Early stage of pitted keratolysis on the feet

Pitted keratolysis is a bacterial infection affecting the thick outer layer of the soles. The small depressions may be easiest to see on the weight-bearing areas, especially when the skin is wet. Odour can be stronger than the visible change because moisture and bacteria interact inside socks and footwear. The skin may feel soft, macerated, or mildly tender, but severe inflammation is not required. The smell can overlap with general [Body Odour](/symptoms/body-odour/), while the pits point toward a surface infection rather than a hygiene failure.

Wash the feet gently, dry carefully between the toes and across the soles, and change socks after sweating. Rotate shoes so each pair can dry fully; breathable footwear may help. Avoid sharing towels or shoes, and do not scrape the pits because damaged skin is easier to irritate. If sweating is a major trigger, a clinician may discuss [Prescription Antiperspirant](/treatments/medical-dermatology/prescription-antiperspirant/). Confirmed infection may need [Topical Antibiotic Therapy](/treatments/medical-dermatology/topical-antibiotic-therapy/), used exactly as directed.

Arrange an examination if odour persists despite careful drying, pits spread, walking becomes uncomfortable, or the diagnosis is uncertain. Seek prompt attention for spreading redness, warmth, swelling, drainage, fever, or a wound in someone with diabetes, reduced sensation, or poor circulation. Fungal infection, eczema, and pressure-related changes can look similar and may need different treatment.

Ask whether the pits fit pitted keratolysis, how to manage sweating, whether shoes need cleaning or replacement, and when improvement should be checked if the odour remains.