Foot care is a critical part of managing diabetes, yet it's often overlooked until problems arise. One of the most common foot issues among people with diabetes is the development of calluses—thickened areas of skin that form due to repeated pressure or friction.
While calluses are generally harmless in the general population, in people with diabetes, they can be the early signs of more serious complications, including ulcers, infections, and even amputations.
In this in-depth guide, we'll explore the relationship between calluses and diabetes, explain why diabetics are more vulnerable to foot complications, and offer practical advice on prevention and treatment to maintain healthy feet.
What Are Calluses?
Calluses are areas of thickened, hardened skin that develop in response to repeated pressure or friction. They most commonly form on the soles of the feet—particularly the heels, balls of the feet, and under the big toes. Calluses can vary in size, shape, and thickness and are often yellowish or grayish in color.
Why Are Diabetics More Susceptible To Calluses?
People with diabetes are more likely to develop calluses due to a combination of factors:
1. Peripheral Neuropathy
Nerve damage (neuropathy) in the feet leads to reduced sensation, so individuals may not notice when their shoes are causing pressure or rubbing. This unnoticed friction contributes to callus formation.
2. Foot Deformities
Conditions like bunions, hammertoes, and Charcot foot are more common in diabetics. These deformities create abnormal pressure points, increasing the risk of calluses.
3. Poor Circulation (Peripheral Arterial Disease)
Reduced blood flow to the lower extremities affects the skin's ability to heal and stay healthy. When combined with calluses, the risk of breakdown or infection increases.
4. Dry Skin
Diabetics often suffer from dry skin due to autonomic nerve dysfunction, which affects sweat glands. Dry skin makes the feet more prone to cracking and callus development.
Dangers Of Calluses for Diabetics
While calluses may seem like minor inconveniences, they can pose serious health risks to people with diabetes:
1. Ulceration
Thick calluses can press into the skin and cause bleeding under the skin surface, leading to the formation of foot ulcers. These open wounds are prone to infection and are a leading cause of hospital admissions among diabetics.
2. Infection
When calluses crack or turn into ulcers, bacteria can enter and cause infection. In severe cases, infections can spread to bones and require surgical intervention.
3. Amputation
If infections become uncontrollable or damage tissues extensively, amputation of the affected part of the foot or leg may become necessary to save a person’s life.
Identifying Calluses: What To Look For
People with diabetes should examine their feet daily and look for the following signs:
- Hard, thickened patches of skin
- Yellowish or grayish discoloration
- Areas of pressure, especially over bony prominences
- Cracked or splitting skin
- Pain or tenderness in certain foot areas (if feeling is intact)
- Changes in foot shape or posture
If you notice any of these signs, it’s essential to address them promptly.
Prevention Strategies for Calluses In Diabetic Patients
1. Daily Foot Inspection
Use a mirror or ask a caregiver to help you check your feet every day. Look for changes in color, shape, texture, or the presence of calluses or blisters.
2. Moisturize Daily
Apply a non-greasy, fragrance-free lotion to keep skin soft. Avoid putting lotion between the toes to prevent fungal growth.
3. Wear Proper Footwear
Choose diabetic shoes with a wide toe box, cushioned soles, and breathable materials. Orthotic inserts can help redistribute pressure.
4. Avoid Walking Barefoot
Even indoors, avoid walking barefoot to prevent injury from small objects or pressure buildup.
5. Regular Podiatrist Visits
See a podiatrist every 6–12 weeks for routine foot care. They can safely remove calluses and monitor for early signs of complications.
6. Manage Blood Sugar Levels
Proper blood glucose control helps improve circulation and nerve function, reducing the likelihood of callus formation and complications.
Treatment Options for Calluses In Diabetics
1. Professional Debridement
A podiatrist can safely trim thickened skin using sterilized instruments. This reduces pressure and lowers ulcer risk.
2. Offloading Devices
Special shoes, pads, or orthotic inserts can relieve pressure on high-risk areas, allowing existing calluses or ulcers to heal.
3. Callus Creams (With Caution)
Urea-based creams or salicylic acid (under supervision) may help soften calluses. Never self-treat without a podiatrist’s guidance, as misuse can damage skin.
4. Custom Orthotics
Custom-made shoe inserts correct gait issues and distribute weight evenly across the foot.
5. Surgical Intervention
In cases where foot deformities cause chronic callus formation or ulcers, surgical correction may be recommended.
Signs You Should See A Doctor Immediately
- A wound that doesn't heal within 7–10 days
- Redness, warmth, or swelling
- Drainage or pus
- Fever or chills
- Blackened skin (indicating tissue death)
Prompt medical attention can prevent minor foot issues from escalating into life-threatening conditions.
Foot Care Routine for Diabetic Health
- Wash Feet Daily – Use lukewarm water and mild soap; dry gently, especially between the toes.
- Moisturize – Apply lotion or cream after washing, avoiding toe gaps.
- Check Feet – Use a mirror or caregiver help to inspect soles and heels.
- Trim Nails Carefully – Cut straight across and file gently.
- Schedule Regular Checkups – Keep up with podiatry appointments and report any changes.
Calluses may seem minor, but for people with diabetes, they can signal much more serious problems ahead. Understanding why they form, recognizing the warning signs, and taking proactive steps to manage them is essential to prevent ulcers, infections, and amputations.
By incorporating daily foot care and seeking regular professional support, diabetic patients can maintain mobility and avoid complications.
If you or someone you care for has diabetes, don’t underestimate the importance of foot health. Prioritize prevention and professional care—it can make all the difference.
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