Sharp Blade: Removing Calluses with a Scalpel

Did you know? The scalpel is an instrument primarily used in the surgical field. However, it is also essential equipment in foot care studios and podiatry practices. In professionally trained hands, different blade shapes can quickly, gently, and almost painlessly remove hyperkeratoses, calluses, and corns. In addition to sensitivity and motor skill, the right technique and experience in assessing the skin condition are essential.

Important: A scalpel should not be used by amateurs!

The skin, with an area of about 1.8 square meters, is not only the largest human organ but also a marvel of cell renewal. This can be seen on the surface of the skin, where dead cells are shed as skin flakes. When hard skin or calluses form, this renewal process is disrupted. Too many skin cells are produced, or the old cells do not shed quickly enough.

There are various causes of hyperkeratosis on the feet. Primarily, overuse and excessive pressure are triggers for its development. Certain skin conditions, such as eczema, psoriasis, and ichthyosis, can also cause hyperkeratosis. Additionally, obesity and foot deformities or misalignments can promote its development.

Find out more about hyperkeratosis now

Calluses and hard skin may be unsightly and annoying, but the more problematic issues are the subsequent consequences. Fine cracks in very dry skin can develop into fissures or deep rhagades. These can be potential entry points for bacteria, which in the worst case can lead to painful inflammation. This is especially critical for at-risk patients, such as diabetics with neuropathies in their feet. Regular and professional foot treatment in a podiatry practice should therefore be a given.

The scalpel technique is a particularly gentle treatment method for removing calluses and corns. However, callus scrapers are often used, especially in the private sector. In professional foot care, however, they are not recommended for the following reasons:

• Limited visibility of the treatment area
• The handling is less safe
• No fine detail work possible due to the width of the blade

Therefore, podiatry schools typically teach only the scalpel technique. Hand positioning and movements are extensively practiced before the first use on patients, for example, on wax foot models, as fine motor skills must be developed through intensive practice.

As preparation, it is generally recommended to give a foot bath. The skin becomes softer, making the removal easier. The affected area is often pre-treated with callus-softening agents. With the free hand, the skin is lightly stretched, and the hard skin is removed layer by layer with short, circular movements. Excessive removal would be counterproductive, as it could cause pain while walking if the protective layer is missing. Additionally, too much removal stimulates cell growth, leading to faster callus formation. Finally, the transitions are smoothed with grinding caps or a diamond grinder, creating an even skin texture.

Scalpel holders and blades form a single unit and are classified as a combined medical device. A basic distinction can be made between flat holders with blades for the rotational technique and rounded holders for thrust blades. As the name suggests, with thrust blades (= hollow chisel blades), the motion is directed straight forwards. With the appropriate blade width, flat filing is also possible; however, narrow blades are usually preferred, for example for clearing out beneath the nail plate.

With blades with a lateral cutting surface, the movement is different. The index finger, resting on the skin side, serves as a pivot point for a rotating cutting motion. This makes it especially well possible to incorporate gentle and wide-area filing of calluses. It is also possible to straighten the edges of calluses and go deep with pointed blades to treat corns, without causing pain or injury. Provided, of course, that the necessary professional expertise is available.

In her latest video, podiatrist Elisabeth Prinz demonstrates how to successfully file calluses with a scalpel and offers tips on choosing the right blade shape:

Important!
Scalpel blades are single-use items that must be disposed of properly after use. Care must be taken when removing them, as the risk of self-injury is large. Special blade removers are available to provide assistance, and puncture-proof containers such as the Rigi-Box are available for disposal.

Note for consumers: Are you not a podiatrist, but looking for help with your own podiatry?
In our official peclavus shop, you’ll find suitable products and important tips on calluses, cracked skin and fissures.

Find out more at peclavus.de