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Are there any patches of hard skin on your feet? If so, you could well be experiencing hyperkeratosis. It’s a common problem and means that your skin’s outer layer has become thicker than normal in some areas.

The excessive thickening is due to an overgrowth of keratin. This tough, fibrous protein is hugely important, as it helps to protect your skin and prevent pathogens from entering your body. However, excessive amounts of keratin can be problematic for your feet.

Keratin overgrowth frequently affects the bottom of the foot. This is known as plantar hyperkeratosis (‘plantar’ refers to the sole). The skin on your soles needs to be thicker than elsewhere in order for it to act as a robust, protective barrier every time your feet strike the ground. But if excessively thick skin appears, you can easily run into problems, as the sensitivity of your feet will be impaired. It’ll be more difficult for them to detect changes in temperature and terrain. It could take you longer than usual to become aware of a foot injury or infection. If the hard skin is uncomfortable to walk on, you’ll struggle to be active and may develop a limp.

Typically Caused by Excessive Pressure

Plantar hyperkeratosis typically occurs when areas of the sole are put under too much pressure (for example, if ill-fitting shoes rub and pinch your feet). Excessive pressure triggers excessive keratin production, which results in the excessive thickening of the skin. That’s why thick, hard skin often forms on the sole’s pressure points, such as the ball and heel.

‘Hyperkeratosis can be understood as a natural defence mechanism of the skin, which increases in thickness to compensate for pressure, friction or other irritants,’ ScienceDirect explains. In a nutshell, it’s your skin’s attempt to protect itself and avoid damage – but the excessively thick areas can lead to foot problems.

Hyperkeratosis Leads to Calluses and Corns

If you experience mild plantar hyperkeratosis, you’re likely to develop a small number of calluses or corns; they often appear on the pressure points.

  • Calluses are patches of thickened skin without a well-defined border. They’re commonly yellowish.
  • Corns are small lumps of hard skin. At the centre, there’s often a tough keratin plug. When they appear on the soles, they’re called seed corns.

Calluses and corns on the bottom of the feet are examples of plantar hyperkeratotic lesions. Such lesions are a widespread problem, especially among mature adults, whose skin is less supple and well cushioned due to the ageing process. ScienceDirect estimates that ‘30–65% of people aged over 65 years’ are affected by them.

Women of all ages are likely to develop calluses and corns on their soles if they wear high heels or other feminine shoes that put feet under too much strain.

Thickened skin is often painful to walk on; indeed, seed corns can be agonising.

Severe Hyperkeratosis is Debilitating

While a callus or corn can make life difficult, severe plantar hyperkeratosis is debilitating. The bottoms of the feet often resemble a patchwork of seed corns and large, dense calluses. Deep cracks can appear, making the skin more susceptible to infection.

When the soles are overwhelmed by abnormally thick, scaly skin, the culprit will almost certainly be a health complaint. For that reason, it’s vital that cases of severe plantar hyperkeratosis are investigated by foot and skin experts. There are many potential causes, such as fungal infections, chronic eczema, psoriasis and reactive arthritis. A biopsy may help health professionals to reach a firm diagnosis.

The way a case of severe plantar hyperkeratosis is treated will depend on what exactly is causing the problem. Corticosteroid creams (which are effective on scaly, irritated skin), urea creams (capable of breaking down an accumulation of keratin) and debridement (using a scalpel to remove thickened skin) are among the most common treatment options.

Relief from Hyperkeratosis at London Foot Clinics

Whether you have a single corn or feet covered in calluses, our skilled London chiropodists can help you.

Gently removing corns and calluses, as well as applying protective padding, is a key part of our chiropody service. What’s more, we can check for foot function problems that may contribute to hard skin formation and provide bespoke orthotics designed to reduce pressure on sensitive areas. We also have the expertise to investigate and treat severe hyperkeratosis issues.

We see patients at five modern London chiropody clinics, such as our foot clinic in The City EC2.

For relief from hard skin problems, book your appointment with Feet By Pody today!