When it comes to bacterial skin infections, Pitted Keratolysis is a gram positive bacteria caused by the Micrococcus sedentarius. Pitted Keratolysis usually affects the soles of the feet and occasionally the palms of the hands. It is most common in people who wear tight-fitting shoes or those who exercise a lot, which makes their feet sweat. Other people who get it may just have excessive sweating of the feet. It can make the feet have a very foul odor, which may be embarrassing to some.

Pitted Keratolysis causes a white pitting-like appearance on the souls of the feet. They may even look like craters on the feet. This most commonly affects the areas of the feet that bear most of the weight, such as the heel or the forefoot, but can be found on other areas of the feet.

Treatment

Pitted Keratolysis is treated fairly easily with the use of topical antibiotics or an oral antibiotic such as erythromycin. These can be prescribed by your doctor. He may also prescribe an antiperspirant containing aluminum chloride. In the most severe cases, your doctor may give you injections of botulinum toxin. These can be painful since they inject the BOTOX® medication into the affected areas. Some treatments may take up to four weeks to completely resolve the problem, but you should have some relief within a week or so.

Prevention

There are ways to prevent developing Pitted Keratolysis. The best way to prevent developing an infection is to change your socks frequently if your feet sweat excessively. Keeping wet socks on can cause the bacteria to grow and cause the infection. Trying wool socks may also be an option since they will draw the moisture away from the foot. Another way to prevent developing Pitted Keratolysis is to avoid wearing shoes that are tight and confining to the feet or wear a different pair of shoes every other day. You may even try placing antifungal foot powder in the bottom of your shoes. This can help with killing the bacteria and keeping the feet dry. 

Wearing loose shoes will allow the feet to breathe easier. If it is not an option to wear different shoes make sure that when you are at home or even driving in the car take your shoes off and allow your feet to breathe. If these options do not work for you, try applying an antiperspirant to the bottom of your feet. This should help to reduce some of the sweating your feet may produce. If none of these options work for you, talk to your doctor about botulinum toxic injections. These injections may need to be repeated every few months since they are not permanent.

If you think you have developed Pitted Keratolysis talk to your doctor to determine a correct diagnosis. He will help find the best treatment for you and give you ideas on how to prevent it from coming back.