Calluses can form on any area of the body but are particularly common on the hands, feet and elbows. Whilst many people experience calluses on the ball of the foot, a heel callus affects the heel area, where the back of the foot joins the ankle.
Used as a defense mechanism, the body forms a heel callus when the area is exposed to excessive pressure or friction. Rather than allowing the skin and underlying tissues to be damaged, the skin becomes hard and is thicker than normal.
Patients usually notice a heel callus because the skin has become hard or rough. Prior to this, they may have experienced some pain due to friction in the affected area. Whilst patients may sometimes experience pain when they have a heel callus, a significant number of people find that a callus acts to protect their foot from repeated pressure and actually reduces the pain they were suffering from before the heel callus formed.
A heel callus can vary in size and may cover the entire area, in some cases. Unlike corns, calluses are not clearly defined, so a heel callus may have ragged edges or cover an uneven area. In addition to this, a heel callus tends to reduce skin sensitivity. Although most patients don’t notice this on a day-to-day basis, reduced sensitivity can be problematic.
If patients have reduced skin sensitivity, they may not respond to pain or excessive temperatures as quickly as they normally would. Due to this, patients are at risk of sustaining further injuries, as they may not be aware they are being hurt when the injury is occurring.
A callus is usually formed when a specific area of the skin rubs against something. This normally occurs over time and with repeated friction. In the case of a heel callus, the skin may rub on the bones under the skin or on something external, such as a shoe. Common causes of a heel callus include:
If individuals have broken a bone in the foot, it may have healed in such a way that causes the skin to rub against the newly set bone. Similarly, bone growths or spurs can cause the skin to rub against bone tissue and this may cause a heel callus to form.
Similarly, patients who have a reduced amount of fatty tissue may be more prone to heel calluses. Usually, fatty tissue sits between the bones and the skin, preventing the skin from rubbing on the bone. If the individual has a low amount of fat, the skin is more likely to rub against the bone and a heel callus may be formed. This is particularly problematic for older patients, who generally have less fatty tissue than younger people.
Wearing inappropriate footwear is a leading cause of calluses. If shoes are too tight, the continued rubbing on the skin can easily cause a heel callus. Conversely, shoes which are too big can cause the feet to slide around when you’re walking and this increases friction on the skin, which may result in a heel callus. When choosing shoes, it’s important that individuals are properly measured and that they have access to appropriate footwear.
Although shoes should always be the correct size, individuals should be aware that some types of shoes may not suit the shape of their feet. If a particular type of shoe is causing calluses, despite being the correct size, the individual may need to avoid wearing this type of shoe in the future.
Whilst footwear can be responsible for heel calluses, walking barefoot can also cause these types of calluses to form. Although individuals may not experience friction between their skin and a shoe when they’re walking barefoot, the skin is exposed to a range of materials, such as stone, concrete, grass and sand. Due to this, the skin on the feet will rub against these hardwearing materials and a heel callus is highly likely to form.
Individuals who exercise on a frequent basis should also be wary of developing a heel callus. Regular running increases the amount of friction on the feet, for example, and could lead to heel calluses. Although there are many benefits associated with regular exercise, individuals should make sure they have the appropriate footwear and environment in which to work out.
Fortunately, there are various options available for treating a heel callus. When patients are keen to remove or reduce a heel callus, they may opt for the following forms of treatment:
By moisturizing the affected area regularly, patients can soften the callus. Although this can take some time, regular moisturizing can help the callus to reduce in size and may diminish it completely.
Similarly, exfoliating a heel callus can help to remove thick skin. A pumice stone or exfoliating brush can generally be used to successfully treat a heel callus. If patients opt to exfoliate and moisturize the area, this can speed up the treatment process and minimize the callus more quickly.
Although these treatments can be performed at home, individuals should not attempt to treat a heel callus until it has been diagnosed by a physician or podiatrist. If self-care treatments have not reduced the callus, it may be removed by a professional. Whilst this is effective in removing the damaged skin, the surgical removal of a heel callus is rarely required.
Wearing appropriate footwear and undertaking regular self-care routine can help to prevent calluses from forming or returning. If individuals are particularly prone to heel calluses, using a heel insert can help to add cushioning to the area and prevent the skin from rubbing on footwear.
If individuals regularly wear different types of shoes, exfoliate hard areas of the skin and moisturize their feet, there is a good chance they will be able to prevent a heel callus from forming.