Plantar Keratosis: Understanding Symptoms, Causes, and Treatments
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Plantar keratosis is not pathological; it is a thickening of the stratum corneum of the epidermis related to a local increase in pressure or shear stress. In cases of plantar hyperkeratosis, there is a potentially bothersome or painful thickening of the tissues on a limited area of the skin. This condition is one of the numerous foot disorders that can affect quality of daily life.
Symptoms and signs of plantar keratosis
The symptoms of plantar keratosis can vary from one person to another. Generally, you may feel as if you are walking on a small pebble, especially if you have a corn on your foot. Thick, hard, and sometimes cracked areas can appear on the sole of your feet. These areas may be sensitive to the touch and cause some discomfort when walking. These areas may also display a yellowish or brownish color. It is important to differentiate plantar keratosis from other conditions such as metatarsalgia, which affects mainly the forefoot.
When to consult a specialist
We recommend consulting a podiatrist as soon as the first signs of plantar keratosis appear. Early consultation enables an accurate diagnosis and prompt management. If you experience discomfort or pain in the sole of your feet, or if you notice changes in the appearance of your skin, do not hesitate to make an appointment with a podiatrist. Comprehensive foot examinations may be necessary to establish a differential diagnosis.
Diagnosis of plantar keratosis
The diagnosis of plantar keratosis is mainly based on a clinical examination performed by a specialized healthcare professional. Visual observation and palpation generally make it possible to identify areas of hyperkeratosis.
Additional tests
In some cases, additional tests may be necessary to rule out other conditions. The podiatrist can analyze your foot type to understand the areas of excessive pressure. A gait analysis or a podoscopic examination can reveal biomechanical abnormalities contributing to the formation of keratoses.
Causes of plantar keratosis
Plantar keratosis, although it may seem harmless, can have multiple and diverse origins. It is therefore essential to understand the causes and risk factors associated with this condition in order to better prevent it and maintain good foot health.
Risk factors
The risk factors for plantar keratosis are numerous. Among them, advanced age plays a significant role, as the skin loses its elasticity over time. Similarly, wearing shoes that are too tight or uncomfortable can promote the development of these calluses. Excessive exposure to friction or pressure on the skin of the feet, as is the case for athletes or people whose jobs require them to stand for long periods, is also a significant risk factor. Diabetic patients need to be especially careful because they are more likely to develop complications, which is why it is important to understand and prevent diabetic foot.
Common causes
Among the common causes of plantar keratosis are fungal infections, structural foot disorders such as flat feet or bunions, and skin diseases such as psoriasis. Poor foot hygiene can also encourage the development of plantar keratoses. Other inflammatory conditions such as bursitis can also contribute to changes in gait and promote the appearance of hyperkeratosis areas.
It is therefore essential to take care of your feet and protect them as much as possible to prevent the onset of this condition. This includes wearing comfortable and well-fitting shoes suited to your foot shape, regularly applying moisturizer, and maintaining good hygiene. Discover our tips for effectively protecting your feet from injuries.
Why choose The Foot and Ankle Clinic?
The Foot Clinic offers expert and personalized care to effectively treat foot disorders, whether they are related to trauma, chronic pathology, or surgery. Thanks to a multidisciplinary team and state-of-the-art equipment, it provides care tailored to each patient, with the goal of a quick, lasting, and safe recovery.
Medical treatment for plantar keratosis
Among the medical treatment options for plantar keratosis are creams and ointments containing salicylic acid, which help soften and gradually remove calluses. For more advanced cases, more invasive procedures may be considered, such as cryotherapy, which uses cold to destroy keratosis cells, or surgery. In some cases, injections may be offered to relieve associated pain.
We also offer custom-made plantar orthotics, which can help reduce pressure on the affected areas and prevent the recurrence of keratosis.
Effectiveness of Treatments
The effectiveness of treatments for plantar keratosis depends on several factors, including the type of keratosis, its location, and its extent. However, most patients notice a significant improvement in their comfort and foot health after receiving podiatric care.
Prevention of plantar keratosis
To effectively prevent plantar keratosis, several measures can be adopted on a daily basis. Regular hydration of the skin on the feet with suitable creams is essential. Choosing appropriate shoes that provide good support without areas of excessive pressure is crucial. It is also recommended to regularly perform pedicure care to remove dead skin before it accumulates. People suffering from conditions such as talalgia should be especially cautious, as changes in gait can encourage the appearance of compensatory keratosis.
Possible complications
The complications of untreated plantar keratosis may include deep cracks that can become infected, particularly in diabetic or immunocompromised patients. In rare cases, cystic formations may develop beneath the areas of hyperkeratosis, requiring specialized management. To learn more about these formations, see our article on foot cysts. Chronic pain may also change gait and lead to secondary biomechanical problems in the ankles, knees, and hips.
FAQ - Plantar Keratosis
Yes, in most cases. Many people do not experience significant discomfort, even if the skin is thickened. However, advanced forms can lead to pain, cracking, or difficulty walking, requiring management to preserve comfort and mobility.
- Hereditary form: symptoms appear in childhood, often with involvement of the palms and soles that is diffuse or associated with other signs (nails, hair, cardiac anomalies…)
- Acquired form: appears in adulthood, often linked to a condition (psoriasis, eczema, lymphoma, hypothyroidism) or to taking medications (lithium, tyrosine kinase inhibitors)
- Diffuse: general thickening of the soles and palms
- Focal: localized calluses at pressure points
- Punctate: small isolated plaques on the soles of the feet
Yes, several measures help to limit progression:
- Regular check-ups with a podiatrist to remove excess callus
- Use of insoles or orthotics to distribute pressure
- Daily moisturizing with emollient or keratolytic creams (urea, salicylic acid…)
Depending on the type and severity:
- Keratolytics and emollients for topical application
- Mechanical debridement (shaving, professional debridement)
- Topical or oral retinoids (acitretin) for severe forms
- Cryotherapy, UV phototherapy, or surgery in resistant or syndromic cases
- Clinical examination and collection of family history
- Skin biopsy if the presentation is atypical or to rule out other disorders
- Genetic testing to confirm a hereditary form
Yes, in some cases:
- It can be a paraneoplastic sign (indirect indicator) of cancers such as bladder, colon, or lung cancer
- It may occur alongside systemic diseases: lymphoma, hypothyroidism, chronic eczema…
Seek prompt medical attention in case of:
- Severe pain, bleeding cracks, signs of infection
- Sudden onset of thickening or the appearance of neurological or systemic symptoms
- Suspicion of a paraneoplastic form (after age 40, cancer risk factors).
Conclusion
At the Foot Clinic, our podiatrist can see you for a podiatric evaluation. Keratosis, or more precisely plantar hyperkeratosis, is most often treated medically. Certain causes of excessive pressure on the sole of the foot can be relieved by wearing orthopedic insoles, or plantar orthotics. As a last resort, surgical treatment may be indicated to correct static disorders of the ankle and foot in order to relieve areas of excessive pressure. Early and appropriate management generally prevents complications and helps restore optimal walking comfort.