Plantar hyperkeratosis, also called keratosis, is characterized by abnormal thickening of the epidermis. What is it due to? What to do to avoid and treat it? Answers and advice from Ornella Ruopoli, pedicure-podiatrist, healthcare manager and teacher at the Bordeaux pedicure-podology training institute.

Plantar hyperkeratosis is an accumulation of stratified layers of the epidermis in response to micro-trauma or excessive pressure on an area of ​​the foot. “It’s a protective skin response to excessive and prolonged friction or pressure. Hyperkearatosis is dark yellow in appearance, more or less extensive and preferably sits under the forefoot or at the heel ”, says Ornella Ruopoli.

“The causes of plantar hyperkeratosis can be multiple and concern, deformities of the foot causing pressure on abnormal bone protrusions (hallux valgus, toe claws, etc.), morphological abnormalities of the foot (hollow feet, flat feet ), unsuitable footwear, poor patient dynamics or intensive sport practice. There are predisposing factors such as skin dryness, physiological abnormalities of the skin, abnormal skin thinness or even aging ”, explains our expert.

The diagnosis is made on clinical examination by observation. The patient will feel burning sensations, overheating, discomfort when walking but no pain when the foot is not resting on the ground. Sometimes this pathology can be painless.

The possible complications are the presence of a horn (small area of ​​hyperkeratosis resembling a pinhead that is embedded in the area and is very painful), or the presence of a hematoma in the area of ​​hyperkeratosis. if the pressure bursts small capillaries. “In both cases, the patient will feel more intense pain. The presence of this hyperkeratosis can cause repercussions related to pain. The patient may have an analgesic gait, he will not put his foot correctly on the ground when walking, which can cause pain higher up in the body (ankle, knee, hip or back) ”, adds the chiropodist.

The treatment will consist of removing the superficial stratum corneum. The chiropodist can use different techniques of instrumental care, either by mechanical stripping using a sharp instrument (scalpel, gouge), or using a rotary instrument (turbine, handpiece). These treatments are painless. “There are chemical treatments using keratolytic products but these products are rarely used because there is a risk of burning the adjacent healthy skin. In all cases, this pathology will recur if the cause is not eliminated, warns the specialist. For this, preventive actions are essential and consist, if necessary, in changing the footwear, correcting static or dynamic disorders using orthopedic insoles, or performing a surgical action in the event of excessive deformation of the body. foot. Pedicure care should be regular, and daily hydration of the skin with specific creams is essential ”.