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Clavus

A clavus (also known colloquially as a "corn") is a localized, hardened thickening of the upper layer of the skin (stratum corneum), which occurs particularly in areas where pressure and friction frequently occur - for example on the toes or soles of the feet. In contrast to flat corneal thickening(callositas), a clavus forms a cone-shaped core that presses inwards, often causing pain.

Origin and causes

1. Mechanical stress:
   • Pressure and friction caused by shoes that are too tight or ill-fitting, deformities (e.g. hallux valgus), foot misalignment or prolonged strain (e.g. prolonged walking/standing).
2. Physical protective mechanism:
   • The body reacts to prolonged strain with increased horn formation as protection, resulting in the development of a clavus.

Typical shapes

• Clavus durus (hard corn):
  • Most common form, usually occurs on the back of the toes or under the foot; the core penetrates deep into the skin.
• Clavus mollis (soft corn):
  • Often forms between the toes where there is moisture; the callus remains softer.
• Special forms:
  • Clavus neurovascularis (contains blood vessels and nerve fibers) or clavus subungualis (under the nail).
  • These variants are usually particularly painful and can bleed more easily.

Symptoms

• Pain when walking or standing, often stabbing.
• Sensitivity to pressure at the affected area.
• Visible, hardened, usually circular or oval-shaped thickening of the cornea with a central, usually yellowish-white "core".

Treatment and prevention

1. Pressure relief:
   • Suitable footwear that does not pinch.
   • Padding, insoles or small felt rings can reduce the pressure.
2. Medical foot care (podiatry):
   • Professional removal of the clavus using a scalpel, milling cutter or special instruments.
   • Professional help is advisable for particularly painful or complicated cases (e.g. neurovascular clavus).
3. Callus softening agents:
   • Plasters or tinctures with salicylic acid soften the callus so that it can be removed more easily.
   • Caution with diabetics or people with sensitive skin (risk of injury!).
4. Long-term measures:
   • Correction of foot malpositions (e.g. insoles, orthopaedic shoes).
   • Regular care (foot baths, application of moisturizing creams) to prevent excessive callus formation.

Conclusion: A clavus is not just a beauty problem, as the hard core can protrude deep into the tissue and sometimes cause severe pain. However, with suitable shoes, regular foot care and, if necessary, professional support, a painful corn can often be treated effectively and avoided in the future.