That painful callus is called a heloma molle which literally means “soft corn.” When most people picture a corn they think of that hard skin that overlies a knuckle on their toe, and is caused by friction between the shoe and a toe. Heloma molles are slightly different because they occur between toes, most commonly between the 4th and 5th toes a.k.a. the “ring” toe and “pinky” toe.

Heloma Molles form between toes because of the close proximity of bony prominences of adjacent toes. Pressure can begin after arthritis, a healed toe fracture, or when contracted toes from over time. Wearing tight shoe gear can exacerbate pressure between the toes leading to painful corn formation as well. Typically the corn in soft and not hard like those found on the tops of toes because the space between our toes holds moisture very well. This increase in moisture can lead to athlete’s foot infection or more severe bacterial infections if hygiene is poor or treatment is not sought.

The clinical picture of a heloma molle is thick yellow corn usually on the inside of the 5th toe but often on the outside border of the 4th toe as well. Often it appears to have a central core of thickened skin. If the patient sweats a lot or has poor hygiene it can be very moist and sometimes have an odor. As the callous builds it can cause pain and can possibly become infected if left untreated.

Treatment falls into two categories, conservative and surgical. In most cases surgery is not required. A podiatric physician can trim the lesion and remove its central core to healthy skin the office, therefore reducing pain and risk for infection. Afterwards, gel padding and wider shoes can be used to reduce pressure, topical prescription creams can be applied to help soften lesion, and instruction of manual reduction at home can be given.   

Padding, creams, manual removal of callus and altering shoe gear is not curative. It only reduces pressure and the rate of recurrence. This is a chronic condition caused by increased pressure of bones that are not changed by conservative therapy. 

In the cases of chronic heloma molle formation with severe pain or infection, surgical correction is recommended. Surgery removes the parts of the bone that cause the painful irritation. The surgical procedure allows the patient to return home the same day as procedure and ambulate with the protection of a flat bottomed surgical shoe or boot.

Heloma molle is a treatable condition that you do not need to suffer through. Come see us for evaluation and treatment so you can help eliminate your painful symptoms!

5 Comments
Hello I'm having the same problem I need help or pointed to the right direction or a name of a behind the counter med
by Christian Daniels December 27, 2016 at 04:20 AM
Desperately need help on my 4th an 5th toe. My blister or callas has been there for about 6 months an pain is increasing with a burning sensation. I've soaked them, put athletes foot spray all over bottom of my feet thinking i hav athletes feet. I'm very active an always on my feet!! So please give me some tips on how to get rid of this agonizing pain day in an DAY out!!!
by JACQUE DOAN December 9, 2016 at 12:30 AM
Yes, this looks and feels exactly what shown on picture. I have done everything possible to make this go away and it's painful. I do take care of it myself but it keeps coming back. I need your help, please.
by maria February 19, 2016 at 09:12 PM
I have the corn problem between my pinky toe,it hurts,I've had it for awhile.What should I do
by martin December 4, 2015 at 05:19 AM
Please I am nigerian my middle pinky toe hurts a lot and the skin is thickened I need help on treatment.
by iloama samuel August 1, 2015 at 04:08 PM
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