Pain from callus with blood blister on ball of big toe

by Rodger
(Athens, Al USA)

Left foot ball of big toe has a callus that is starting to get circular cracks on it. Have had the callus for years. Haven't paid any attention to it, in that, I left it there assuming my foot needed the callus for some reason. My reasoning was it serves the same purpose as calluses on the end of my fingers did when I was actively playing the guitar.
Recently with the cracks, have come soreness on the callus. From the drug store I purchased a salicylic acid treatment in the form of small round acid sticky dots with larger padded oval bandages to go over top. It is a two week treatment with the medicated dots changed out every 48 hours.
I'm in my second week of treatment and have started to have shooting pain under the callus. Upon inspection, a blood blister is forming under the callus. The callus appears to be getting condensed and white. The blood blister has grown larger on a subsequent changing of the medicated pad and inspection.
I walk on the outside of my foot now because of the pain.
I am contemplating lancing the blister. It seems to be under quite a thick layer of skin.
Should I stop treatment and see a doctor? Should I continue treatment? Should I lance the blister?

RESPONSE

Hi Rodger,

I think your days of self treatment are over. You are right in the fact that a callus by itself is usually nothing to be concerned with and it does serve a purpose in protecting an area of the body in this case the first metatarsal head. Specifically in your case, it also tells us that you are creating excessive pressure under the first metatarsal head and the body's reaction to that is to form the callus.
The problem here is that apparently the callus got too thick and began to crack. Once it cracks, it becomes subject to infection.
I do not know how old your are, nor do I know anything about your medical history, but the older you are and with a history of diabetes, poor circulation or a host of other potential problems, an infected callus can become a very serious issue. This is how some people end up with amputations.
I am not saying you are going to end up there, again, because I know nothing about your overall health, but it is now time to see a foot specialist.
If the area has blistered or abscessed, the doctor will drain it and show you how to properly dress the area and give you proper home care instructions. Additionally, at the discretion of the doctor, he or she may prescribe an antibiotic. It would be well worth your time to see a doctor in order to prevent this from becoming a major problem.
Many people will try salicylic acid patches in an effort to soften up a callus but they need to be aware of the potential pitfalls in using this type of medication.
In other wise healthy individuals I do not see it as a major issue, but in diabetics and others with at risk foot problems, this type of medication should be avoided.
Once the foot is treated, you may or may not find the callus becomes an issue in regards to pain. If the callus begins to hurt on a regular basis, you might want to consider the use of an orthotic, which is a device that fits into your shoe. The purpose of an orthotic would be to remove pressure from the callus area and redistribute body weight in an effort to prevent the callus from building up too quickly.

Marc Mitnick DPM
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