Pitted keratolysis in the hands

Small depressions on the palms or fingers can follow repeated wet work, sweating, friction, or contact with gloves. However, hand skin can also develop pits or erosions from eczema, irritation, infection, or other conditions. Burning, peeling, tenderness, cracks, or a noticeable smell can provide useful clues, but the appearance alone is not enough to identify the cause.

Because classic pitted keratolysis most often affects the feet, a clinician should inspect the hands and ask about work, sport, glove use, and exposure to water or chemicals. Avoid borrowing foot treatments for hand lesions without advice, especially if the skin is broken.

Rinse off irritants, dry the hands thoroughly, and replace damp gloves. Use protective gloves suited to the task, with breaks that allow the skin to dry, and apply a bland moisturiser if the skin is dry or cracked unless a clinician has advised otherwise. Do not pick at pits or apply strong antiseptics repeatedly, as this can worsen irritation.

A healthcare professional may recommend a targeted treatment after examination. If sweating is central, ask about [Prescription Antiperspirant](/treatments/medical-dermatology/prescription-antiperspirant/); [Topical Antibiotic Therapy](/treatments/medical-dermatology/topical-antibiotic-therapy/) may be relevant when a bacterial infection is confirmed. Persistent smell is discussed under [Body Odour](/symptoms/body-odour/).

Arrange prompt assessment for spreading redness, warmth, swelling, pus, severe pain, fever, or reduced movement. Seek review when hand pits persist after irritants are removed or when cracks keep reopening. A clinician can decide whether testing or a different treatment is needed.

Could this be pitted keratolysis, hand eczema, or contact irritation? What exposures should I avoid, and which product is safe on my hands? Should my feet or footwear also be checked?