I have been practicing podiatric medicine for more than 30 years and truly have a dedication to my patients and passion for the profession. Please take a look at my website and the resources I have provided. I look forward to meeting you and providing you the food care you deserve.

Click here to learn more about Dr. Richard Rees

Dr Richard Rees Read More

Intractable Plantar Keratoma in Houston TX.


Keratomas or Intractable Plantar Keratoma (IPK) is a common foot problem. It is basically a very deep and painful callus, which will not go away by itself. Its cause is basically abnormal pressure on the foot caused by misaligned metatarsal bone.

It is when one metatarsal bone is longer or lower than the other that the bone tends to hit the ground first, with more force than it can handle. Repeated such movements lead to a keratoma. Sometimes, keratomas are also caused by the wart virus, and can occur all over the foot. Even poor fitting shoes and hammertoe deformity can lead to keratomas.


Non-surgical treatment for keratomas include

  • Trimming and padding the keratoma for temporary pain relief.
  • You could also use metatarsal bars and orthotics to redistribute body weight from the misaligned metatarsal bones to the other foot parts.
  • Even a strapping or tape applied to the foot is effective in providing some relief from pain.
  • Moisturizing lotions and creams help soften the IPK and reduce its pain. Some creams also have mild lactic acid that helps remove callus tissue.
  • It is possible to permanently remove keratomas using a chemical called Cantharone. While this chemical is painless while applying to the foot, it causes a blister that can hurt for a few days. If required, painkillers like Tylenol can be taken for the pain and nothing more than a band aid is required for the blister.


Lasers are also used to remove the IPK where the only pain you experience is the pain of the anesthesia shot under the IPK.

Another option is paring of callus tissue wherein the central core of the lesion is removed.

In case a deformed bone is the cause for the problem, then surgical treatment is the best treatment choice. Once the deformities are taken care of, there will be no chance of keratomas occurring.

After surgery

It is important to wear the right shoes after surgery or any other treatment option to prevent the recurrence of IPK. Wear shoes with sufficient toe box space and with a reasonable heel height.

If required, wear custom orthotics to provide support to the foot. It is always better to have periodic follow-up sessions with your doctor to check any recurrence of IPK or the presence of any transfer lesions.

Other Podiatry Conditions Treated

Quarterly NewsletterGet Adobe Acrobat Reader Start your foot health today Search our products
Click here and educate yourself today!
Here you will find invaluable information on common foot problems and how to begin immediately on the path to recovery.