They can look similar, but the difference matters enormously. Here's how to tell them apart and what to do about each.
At ASG Foot & Ankle Specialists, one of the most common — and most dangerous — situations we encounter is a patient who has been treating what they thought was a callus, only to discover a pressure sore hiding underneath. This is especially common in diabetic patients, where neuropathy masks pain and allows wounds to develop undetected.
Knowing the difference between a callus and a pressure sore can literally save your foot — or your life.
This is the scenario that keeps podiatrists up at night: a thick callus forms over a pressure point, and beneath it, a pressure ulcer quietly develops. The callus acts as a mask — it hides the wound and, in diabetic patients with neuropathy, eliminates the pain signal that would normally alert you something is wrong.
By the time the callus is removed, the underlying ulcer can be deep, infected, and potentially involving bone (osteomyelitis). This is one of the leading pathways to diabetic foot amputation.
Intact skin with non-blanchable redness. The area may feel warmer, firmer, or softer than surrounding skin. Painful in patients with normal sensation.
Partial thickness skin loss — shallow open wound with a pink/red wound bed, or an intact or ruptured blister. No slough (dead tissue) present.
Full thickness skin loss. Subcutaneous fat may be visible. Slough may be present. Depth varies by location — can be quite deep on the heel or ball of foot.
Full thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar (dead tissue) often present. Osteomyelitis (bone infection) is possible. Requires urgent specialist care.
Diabetic patients should never self-treat calluses. Learn about our specialized diabetic wound care program.
Diabetic Wound Care →Learn the top tips for faster foot wound healing from our expert podiatrists.
Wound Healing Tips →A callus is a thickened, hardened area of skin that is usually painless and yellowish. A pressure sore (pressure ulcer) involves tissue breakdown — it may look like a blister, open wound, or area of discolored skin that doesn't blanch when pressed. Pressure sores are often painful (or painless in diabetics due to neuropathy) and can have a soft, boggy center. If you're unsure, see a podiatrist — a callus hiding a pressure sore underneath is a common and dangerous situation.
Yes — this is one of the most dangerous foot problems we see, especially in diabetic patients. A thick callus can hide a pressure ulcer developing underneath. The callus masks the pain, so patients don't realize there's a wound forming beneath the hardened skin. By the time the callus is removed, the underlying ulcer can be deep and infected. Regular podiatry visits for callus debridement are essential for diabetic patients.
Pressure sore treatment involves removing pressure from the area (offloading), wound debridement, appropriate wound dressings, infection management if needed, and addressing underlying causes like poor circulation or ill-fitting footwear. Diabetic patients with pressure sores need specialized wound care and close monitoring to prevent serious complications.
Our board-certified podiatrists can quickly determine whether you have a callus, a pressure sore, or something more serious — and get you on the right treatment plan. Three locations in the South Chicago suburbs.