Tailor's Bunion (Bunionette)

Quick answer

A tailor’s bunion is the lateral cousin of a regular bunion — a bony bump at the base of the pinky toe, on the outside of the foot. The name comes from tailors who historically sat cross-legged with the outside of their feet on the floor, irritating the area. Mostly a footwear and pressure problem; surgery is reserved for cases that limit daily life.

How to recognize one

• A bony bump on the outside of the foot at the base of the pinky toe
• Often a callus over the bump where it rubs the shoe
• Pain that’s worse with narrow shoes
• The pinky toe may angle toward the fourth toe over time
• Sometimes redness and swelling around the bump

Why it forms

The fifth metatarsal head (the bone behind the pinky toe) drifts outward, the pinky toe drifts inward, and a prominence develops where the bone now sticks out. The drivers:

• Inherited foot shape — often the strongest factor
• Years in narrow shoes that compress the forefoot
• High heels — push the front of the foot into a narrow toe box
• Foot mechanics — wide forefoot, splayed metatarsals
• Aging — collagen and ligament changes allow more drift

There are three anatomical types based on what specifically is bony — useful for your podiatrist if surgery is being considered.

What to do about it

Conservative care (works for most people)

• Wider shoes — soft uppers, roomy toe box. The single most impactful change.
• Avoid narrow / pointed / high heel shoes for daily wear
• Bunionette pads — donut-shaped padding to offload the bump
• Silicone sleeves over the toe to reduce friction
• Ice and NSAIDs for flare-ups
• Custom orthotics in some cases to redistribute pressure
• Address the callus — gentle filing after soaking, but no aggressive removal

Surgery — when conservative care isn’t enough

Several procedures exist depending on which bony deformity is dominant:

• Bone shave (exostectomy) — removes just the bump
• Osteotomy — cuts and repositions the fifth metatarsal
• Distal vs. proximal osteotomy — depending on where the deformity is

Recovery is typically 6–8 weeks, with a stiff post-op shoe and limited weight-bearing initially. Outcomes are generally good for the right candidate.

When to see a clinician

• Pain that limits walking or shoe choice
• Recurring callus or skin breakdown over the bump
• Visible deformity that’s getting worse
• Conservative measures haven’t helped after 2–3 months
• You have diabetes — even minor friction warrants closer attention

Bottom line

A small bunionette without symptoms doesn’t need treatment. If it’s painful or limiting your shoes, start with footwear changes — most people improve significantly. Surgery is a real option for stubborn cases but isn’t first-line.