A very common problem seen in our office are corns between toes. Soft corns, also known as helloma molle,form after irritation between 2 toes.The corn is usually whitish but can appear yellow and has a spongy texture. Soft corns are moist because they absorb excessive skin sweat trapped between the toes. Pain is usually the major symptom, but if neglected the skin and underlying bone may eventually become infected. Due to women’s shoe styles of high heels and narrow pointy shoes this problem is seen more often in women but men can be effected as well.
After proper diagnosis, a treatment plan is established to control the pain, reduce the corn in size and in many cases permanent surgical removable is available. The lesion is most often found between the 4th and 5th toes but can be found between any toes. Usually the bone in 2 adjacent toes rub against one another and the area of skin on the toe that is between those bones develops a corn in response to the pressure. With continued pressure it grows in size and increases in pain making wearing closed shoes very difficult.Often the patient develops”kissing corns” where the adjacent toes develop corns overlying the bony prominences and touch when in shoes.
Treatment can be palliative or surgical. When treating it conservatively, the corns are shaved down and a small soft dispersion pad is placed around the corns to prevent them from rubbing against each other. This can be done every few weeks or months depending on how quickly the pain comes back. If a permanent solution is sought, surgical correction can be achieved in the office, surgical center or a hospital on an outpatient basis. The toes involved are anesthetized with a local anesthesia and the bones involved are shaved down so that the two adjacent bones won’t rub against each other when in a closed shoe. A few stitches are used to close the incisions and a small bandage is applied. The patient usually returns back to shoes in a few weeks with very little interruption of normal activities.