What should you know about pitted keratolysis antibiotics?

Pitted keratolysis is a bacterial infection of the thick skin on the soles. Bacteria can break down surface keratin, leaving small crater-like pits, softened areas, and a noticeable odour. A clinician may prescribe a topical antibiotic therapy to reduce the bacterial load. The choice depends on the examination and whether another condition, such as athlete’s foot, is also present. Antibiotics do not correct ongoing sweating or damp footwear by themselves.

Use the prescribed product exactly as directed and complete the advised course unless the prescriber changes the plan. Keep feet clean and thoroughly dry, change socks when damp, and allow shoes to air out between uses. Avoid sharing footwear or towels. If sweating is a major contributor, ask about prescription antiperspirant. Do not apply someone else’s antibiotic or continue a leftover product, because the diagnosis may be wrong and irritation can complicate the picture.

Contact the prescriber if pits, odour, soreness, or softened skin are not improving as expected, or if treatment causes a new rash or marked irritation. Seek urgent care for rapidly spreading redness, severe pain, swelling, pus, fever, or red streaking. A foot problem deserves earlier review when diabetes, circulation problems, or reduced sensation make unnoticed injury more likely.

Ask how the diagnosis was made, which antibiotic is being prescribed and for how long, how to apply it, and what improvement should look like. Discuss whether moisture control or prescription antiperspirant is needed and whether scaling suggests a second infection.