Q: Can you suggest some strategies for treating corns and calluses? I am from Southeast Asia, where we are accustomed to walking three to four blocks to and from errands and performing tasks on the way to work. I am aware about corn and bunion cushions and callus removers produced by Dr Scholl's, and have tried them, but so far they have not produced the desired result of complete corn eradication. — Brad

A: This is a great topic to discuss. I am very happy that you continue to walk as much as possible. Exercise is definitely the single cheapest and most effective thing to do to stay healthy and live longer. I used to write here that it also had no side effects. You, however, remind all of us that sometimes that's not true. Let's review three problems we all encounter at times while walking: blisters, calluses and corns. All three have a very similar origin: They form in response to both pressure and friction. In the case of blisters, there is a layer of fluid between sheered layers of skin. With corns and calluses, there are deposits of dead cells, over time getting thicker and harder with material called keratin. Our body is designed to protect the skin from the pressure, but unfortunately at times it will actually contribute to increased pressure, as well. Blisters, calluses and corns are commonly found on parts of our body subjected to pressure, like the ball of the foot, outer aspect of the big toe or brim of the heel. Sometimes they can be found on hands

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(woodworkers and writers can attest to that). There are other explanations besides the pressure one has to take under consideration dealing with calluses, blisters and corns. This is important, especially when, just like with you, simple remedies are not effective. Poor-fitting shoes, an abnormal pattern of walking, obesity and protruding bones can be the reason a stubborn corn or callus will not go away. Well, how should we deal with our feet (or hands) to protect them? First and foremost, eliminate the pressure. Changing shoes is the first step to consider. Generally speaking, shoes with a reasonably thick cushion and wide comfortable base are the best. Yes, we will have to part, at least for a while, with high-heeled shoes. If you choose not to eliminate pressure, it does not matter that you have removed a callus or healed a blister. They will be back. I suspect that the reason your attempts were not successful is precisely that.

If there are problems with walking or the way your bones are positioned, you may need special orthotics (inserts made by a specialist). You may actually need custom-made shoes. Only rarely will there be a need for surgery. The best way to minimize the discomfort of the callus or corn is to soften it in warm water and file it using a natural pumice stone. It is not advisable to cut out corns and calluses yourself. Usage of strong dissolving liquids is also discouraged, since it will not distinguish the dead and alive skin and may cause some damage, even infection. People who suffer from diabetes should NEVER try to remove the corns — the risk of complications is just too high. Regular usage of a simple moisturizer like Vaseline will also help. When in doubt, a visit to podiatrist (the foot doctor) may prove to be extremely helpful. So, to all: forget the uncomfortable shoes, invest in a pair of good sneakers and let's go for a walk.

Dr. Beata Skudlarska is a Bridgeport geriatrician. Send questions to Bridgeport Hospital Center for Geriatrics, 95 Armory Road, Stratford CT 06614 or geriatricmd@aol.com.