Blood Under Thick Calluses: Treatment and Concerns

Bleeding under the callus of the thumb?

Doctor: Hello, my father has developed a thick callus due to hallux valgus, which has been rubbing against his shoes.
Recently, while trimming the callus, we noticed some red spots underneath.
Although it doesn't hurt, we were concerned and visited a dermatologist.
The doctor said that the redness underneath the callus is due to bleeding and prescribed Duofilm to apply for two weeks, suggesting it would fall off naturally.
I would like to ask:
1.
I noticed that Duofilm is used for treating warts and corns.
If the redness is due to bleeding, does this mean it is just a scar from an old injury? Otherwise, wouldn't the wound cause harm?
2.
Another concern I have is that the pharmacist advised me to seal the area with non-breathable tape after applying the medication.
However, I have seen many doctors online recommend covering the area with breathable adhesive bandages, like Band-Aids or regular medical tape, once the solution dries.
I don't understand if the breathability will affect the effectiveness of the treatment.

Thank you for patiently reading my many questions.

Xiao Min, 50~59 year old female. Ask Date: 2017/09/15

Dr. Wu Yuxin reply Dermatology

1.
It can be used if there is no pain, but it may cause irritation if there is an open wound.
2.
Using non-breathable adhesive bandages is appropriate, as it can enhance the depth of drug penetration, resulting in better efficacy.

Reply Date: 2017/09/15

More Info

When dealing with a case of thick calluses on the toe, especially when there are signs of bleeding underneath, it is essential to approach the situation with caution and a clear understanding of the underlying issues. Here are the answers to your questions based on the medical knowledge available.

1. Understanding the Treatment with Duofilm: Duofilm is a topical treatment primarily used for warts and corns. The presence of red or blood-like material under the thick callus could indicate that there has been some trauma or irritation to the skin, leading to localized bleeding. If the doctor has diagnosed this as a result of the thickened skin, it may not necessarily be a fresh wound but rather a sign of chronic irritation or damage that has occurred over time. The treatment with Duofilm aims to help remove the thickened skin and promote healing. However, it is crucial to monitor the area for any signs of infection or worsening condition. If the bleeding persists or if there are signs of infection (such as increased redness, swelling, or discharge), further evaluation by a healthcare professional would be necessary.

2. Concerns About the Use of Non-Breathable Tape: The advice given by the pharmacist to cover the treated area with a non-breathable tape may raise concerns. Generally, after applying a topical treatment like Duofilm, it is advisable to allow the area to breathe. Covering it with a non-breathable tape could potentially trap moisture and create an environment conducive to bacterial growth, which could lead to infection. On the other hand, using a breathable bandage, such as an adhesive bandage or gauze, allows for air circulation while still protecting the area from further irritation or injury.
In summary, while the treatment with Duofilm can be effective for managing thick calluses and any underlying issues, it is essential to follow the instructions carefully and consider the type of covering used after application. If there are any concerns about the treatment's effectiveness or the condition of the skin, it is advisable to consult with a healthcare professional for further guidance.

Additional Considerations:
- Monitoring for Complications: It is important to keep an eye on the area for any signs of complications, such as increased pain, swelling, or discharge. If any of these symptoms occur, it would be prudent to seek medical attention.

- Proper Footwear: Ensuring that proper footwear is worn can help prevent further irritation and trauma to the area. Shoes that fit well and provide adequate support can significantly reduce the risk of developing calluses and other foot problems.

- Regular Foot Care: Regularly inspecting the feet, especially for individuals with conditions like diabetes or circulatory issues, is crucial. Keeping the feet clean and moisturized can help prevent the formation of calluses and other skin issues.

- Consulting a Specialist: If the condition does not improve or worsens, it may be beneficial to consult a podiatrist or dermatologist who specializes in foot care. They can provide more targeted treatments and advice tailored to the specific condition.

In conclusion, while the treatment plan seems appropriate, it is essential to remain vigilant about the condition of the skin and to follow up with healthcare providers as needed.

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