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Pitted keratolysis is a foot infection caused by bacteria that thrive in damp environments. It can be treated with topical or oral antibiotics, and prevention involves keeping feet clean and dry, wearing breathable footwear, and using antibacterial soap. Enzymatic cleaners can be used to clean infected shoes, but may damage certain materials.
Pitted keratolysis is a skin infection most commonly seen on the soles of the feet, although it can also appear on the palms. It occurs when damp, wet feet are kept in tight-fitting socks and shoes, as might happen when someone who sweats a lot wears boots most of the time. This condition can be evaluated and treated by a dermatologist who can confirm that it is pitted keratolysis and prescribe medication to treat the infection, as well as make recommendations to avoid a recurrence of the infection in the future.
A number of bacteria may be responsible for pitted keratolysis. The infected skin usually turns white to reddish and develops deep pits around the weight-bearing areas of the foot. The skin may flake or flake and, in extreme cases, it may appear as though a patient has walked on hot coals. Pitted keratolysis is also often accompanied by a strong odor; for people who normally have strong smelling feet, the odor associated with this infection is usually different and more noticeable.
Topical antibiotics can be applied to treat the infection and patients can also take oral medications. During the treatment, the feet should be washed regularly, dried gently and allowed to air. A doctor may recommend that a patient throw out old socks and buy new ones, looking for socks that wick away moisture and allow the feet to breathe. It is also advisable to replace footwear.
Long-term prevention of pitted keratolysis relies on keeping your feet clean and relatively dry. Using a gentle antibacterial soap on your feet can be helpful, as can spending time in bare feet to give your feet a chance to fully air out. Buying footwear that allows your feet to breathe will also prevent future outbreaks.
If a particularly beloved pair of shoes has acquired an unpleasant odor due to a pitted keratolysis infection and the patient cannot replace the shoes or bear to throw them away, the shoes can be cleaned with an enzymatic cleaner. Such cleaners are commonly used to clean wetsuits and scuba gear and are available at dive shops and some shoe stores. However, patients should be aware that the cleaner can damage the finish of the shoes; suede shoes, for example, usually can’t stand the use of an enzymatic cleaner. A shoe store may have cleaning recommendations, or it may be possible to address much of the odor by having the shoe resoled by a cobbler.
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