What to know about pitted keratolysis in athletes

Tiny shallow pits or crater-like depressions may appear on pressure areas of the sole, especially under the toes and heel. The skin can look softened or whitish after training, and a strong foot odour is common. It may itch, sting, or cause tenderness, although some people mainly notice the smell and texture. Repeated sweating, long sessions in boots or trainers, and wearing damp socks can keep the skin moist enough for the bacteria to multiply. This condition is different from a simple hygiene problem and can return if moisture remains.

Arrange a clinician assessment if the pits, odour, or soreness persist. Treatment may include a prescribed antibacterial medicine and measures to dry the skin. Wash the feet, dry carefully between the toes, change socks after exercise, and rotate footwear so it can dry fully. Breathable shoes and moisture-wicking socks may reduce dampness. Avoid sharing towels, socks, or shoes, and do not scrape the pits or apply harsh household chemicals. Follow the prescribed course even if the smell improves quickly.

Seek prompt medical advice if redness spreads, swelling develops, walking becomes painful, or the foot feels hot and increasingly tender. Pus, fever, red streaks, or feeling unwell may indicate a more serious infection and need urgent assessment. Diabetes, reduced circulation, nerve problems, or a weakened immune system lower the threshold for contacting a clinician. If treatment does not improve the pits or odour, the diagnosis may need checking and another cause considered.

Could these pits be pitted keratolysis or another foot condition? Which treatment is suitable for my training schedule? How should I clean and dry my shoes? When can I return to shared changing rooms or sport? What signs would mean I should come back sooner?