Have you wondered how to remove hard skin and what causes it in the first place? Hard areas of skin are fairly common - from the callused hands and feet of athletes to thick and cracked heels as we age - skin can become hard for many reasons. The common feature of all causes of hard skin is that the dead skin cell layer is thick, dense and hardens. It is called hyperkeratosis and hyperkeratotic hard skin can crack and become painful.
The medical name for hard skin is hyperkeratosis.
I'm going to explain the causes of hard skin and share dermatologist's tips for keeping your skin soft and preventing hard skin from forming.
What is hard skin aka hyperkeratosis?
Areas of hard skin care caused by a buildup of excess dead skin cells that have become compacted and thick. Some forms of hard skin are limited entirely to the dead skin cell layer of the epidermis, which is called the stratum corneum. Others also involve thickening of the living epidermal layer of squamous and basal cells that are then covered by excessive hardened and thick dead cells. This is important to understand when it comes to your expectations for getting rid of hard skin. It's easier to get rid of the stratum corneum dead cells than it is to soften and get rid of thickened cells in the living squamous and basal cell layers.
What are the 5 most common causes of hard skin?
- The most common example of hard skin is a callus. A callus is a thickening of the dead cell stratum corneum layer.
- Warts can lead to hard skin. These are due to a viral infection of skin from the human papillomavirus that also thickens the living epidermal cell layer under the stratum corneum.
- Elbow and knee skin can become thick and dark and has been described as frictional asymptomatic darkening of the extensor surfaces. It can run in families. The skin of elbows and knees is always thicker but when the dead cell layer becomes excessively thickened and callused the skin becomes hard. Friction typically plays a role.
Seborrheic keratosis, a type of age spots, are warty growths that can form hard crusty skin. We don't know what causes these growths of hard skin but they are structured like a wart with thickening of both the epidermal and stratum corneum dead cell layer. These growths are often brown and scaly.
- Prurigo nodules, also called picker's nodules, are areas of hard skin due to long term scratching of a small area of skin. These nodules become intensely itchy, leading to more scratching and more hard skin buildup. Prurigo nodules involve a thickening of both the epidermis and dead cell layer and are often a brawny reddish color.
What are the types of hard skin on the feet?
The bottoms of your feet are particularly prone to develop hard skin. This can happen from callouses secondary to repetitive rubbing against your shoes, thick heels from both friction and skin aging, corns and warts.
1. Calluses on the feet
Hard skin from foot callus can be protective and help prevent a friction blister. When they get too large, they become painful and crack. The large toe and the ball of the foot are particularly prone to painful frictional calluses.
2. Thickened heel skin
The skin on your heels can become hard and thick, leading to cracks and painful fissures. It happens from both friction and the aging process. Women after menopause are particularly prone and the condition at this time of life is called keratoderma climactericum.
3. Plantar warts
Warts are another type of hard skin that commonly happen on the feet. These are caused by a viral infection of the skin and can be contagious to other areas of your sole. The wart virus is called the human papillomavirus and there are over 100 types to date. Warts on the soles (and palms) are called palmoplantar warts. They are caused by a small subset of the large human papillomavirus family.
4. Hard and soft corns
Corns are a form of hard skin on the foot that happens from weight bearing against a bony defect. You become more prone to corns with age as the bones in your feet shift into new positions, often aggravated by poorly fitting footwear that put abnormal pressure on the skin. Corns typically form on the ball of the foot, the top of the toes. When they form between the toes, the skin is sweatier and moist making the corn softer. These corns are called 'soft corns'. Soft corns are still painful. The hard skin of all corns ultimately grows inward to form a 'corn' that jabs into your foot and that can be very painful.
Why is it important to remove hard skin?
Hard skin can build up to the point where it is painful. Your skin can't keep this thickened hyperkeratosis soft and the hard skin is prone to crack, fissure and even become infected. Putting pressure on hard skin usually hurts, whether it is a wart, callus or corn.
How to get rid of hard skin?
It's important to soften and exfoliate the dead skin cells of hard skin to prevent cracking and discomfort. This has to be done gradually once the hard skin has built up. The method used depends on the cause and location of the hard skin.
To help the dead skin cells to slough, we use skin care products with keratolytic ingredients to soften and prepare the skin for exfoliation. Keratolytics are ingredients that break apart the connections between the dead cells so that they can shed naturally. The process can be sped up with physical exfoliation using either a shower cloth or sponge, or a pumice or file, depending on the location of the problem.
