What are the treatment options for pitted keratolysis?

Pitted keratolysis affects the outer skin of the soles and can produce small pits, softened skin, and a strong odour. Warm, damp, enclosed footwear creates conditions in which the responsible bacteria thrive. A clinician can distinguish it from fungal infection, eczema, warts, or pressure-related changes.

Topical antibiotic therapy reduces bacteria on the affected skin. Prescription antiperspirant can reduce sweating and help make recurrence less likely when excess moisture is a major contributor. The product should be used exactly as directed because irritated or cracked soles may react to treatment.

Wash and dry your feet carefully, including between the toes. Change socks when damp, rotate shoes so they can dry, and choose breathable footwear when possible. Avoid sharing towels, socks, or shoes, and keep footwear clean according to its care instructions.

Use the prescribed antibiotic for the full instructed course and apply it only to the intended skin. If sweating continues, ask whether a prescription antiperspirant is suitable and how to apply it without causing excessive irritation. Do not scrape the pits or use harsh acids on the soles.

Arrange review if the odour or pits persist after treatment, return repeatedly, or spread beyond the soles. Seek prompt care for increasing warmth, swelling, pain, pus, red streaks, or fever, particularly if you have diabetes, poor circulation, or reduced sensation in your feet. Burning or a rash after medicine also needs advice.

Does this look like pitted keratolysis rather than a fungal infection? Which topical antibiotic should I use, and for how long? Would a prescription antiperspirant help my sweating, and how can I prevent irritation?