Listen to Larissa Schmidt, DPM, as she highlights key points from her lecture Biomechanics in Podiatric Dermatology at the 6th Annual Elevate-Derm Alliance Conference at the JW Marriott Water Street in Tampa, Florida.

In this video

Dr. Schmidt makes the case that "calluses are pretty boring if you don't understand why they are there" — the mechanics of how the foot works are the driving factor. When clinicians can identify a patient's pain points and coach small corrections to control the foot, she notes the calluses often resolve on their own. For treatment she favors a multidisciplinary approach: keratolytics like urea-based or ammonium lactate products (applied under socks so patients aren't walking on the medication all day), plus plenty of moisturizing agents to counter the drawing-in nature of calluses.

On the more urgent end, she walks through differentiating cellulitis from a Charcot foot — a small but confusing patient population — relying on targeted labs and imaging such as x-rays, MRI, CT, and bone scans, and sending anything "warm, hot, swollen, and confusing" for urgent evaluation. She also praises dermatology colleagues for their head-to-toe thoroughness with diabetic patients, whose progressive neuropathy means they may not feel a callus turning into an ulceration, and closes with when to refer to podiatry once conservative care is exhausted.

  • Treat the mechanics, not just the callus — controlling how the foot works can resolve friction-driven calluses without repeated debridement.
  • For callus care, reach for urea-based or ammonium lactate keratolytics plus moisturizers; have patients apply under socks so they aren't walking on the product all day.
  • Refer anything "warm, hot, swollen, and confusing" urgently; differentiating cellulitis from Charcot foot relies on labs and imaging (x-ray, MRI, CT, bone scans).
  • In diabetic patients, progressive neuropathy means they may not feel a callus becoming an ulcer — inspect the feet, check pulses, look between the toes, and involve caregivers.
  • Recommend skin barrier care, compression for venous insufficiency, supportive shoes, and avoiding barefoot walking; refer to a foot and ankle specialist for persistent pain or recurrence.