Monthly Archives: August 2019

Hardness in the Feet or Hyperkeratosis. What They Are, How to Treat Them and How to Prevent Them

“I have something hard on the sole of my foot that hurts when I support it,” “I have had a pimple between my toes and it hurts when I walk”, “I have cracked heels” …

These are usually the phrases of many patients who come to our consultations looking for solutions to the discomfort they suffer when walking, and their diagnosis is, in many cases, hardness or hyperkeratosis.


Hardnesses or hyperkeratosis are a thickening of the most superficial layer of the skin due to an increase in dead and scaly cells, caused by the pressure or continued rubbing caused by improper footwear or a bad footprint.

It is a skin protection mechanism against an area of more friction.

A more superficial hardness plate may appear or grow inward, which will be called heloma. If you want more information about this lesion, you can consult it in “Plantar heloma. Causes and treatments”.

CAUSES. Why do they occur?

Here are some of the most common causes of hardness or hyperkeratosis:

– FOOTWEAR. Inadequate footwear with a narrow toe encourages the appearance of hardness between the fingers, backs of the fingers and even in the most distal area of ​​these. This is due to the use of a small footwear. Likewise, this lesion will also appear in the lateral area of ​​the first and fifth fingers, if a narrow shoe is used that presses the foot. In turn, the abuse of heels or an incorrect support of the foot negatively affect this aspect.

– DEFORMITY. If the patient has a deformity in the foot, such as a claw or mallet toe, they will also be prone to suffer, as they produce more pressure on the back of the finger against the footwear or even on the pulp.

– DEHYDRATION. Dehydration of the foot is a factor that also helps its appearance. It is very common in the heel area. In the article “Dry and cracked heels?” We tell you all about this dermal lesion.

– NAIL. This accumulation of cells can also appear in the nail channels or under them.

TREATMENT. How to treat this skin lesion?

– VISIT TO THE PODOLOGIST. First of all, it should be commented that it is a mistake to try to treat or cut one’s hardnesses. You should always go to a specialized podiatrist to use the appropriate and sterilized tools, and thus avoid a bad diagnosis and cuts that cause infections and inflammations of the skin. In turn, buying products with chemical components (callicides or similar) can damage the skin causing a burn and macerating it. In the article “Callicides. Are they recommended to end the calluses and hardness of the feet” we analyze the negative consequences they can produce.

– DIABETES. If a person is diabetic or has circulation problems, special care must be taken for complications resulting from poor healing.

– CHIROPODY. This podiatric treatment that consists of the elimination of calluses and alterations in the toenails will help to have 100% healthy feet and that the slight lesions can be aggravated.

– BIOMECHANICAL STUDY. Performing a biomechanical study of the tread we can observe the points of greatest pressure when walking and, with a customized Podoactiva insoles, rebalance the pressures and be able to discharge those points of maximum foot pressure to prevent plantar hardnesses from appearing.

PREVENTION. How to prevent the appearance of hardness?

Going to the podiatrist is essential to avoid this ailment but, in our homes, we can also try to prevent it if we follow these guidelines:

– Wearing appropriate footwear is essential to prevent this ailment as it is very important to change shoes regularly. It is advisable not to always use the same shoe but to alternate using different types so that friction does not always occur in the same areas.

– Keep your feet well hydrated, especially in areas prone to hardness formation.

– Dry the feet well after washing them, taking special care between the toes.

– Apply specific moisturizers to keep them healthy. In the case of hardnesses, those containing urea are beneficial, since this component affects the skin cells, promoting their desquamation. It is important to choose the right urea concentration for each foot. For example, a medical moisturizer for feet with hard and quite dehydrated feet would have to have a concentration of 20% to 30%, while for more extreme cases it would be 40 or 50% urea. For this reason, to assess the type of foot, it is advisable to go to a podiatrist so that he can advise you on which one best suits your needs.

– Pumice stone. Using the pumice stone to exfoliate dead skin while showering will help prevent the appearance of hardness. It is important to do it superficially, and before any injury or irritation go to the specialist. It is not a treatment, but a complement.

– Go to the podiatrist at least once a year to do a review of your feet and thus detect possible ailments or pathologies.

TIPS. What is the most suitable footwear to avoid hardness?

Regarding footwear, it is always advisable to buy a suitable shoe that has certain characteristics to avoid damaging our foot. In this link we discuss several aspects to take into account when buying shoes and we leave other points to highlight below:

1. Comfortable and wide footwear that is not too hard and thin toe, because if these characteristics are not met, the shoe will generate even more pressure on the fingers and friction and discomfort will appear. In these cases, for example, hardness may appear between the toes and over them due to the pressure exerted by a tip of a narrow shoe. On the other hand, it is also not advisable to wear shoes that are too large that do not fit our size. Therefore, the recommendation is simple: wear appropriate shoes to our foot size.

2. A good fit of the footwear is essential to avoid any type of injury. For this reason, we advise you to use shoes with closure adjustment such as laces or velcro for a better fit.

3. Avoid wearing heels. However, if you use them, it is recommended a wide heel of about 3 or 4 centimeters, since the higher the entire weight of your body will be concentrated on the forefoot with more pressure on it and the fingers.

4. Footwear that provides stability and that contains rigid buttresses to hold the foot well, in addition to avoiding thin soles to have less reactive ground forces. This is beneficial for shock absorption.

5. In addition, we must buy shoes that are made of quality materials and breathable fabrics. These should be alternated and not always use the same so that it does not generate continuous pressure at the same point and promote hardness.

In short, hardnesses or hyperkeratosis are a very common skin lesion among our patients. On many occasions, chiropody is the treatment we apply to them, but this will depend on the characteristics of the person and in what state their feet are. However, what is certain is that this condition has to be treated by a specialist to avoid increasing the problem.