Understanding Diabetic Calluses on the Feet
If you have diabetes, you may be all too familiar with calluses on your feet. Calluses are thick, hardened layers of skin that develop as a protective response to repeated friction, pressure, or other irritation. For those with diabetes, calluses on the feet can pose special problems and require attentive self-care.
What Causes Diabetic Foot Calluses?
Calluses often develop on the feet as a result of areas of the skin being subjected to excessive pressure or friction. For example, calluses frequently form on the balls of the feet, heels, and bases of the toes.
In the case of diabetes, several factors can make the development of foot calluses more likely:
- Peripheral neuropathy - Nerve damage in the feet from diabetes reduces sensation. Areas of high pressure/friction go unnoticed.
- Foot deformities - Bunions, hammertoes, high arches can lead to uneven weight distribution and callus-prone hotspots on the feet.
- Poor circulation - Impedes healing of skin irritation.
- High blood glucose - May accelerate thickening of skin.
Common Sites for Diabetic Foot Calluses
Some parts of the feet are especially vulnerable to callus formation. Be on high alert for calluses developing in the following areas if you have diabetes:
- Balls of the feet
- Heels
- Bases of the toes
- Edges of the feet
- Bunions
- Hammertoes
- Big toe joint
Risks of Diabetic Foot Calluses
For people with diabetes, calluses on the feet should never be ignored or self-treated without medical supervision. Thats because if left unchecked, seemingly minor skin lesions can progress to much more serious lower extremity complications.
Infection
One major risk posed by diabetic foot calluses is infection. With diabetes there may already be some level of compromised circulation in the lower limbs. Pair that reduced blood flow with the presence of thickened, cracked callused tissue on the feet and you have an ideal breeding ground for dangerous bacterial or fungal infections to take hold.
Warning signs of an infected callus include:
- Swelling
- Redness
- Pain/tenderness
- Pus/discharge
- Unpleasant odor
- Fevers/chills
Diabetic patients with any of the above symptoms related to a callus need urgent medical care to treat the infection before it spreads deeper into the limb tissue, bones or bloodstream where consequences can turn catastrophic, even resulting in amputation.
Ulceration
Repeated pressure and friction from callused skin can also gradually wear down surrounding tissue over time. The result is a diabetic foot ulcer - an open sore. Diabetic ulcers are notoriously slow to heal due to depleted blood supply and high blood sugar levels.
These loophole-like lesions invite bacteria to enter and make infections more likely. Over half of diabetic foot ulcers become infected, causing complications which can degrade overall health or set the stage for limb loss.
Other Problems
Besides increased infections and ulcer risk, other issues potentially stemming from diabetic foot calluses include:
- Difficulty walking due to callus pain/discomfort
- Abnormal gait changes that create foot strain elsewhere
- Callus debridement that nicks or cuts non-callused tissue if done incorrectly at home
Treating Diabetic Foot Calluses
See Your Podiatrist
With so many threats on the line, managing calluses is not a DIY project if you have diabetes. Instead, routinely visit a podiatrist - a foot specialist for proper, professional diabetic foot care.
At office visits the podiatrist will:
- Inspect - Check feet all over for any cuts, lesions, infections, structural issues, loss of sensation, circulation problems, calluses/corns and more using visual, physical and advanced diagnostic examinations as needed.
- Debride - Carefully pare down thick calluses via scalpel, sanding disc, biopsy punch or liquid callus solvents designed to gently shed excess layers of skin. Any signs of redness/bleeding during debridement means its time to stop and let the area rest/heal before further reduction.
- Offload - Have you avoid direct pressure on calloused areas whenever possible by recommending custom orthotic shoe inserts, pads, specialized diabetic footwear, canes, walkers or wheelchair use if issues with mobility arise.
- Protect - Prevent reoccurrence and shield sensitve spots of concern using felt pads on callus-prone zones, toe spacers, metatarsal pads and gentle moisturizers daily if skin is dry and cracked.
Continue Care at Home
Though guided expert care is key for diabetic callus treatment, diligent at home foot maintenance between office visits is also important. Some self-care tips include:
- Wash & dry feet daily, but avoid soaking for more than 5 minutes.
- Use lotion on dry areas - but not between the toes.
- File down thicker callus areas with a pumice stone or foot file only if skin in intact.
- Wear clean, dry, well-fitted socks and shoes.
- Never apply hot pads/heating lamps to high risk feet.
- Get your blood sugar under control via diet, activity, medication.
Also be sure to return to the podiatrist right away if you notice any discoloration, wounds, pain, foul odors or other troubling signs related to calluses or other foot problems so preventative or corrective steps can be taken promptly.
Preventing Diabetic Foot Calluses
They say an ounce of prevention is worth a pound of cure. This is especially true when it comes to minimizing diabetic foot complications like calluses. Some key callus prevention pointers include:
Daily Foot Checks
Get in the habit inspecting your feet thoroughly each day - tops, sides, heels, between the toes and dont forget to look under the feet too with a mirror. Watch for any cuts, scrapes, cracks, red marks, blisters, corns and calluses possibly brewing. Early detection allows early intervention which translates to better outcomes.
Proper Footwear
Many foot woes can be avoided simply with well-fitted, protective shoes that cushion and accommodate the unique features of your feet without rubbing or pinching. Characteristics to look for include:
- Roomy toe box
- Lightweight
- Leather/mesh upper
- Removable insert to accommodate orthotics
- Rocker sole design to facilitate rolling heel-to-toe stride
- Minimal seams
- Extra depth to accommodate hammertoes, bunions etc.
Go Barefoot in Moderation
Some exposure of feet to air is healthy. But too much barefoot time on hard floors that exert pressure can encourage calluses. Wear shoes, slippers or socks most of the day and limit plodding around shoeless to softer carpeted areas only.
Foot Skin and Nail Care
Regular moisturizing plus gentle exfoliation maintains foot skin suppleness to prevent excess hardening into troublesome calluses. Care for thick, difficult to
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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