Hyperkeratosis also known as callus is caused by an accumulation of dead skin cells that harden and thicken over an area of the skin. This callus formation is the body’s defence mechanism against excessive pressure, friction and/or shearing. Calluses are commonly found on the ball of the foot, the heel and the inside of the big toe although any area of the skin that is submitted to these mechanical forces may be affected. Some calluses have a deep-seated core. This particular type of callus can be especially painful to pressure or while bearing weight. This condition is often known as Intractable Plantar Keratosis (IPK).


Calluses develop because of excessive pressure at a specific area of the foot. Some common causes of callus formation are high-heeled dress shoes, ill-fitted shoes, obesity, gait cycle abnormalities (walking motion), flat feet, high arched feet, bony prominences, and loss of the fat pad normally present under the foot. In addition, although less frequently, some systemic and hereditary diseases may also cause hyperkeratosis of the skin, especially on the plantar surface of the feet and palmar surface of the hands.

Treatment and Prevention

This skin condition may cause a burning sensation, acute pain upon walking or may fissure and cause additional pain (around the heels, for example). Many people try to alleviate the pain caused by calluses by cutting or trimming them with a razor blade or knife. This is not the way to properly treat calluses. It is very dangerous and can worsen the condition resulting in unnecessary injuries. Diabetics should never try this type of treatment because of their increased risk for infection or in some cases, their loss of sensation of the area. Podiatrists on the other hand, have the training for safely removing calluses by a technique called debridement. They are also qualified for removing deep-seated cores.

Changing footwear for better fitting shoes is a good way to start and sometimes women should also steer away from wearing high-heeled shoes. It is also recommended to use a good moisturizing cream or pumice stone.  In some cases, an effective foot orthotic transfers pressure away from the “hot spots” or high-pressured areas to allow the callus to heal and to prevent or slowdown its return. The orthotic should be made with materials that absorb shock and shear (friction) forces.