What to expect from topical antibiotic therapy for pitted keratolysis

Pitted keratolysis affects the thick skin of the soles and can cause small pits, tenderness, and a strong odour when feet stay damp. A prescribed topical antibiotic targets bacteria at the skin surface. Odour and moisture may improve before every pit has disappeared, so early improvement does not necessarily mean treatment should stop.

The medicine is meant for the diagnosed area and may irritate skin if overused. It does not replace measures that limit sweating and damp footwear.

Wash and dry the soles carefully, especially between the toes, before applying a thin layer. Follow the prescriber’s directions for frequency and duration, and wash your hands afterwards. Change socks when they become damp, rotate shoes so they can dry, and choose breathable footwear when possible.

Avoid sharing towels, socks, or shoes. Do not apply extra medicine to speed recovery, and do not cover the area with an occlusive dressing unless instructed. Record whether odour, soreness, and pits are changing so you can describe the response at follow-up.

Contact the prescribing clinician if burning, swelling, blistering, or a spreading rash develops after application, or if the skin becomes increasingly painful. Arrange a review when symptoms do not begin to settle as expected, return soon after treatment, or interfere with walking.

Seek prompt medical attention for rapidly spreading redness, marked warmth, pus, fever, or feeling unwell. People with diabetes, reduced circulation, or reduced sensation in the feet should seek advice early for a painful or broken area.

Ask which product and application schedule are right for your soles, how long to continue after odour improves, and whether sweating or footwear changes should be added. You can also ask what to do if the treatment causes irritation or if the pits return.