As podiatrists, we are presented with a wide variety of foot conditions every day. Two of the most commonly confused presentations we see in clinic are corns and plantar warts. While they may look similar to the untrained eye and can both cause significant discomfort, they are very different conditions with different causes and treatment approaches. Accurate diagnosis is essential to ensure effective treatment and avoid unnecessary pain or prolonged symptoms.
What Is a Corn?
Corns, medically known as heloma durum, are uncomfortable, thickened skin lesions that develop as a result of repeated mechanical trauma. This trauma is usually caused by ongoing friction or pressure forces, most commonly from footwear, abnormal foot mechanics, or walking pattern issues.
A heloma durum typically presents as a firm, dry, and compact lesion, often yellow or brown in colour, with a smooth or polished surface. One of the key distinguishing features of a corn is that it is sharply demarcated from the surrounding skin.
Corns are frequently seen in:
- Athletes
- Older adults
- People with poorly fitting footwear
- Patients with gait abnormalities
These small but painful lesions are often described as feeling like a “stone” in the shoe. Careful removal of the hard central core using a scalpel is the gold standard treatment and provides immediate pain relief when performed correctly by a podiatrist. This is commonly followed by protective padding, either thin or thick depending on the location, to offload pressure and prevent recurrence.
What Is a Plantar Wart?
Plantar warts are benign skin lesions caused by the Human Papillomavirus (HPV). Unlike corns, warts are viral in origin and can be contagious. Warts are generally obtained from public areas such as swimming pools, showers, saunas or gyms. They are most common in children and teenagers, although adults are also frequently affected.
Plantar warts usually appear as skin-coloured, rough, grainy growths on the sole of the foot, commonly on the heel, ball of the foot, or toes. They are often covered by thickened skin that can resemble a callus, which contributes to misdiagnosis. A classic sign of a wart is the presence of tiny black dots, which are clotted blood vessels, and an interruption of the normal skin lines.
Warts often cause pain during walking, particularly when pressure is applied through the foot. Treatment can be challenging, as warts are known to be stubborn. Our treatment approach typically involves:
- Removing as much of the wart tissue as possible
- Applying medical grade anti wart chemicals directly to the lesion
- Laser Therapy (for persistent warts)
While some warts respond quickly, many require multiple treatments to fully resolve. Persistence and appropriate follow up are key to successful outcomes.
How Do We Clinically Differentiate Corns and Warts?
One of the most reliable ways to distinguish between a corn and a wart is through clinical pressure testing:
- Direct pressure applied straight down onto the lesion tends to reproduce pain in a corn
- A lateral squeeze (pinching from the sides) is more likely to cause pain in a wart
This simple but effective examination technique, combined with visual assessment, allows podiatrists to make an accurate diagnosis and tailor treatment appropriately.
Why Early Treatment Is Important
Prompt treatment of both corns and plantar warts is strongly advised. Leaving these conditions untreated can lead to worsening pain, altered walking patterns, skin breakdown, and in some cases secondary complications particularly in high risk patients such as those with diabetes.
If you are experiencing ongoing foot pain or are unsure whether you have a corn or a wart, professional assessment is essential. Early and accurate diagnosis not only relieves discomfort but also helps prevent recurrence and further complications.
If you have concerns about painful foot lesions, book an appointment with your podiatrist for an expert assessment and tailored treatment plan.