ONE of the most painful types of corn — known as the soft corn — is located on the foot between the fourth and fifth toes. It is also called an interdigital corn or heloma molle.

Interdigital corns occur due to excessive friction between the toe bones (phalanges) of the fourth and fifth toes. If the heads of the phalanges are slightly wider than normal, they rub against each other and a soft corn develops.

These corns may also develop due to a short fifth metatarsal bone. The situation is often made worse by ill-fitting or tight footwear, however, I have treated patients who are constantly barefoot and they still develop soft corns.

People who are obese, people with swollen feet and those who wear tight hosiery are also more likely to develop these corns. Patients may confuse soft corns with fungal infections due to the location and appearance, so a proper diagnosis needs to be made by a podiatrist.

The skin will often be white and fissured due to the moisture content of the skin. In severe, neglected cases, the area can become infected and antibiotics may be prescribed. Soft corns are found equally in both sexes and are more common in people of African descent.

TREATMENT

As with all corns, your podiatrist will debride the area (remove the hard skin) using a scalpel. Depending on the severity, chemicals may be applied to the corn to slow down its growth rate.

To prevent the toes from rubbing together, silicon or foam spacers can be worn with shoes. It is imperative that the footwear is wide enough to accommodate the toes properly or the corn will grow back very quickly.

When all of the previous treatments fail to give adequate relief, surgery may be indicated. Here, the bony prominence that is causing the problem may be filed down. In some rare cases, surgeons may choose a syndactyly approach and stitch the two toes together.

The key thing to remember with soft corns is to have them treated by a podiatrist regularly and wear the correct shoes. They can be just one of life’s small annoyances or, in a worse case scenario, they can cause a toe amputation from a penetrating infection.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.