Over-the-counter treatment for pitted keratolysis

Pitted keratolysis is a bacterial infection affecting the thick skin of the soles, especially pressure areas. Tiny shallow pits may cluster on the ball of the foot or heel, with a strong odour and sometimes a soggy or tender surface. Warm, damp footwear and heavy sweating allow the problem to continue.

Foot odour alone does not confirm pitted keratolysis. Athlete's foot, eczema, contact irritation, and other conditions can also alter the skin or smell. A clinician can check the pits and choose treatment that fits the finding.

Wash the feet, dry carefully between the toes and across the soles, and change socks when damp. Rotate shoes so they can dry fully, choose breathable footwear, and avoid sharing towels or shoes. A pharmacy antiperspirant may help reduce sweating when used as directed on intact skin; stop if it burns or causes a rash.

Do not cover wet, macerated skin with thick occlusive products. Over-the-counter antiseptics are not a substitute for assessment if pits persist. A clinician may prescribe topical antibiotic therapy when bacterial infection is suspected, and may address excessive sweating with a prescription antiperspirant.

Arrange a review if odour or pits continue despite careful drying, if the area becomes painful, cracked, swollen, or draining, or if the infection keeps returning. Seek prompt help for spreading redness, fever, marked swelling, or difficulty walking. People with diabetes, poor circulation, or reduced immunity should obtain advice early for foot changes.

Ask whether the pits are pitted keratolysis, whether a topical antibiotic is needed, how to manage sweating safely, and which footwear or sock changes would help prevent recurrence.