Callus

Callus or calluses (plural) are thickened areas of skin that become hard over a period of time due to pressure and friction. Calluses occur when the outermost layer of the skin are subject to excess pressure and friction either due to stress or rubbing. Calluses generally occur on the feet, on the fingers, and on the hands. They are painless. They occur due to occupational stresses, ill-fitting shoes, and many other causes. Calluses occur when the skin accumulates keratinocytes. The cells present in the calluses are dead cells. People who have fragile skin tend to have calluses on their feet. Also, people with diabetes who have poor blood circulation have calluses on their feet. People with diabetes have complex mechanisms like compromised immunity, peripheral neuropathy, damage to blood vessels and capillaries, and reduced blood circulation. Poor circulation leads to starvation of the skin, which in turn leads to the thickening of the skin. This leads to the increased risk of calluses and hammer toe. Due to compromised immunity and reduced sensation as a result of damaged nerves, there is a risk of diabetic foot ulcers. Moreover, when the callus gets thickened, the pressure of the callus leads to the tearing of the adjoining capillaries leading to bleeding. High blood sugar levels, and uncontrolled diabetes further increase the risk. The hyperkeratotic tissue can lead to improper walking, diabetic foot, and diabetic foot ulcer and can even lead to foot amputation. Glycemic control, foot hygiene, usage of orthotics, and reduced friction reduces the risk significantly.