Keratolytic ingredients for hard skin
The most commonly used keratolytics in dermatology include salicylic acid (a BHA), glycolic acid and lactic acid (AHAs). Medical grade AHA and BHA products are the best home remedy products for getting rid of hard skin. Salicylic acid is typically what is used in wart and corn treatment products. Glycolic acid is the best keratolytic ingredient overall to treat hard skin because it penetrates skin well and is a powerful keratolytic. You can speed the process by using an exfoliating shower sponge or cloth on your body and/or pumice or foot file on your feet to reduce the buildup of dead cells.
The best home remedy for hard skin is to apply a medical-grade glycolic acid cream after each bath or shower and to exfoliate the skin at the first sign of hard skin buildup. - Dermatologist Dr. Bailey
How to get rid of hard skin on your feet
I depend on the routine in my Soft and Smooth Feet Kit. I've combined medical grade glycolic acid with a really great pumice stone and a foot file. This kit helps control calluses and rough cracked heels. My instructions are as follows:
Step 1: First soak your foot in warm water for 10 minutes. Then gently rub the pumice stone over the areas of hard skin. Be careful not to exfoliate too deeply and injure the living skin beneath. Also, diabetics and people with peripheral neuropathy should consult their physician before filing areas like the feet.
Step 2: Apply the Glycolic Acid Body Lotion after filing to continue softening and treating the area until the hard skin is controlled. Cover your feet with sox so that your feet are not slippery.
Repeat this as needed until your skin is soft and the hard skin is gone.
How to get rid of hard skin on your arms, legs or body
I combine the medical-grade Glycolic Acid Body Lotion with exfoliation with a shower cloth and an AHA/BHA skin cleanser for hard skin on the body. The routine is in my Ultra-Fast Body Smoothing Kit.
To treat hard skin from warts, corns and stubborn age spots, I recommend you see your doctor.
How to get rid of hard skin calluses on your hands
Remember that calluses are protective. People who work and play hard with their hands often get calluses to protect hand skin from friction blisters due to repetitive use - think musicians, carpenters, athletes etc. You don't want to remove the entire hand callus if you need it but you can control its size to help keep it from becoming painful.
My Dry Skin Hand Repair Kit comes with the best hand lotion to soften hand skin, Bag Balm and gloves for intensive nighttime skin softening and the perfect finger file to exfoliate the callus and control its size. If needed, you can also use the Glycolic Acid Body Lotion after showers to harness its keratolytic properties for efficient callus exfoliation with the file.
How do you prevent hard skin?
Prevent hard skin by regularly applying a medical-grade glycolic acid cream after your bath or shower. Use the cream where you are prone to getting hard skin. Always apply the cream within 3 minutes after toweling skin dry for best results. When moisturizing your feet, always wear sox to prevent slipping! Exfoliate the area as needed to prevent hard skin buildup.
The skin care routines in my two kits above are highly effective for removing hard skin on the body and feet when used at least twice a week.
On the days that you are not using the keratolytic and exfoliation skin care routine, I recommend using creams and ointments that contain skin softening ingredients. These include lanolin, urea and oils.
Skin softening creams for hard skin
Urea is a skin softening ingredient that can also be helpful. In high concentrations (over 30%), such as wart and corn medicines, it is also a keratolytic.
Lanolin is another great ingredient to soften hard skin. Time-honored Bag Balm Ointment contains lanolin and is excellent to soften hard skin and prevent cracking. It is important to know that it is possible to develop an allergic skin rash to lanolin.
The botanical oils found in body butters are excellent skin softening ingredients. My Natural Body Butter Cream is rich in avocado oil and shea butter to help keep skin soft and supple. It can be used from head to toe.
When do you need to see a doctor for hard skin?
See a doctor if the hard skin won’t soften and resolve, if it fissures, and/or if it keeps growing; skin growths, including skin cancer, can mimic hard skin from callouses, age spots, warts or prurigo nodules. Athlete’s foot, psoriasis and other treatable skin rashes can also lead to the development of hard skin. A doctor can help make a correct diagnosis if your hard skin fails to improve. Corn and wart care is best directed by your doctor.
Al Aboud AM, Nigam PK. Wart. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431047/
Yousef H, Alhajj M, Sharma S. Anatomy, Skin (Integument), Epidermis. [Updated 2021 Nov 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470464/
Piquero-Casals, J., Morgado-Carrasco, D., Granger, C. et al. Urea in Dermatology: A Review of its Emollient, Moisturizing, Keratolytic, Skin Barrier Enhancing and Antimicrobial Properties. Dermatol Ther (Heidelb) 11, 1905–1915 (2021). https://doi.org/10.1007/s13555-021-00611-y
Author: Dr. Cynthia Bailey M.D. is a Board Certified dermatologist practicing dermatology since 1987. She has done well over 200,000 skin exams during her career and authors the longest running physician written skin health blog in the world.