Blog Post

Verruca or Corn? Spot the difference

  • by Leslie Grant
  • 06 Aug, 2020
Verrucas and corns are two of the most common conditions Podiatrists see in clinic. They are also some of the most commonly mistreated conditions by patients at home.

By the time patients come to see us they have often diagnosed their own condition via Dr Google and had a go at their own self-treatment by buying over-the-counter topical treatments. Often patients come to see us if their treatment hasn't worked or if they have encountered a problem. More often than not, their diagnoses is wrong and this has lead to using the wrong treatment on the wrong lesion. This can, in some cases, lead to serious problems.

So what is the difference between a verruca and a corn? How are they often mistaken for each other?

A verruca is a virus. It comes from the Human Papilloma Virus (HPV). This is highly contagious virus and is passed through person to person contact. They are most commonly found on the soles of the feet or around the toe area. The virus thrives in wet or damp environments, such as swimming pool floors, communal changing areas and showers. 

As with all viruses verrucas can be picked up by anyone, verrucas are not choosy. It has been suggested that children and young adults have the highest incidence of verrucas with an estimate of 5-30% (Sterling et al (2014)). People with severe immunosuppression can be more predisposed to large, persistent verrucas. They can spread to other areas of your skin, if scratched, picked or knocked. The incubation period of a verruca is thought to range from a couple of months to over a year. 

Most interestingly they can clear spontaneously without any treatment however they can also be persistent for years. For some people they can be very painful or for others pain free. They can also be classified into different sub-types such as mosaic verrucas, seen in the image above. 

One of the main ways to differentiate a verruca from a corn is looking closely at the skin, it helps if you use a magnifying glass and a bright light. If you look at the skin on your hand just now, you will see it it has a line pattern and texture, these lines are called striations. The verruca virus is very clever as it infiltrates and disrupts the line pattern of skin, causing the striations to be interrupted. You may also notice that verruca tissue has small black spots in the skin, these are the verrucas blood vessels. If damaged the verruca will bleed.

We often use an easy test to differentiate a corn between a verruca if we are unsure by looking at the skin. If you squeeze the skin around the lesion, medially to laterally, as the diagram. If the lesion is painful to squeeze, then this is most probably a verruca. 

A corn is a cone shaped piece of hard skin that often occurs on an area of pressure, such as prominent joints. Corns are formed by pressure and friction, this can be from shoes, seams, socks, lumps and bumps on your feet. Corns often start as hard, dead skin and as the pressure increases form a conical high pressure area. The hard skin of a corn is formed to protect itself from the unrelenting pressure and friction. Corns can form slowly over time. 

Corns can affect anyone of any age and ability. But some research shows they tend to affect people with a drier skin type. The skin on top and around a corn tends to be hard and thick in nature, often causing the skin to be raised. It can give it a slightly yellow colour tone. 

Corns are often painful to pressure. They can become red, hot and swollen, leading to breakdown and infection, if ignored. 

Looking at the skin closely can reveal if it is a corn or a verruca. A corn tends to have a conical, circular shadow underneath the hard skin. The skin striations appear normal and are not disturbed. 

Instead of squeezing the skin this time, we are doing to put pressure directly on the area. If pain is elicited on this pressure, then the lesion is likely to be a corn.
If you are in any doubt to what your foot lesion could be, it is always recommended to have it assessed by a Podiatrist. If you have any questions about your corn or verruca, please contact one of the team on 01324 621809.
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