CLINIC: Hyperkeratosis is Hereditary

Tue, 6 Dec. 2011 - 1:12 a.m. MT
Credit: ARA Staff - American Running Association


QUESTION:
On the heels of both my feet, as well as the area just below my toes on the bottom of each foot, I have rock-hard tissue that I have attempted to treat to no avail. On the advice of both physicians and podiatrists I have applied moisturizing cream three times a day, put cushioned insoles inside my shoes, soaked my feet in both hot water and hot water with Epsom salts, and rubbed my feet with a pumice stone. This last treatment in particular was a lot of effort and yielded almost no result. The only treatment that has had any results worth noting was rubbing vitamin E oil into the hard areas three times a day. While this appeared to soften my feet, it was such a mess that I deemed it not worth it. The oil got inside my shoes, socks, bed sheets, etc. and there was simply no way to contain it. Any additional solutions to this problem, which I suspect many people have had, would be greatly appreciated.
 
Richard DeAngelis

ANSWER:
I have had success treating excessively hard skin (known medically as hyperkeratosis) with the following regimen:
 
1. Apply Carmol-40 lotion twice a day to all areas. This is a prescription-only lotion with 40% urea, vitamin E, lactic acid, and zinc.
2. Wear cushioned insoles, as you have done, but also non-leather soled shoes.
3. Wear socks at all times.
4. Do not walk barefoot.
5. See a podiatrist every two months initially for paring of the legions with a blade; after this you might be able to lower the frequency of the visits.
 
This is a hereditary and non-curative condition but if you are diligent it can be managed well. With this treatment you will also have the peeling of skin—which can’t be avoided until the condition gets better. Later you can also use a lotion with only 20% urea if you so choose.
 
David A. Lief, DPM


ANSWER:
In addition to Carmol-40, there are over-the-counter lotions or creams, such as Eucerin Plus, that contain alpha hydroxyls (lactic acid and uric acid). Alpha hydroxyls are gentle acids that soften the dry, hard skin.
 
Paul Langer, DPM
 
(RUNNING & FITNEWS®  April / May 2007 • Volume 25, Number 3)
 
DISCLAIMER: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
 
The American Running Association (ARA) and its Clinic Advisory Board disclaims responsibility and shall have no liability for any consequences suffered as a result of your reliance on the information contained in this site. ARA does not endorse specifically any test, treatment, or procedure mentioned on this site.
 


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