdigital space, or may break down from too much pressure to then form an ulcer. This may weep clear fluid, blood or pus.

Treatment
At home
Attempts can be made to do home treatments initially, depending on the severity of the situation. The following may be tried:
• Remove pressure from the corn by using gel pads or other spacers that will assist in separating the toes.
• Clean the webspace well with soap and water.
• Dry the webspace with a tissue
• Apply Betadine (iodine) solution or alcohol, as an antiseptic, at least twice daily
• Soak your feet in epsom salt water with white vinegar twice daily
• Do not attempt to remove the skin as this will provide access to bacteria.
• If redness or swelling is seen, notify your podiatrist/physician as this may indicate a bacterial infection.

Removal of the corn
If you opt to have the corn removed by a doctor or podiatrist, following its removal, it is essential to make an effort to reduce the pressure over the affected area. In addition to avoiding inappropriate footwear, the daily wearing of an interdigital toe separator is the most effective way of achieving this.
If the corn is removed at regular intervals (every 4-8 weeks), and compliance is achieved with regard to avoiding tight footwear, particularly if you are diligent in wearing the interdigital separators, then there are few corns in-between the toes that cannot be cured within a few appointments.
When the corns are located towards the tips of adjacent toes, they are more likely to be rather dry and hard, and can be significantly painful. These types of corns often have a glass-like appearance and directly in the center of each, one can feel the small, yet very hard sharp bony prominence directly beneath. One can also often see a rather dark brown to a brownish yellow discolouration, which is usually evidence that the pressure between the two toes has actually caused some bleeding, within the deeper skin layer. There is very little fat pad to cushion the tissues between the toes, so when left untreated this type of corn can easily become ulcerated or lead to an underlying abscess or serious type of foot infection.

Prevention
• Reduce moisture between toes — Dry flaky skin between toes suggest a fungal infection (athlete’s foot). Dry the toes well after a shower with a tissue. Apply white vinegar to the webspace twice daily. Apply anti-fungal powder between the toes.
• Wear appropriate shoes — Longer toes require a longer vamp. Your toes will elongate as you grow and therefore your vamp will need to be longer. In addition, you may require a different-shaped box as your feet change in size and shape.
My appeal to the ladies, don’t be in denial; let good sense prevail for the Carnival with your footwear choices, especially if you will be playing mas. Have a great time ‘on the road’. Unfortunately, I’m in the cold…so for those in the beautiful sunshine, take in the great soca music for me…be safe and enjoy!
Your feet mirror your general health . . . cherish them!

Leana Huntley is an English trained foot health practitioner attached to ALMAWI Limited The Holistic Clinic. For further information e-mail info@almawiclinic.com or visit www.almawiclinic.com
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