Do you have small pits or craters on the bottom of your feet?

Pitted keratolysis is a relatively common infection of the skin of the foot that is characterized by multiple pits or holes on the sole of the feet and sometimes the toes. The infection is caused by a bacteria from the Corynebacterium species. This condition is more common where wet shoes or boots are worn for extended periods of time without such as work books or military footwear and excessive sweat is allowed to accumulate. The accumulation of the sweat is the environment that the bacteria can grow in and it is also often accompanied with smelly feet as well. The tiny craters that form as a result of the excessive sweat and bacterial infection appear like tiny holes in the foot, usually on the sole and the skin tends to have a white discolouration. The holes are usually from 1 to 5 mm in diameter and are circular and shallow. Usually both feet are affected. These holes or pits seen in pitted keratolysis are caused by bacteria that secretes enzymes which cause the breakdown of the keratin proteins in the top layer of the affected skin. The breakdown of the skin releases sulphur compounds that cause the foot odour. As these bacteria thrive in the dark, warm and humid environment inside the footwear, this problem will continue until that is dealt with. Pitted keratolysis can have similar characteristics as athlete's foot and hyperhidrosis, so clinicians will do some tests and make some observations to distinguish which of these is the actual cause of the problem.

The approach to the treatment of pitted keratolysis is to deal with the infection and deal with the risk factors that caused it in the first place. The infection is best treated with a topical antibiotic that you can usually get over-the-counter or on prescription from a doctor, depending on how strong the medicine needs to be and how severe the pitted keratolysis is. Oral antibiotics are typically not recommended. The antibiotic generally are helpful but tend not to work too well unless the foot hygiene is addressed and that hostile warm and damp environment that the bacteria likes is taken care of. The feet must be washed at least daily with soap and water and then dried thoroughly afterwards, especially between the toes. Using alcohol wipes will also help dry the feet after bathing After doing so, it is better to stay barefoot as long as possible for a through airing of the feet. Socks that absorb moisture and are changed several times a say will be very helpful in the workplace if boots have to be worn. Antiperspirants that are available from the drug store may also help to keep the feet dry. Once the pitted keratolysis has initially settled down, prevention is very important. The feet will still need to be washed thoroughly and antiperspirants will still need to be used. Moisture absorbing insoles can be worn inside the shoes or boots. Powders in the socks can also be used to help absorb the excessive moisture.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.