We are well aware that calluses on the bottom surface of the foot, which are also termed plantar calluses, can become painfully thickened areas of hard skin. This increased pressure on the sole of the foot can sometimes lead to burning pain, especially at the ball of the foot. On a more dangerous scale, these calluses can even crack and form openings in the skin, which can result in infection as a complication. Granted, if the Marlboro man or the Camel has you running for the hills, having calluses does not necessarily mean that one has the body of a smoker. Other causes of plantar calluses include, foot structure (high arch, low arch), irritation from shoes or insoles, or an inflammatory condition of the skin (psoriasis, eczema, etc). The purpose of this article is to inform the reader that lighting up can cause even the most brilliant treatment plans for plantar calluses to turn futile and ineffective.

Smoking a single cigarette can produce vasoconstriction, which is narrowing of the arteries and capillaries, in the tissues underneath the skin for up to 90 minutes. This results in decreased blood flow. The tissue immediately underneath the skin, called subcutaneous tissue, is responsible to cushion and provide shock absorption to the foot. Vasoconstriction of the blood vessels in this area leads to thinning and deterioration of these tissues, which in turn can lead to increased bone to skin contact and callus formation.

Strength is provided to the skin by members of the collagen family. The skin on the bottom surface of the foot needs to have characteristics of both strength and resilience, which is the ability of skin to recoil after transient stretching. This is provided by elastic fibers. Elastic fibers are made up of molecules called elastin. Elastin molecules form a network of fibers in the dermis. These elastin molecules need to form an extensive network because this network determines the capacity of stretching and recoil. Nicotine and cigarette smoking causes damage to elastin, which will cause the plantar skin to become less pliable and this further leads to increased callus formation.

In conclusion, patients should be educated and aware of the relationship between smoking and plantar callus formation not only to benefit the health of their feet, but also to realize the extent of this habit.

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