Pitted keratolysis is a common skin condition primarily affecting the feet, characterized by small, crater-like pits on the skin’s surface. This bacterial infection can cause an unpleasant odor. This article explores whether pitted keratolysis poses a danger and outlines effective management strategies.
What Pitted Keratolysis Looks Like
Pitted keratolysis presents as numerous small, circular indentations on the soles of the feet, particularly on weight-bearing areas like the heels and balls of the feet. These pits, usually 1 to 7 millimeters in diameter, can sometimes merge to form larger, crater-like lesions. The affected skin may also appear white or macerated, especially when wet.
A distinctive symptom is a strong, foul odor emanating from the feet, which results from sulfur compounds produced by the bacteria. While the condition mainly affects the feet, it can also appear on the palms of the hands.
Is Pitted Keratolysis Harmful?
Pitted keratolysis is not considered dangerous or life-threatening. It is a superficial bacterial infection that affects only the outermost layer of the skin and does not lead to serious health complications. The primary concerns associated with this condition are cosmetic issues, discomfort, and the characteristic unpleasant odor.
While it can cause itchiness, soreness, or a burning sensation, especially when pressure is applied to the foot, many individuals experience no physical discomfort beyond the odor. It is a treatable condition, and its impact is largely related to social embarrassment due to the odor rather than a threat to overall health.
Why Pitted Keratolysis Develops
Pitted keratolysis arises from the overgrowth of specific bacteria, most commonly Kytococcus sedentarius, Corynebacterium species, Dermatophilus congolensis, and Actinomyces. These bacteria thrive in warm, moist environments, which is why the condition frequently affects the feet. The bacteria produce enzymes that break down the keratin protein in the skin’s outer layer, leading to the formation of the characteristic pits.
Several factors contribute to this environment. Excessive sweating, also known as hyperhidrosis, significantly increases the risk. Wearing occlusive footwear, such as closed-toe shoes or boots that limit airflow, traps moisture and heat, encouraging bacterial growth. Poor foot hygiene, including not drying feet thoroughly or frequently changing socks, can also contribute to its development.
Addressing Pitted Keratolysis
Effective management of pitted keratolysis involves a two-pronged approach: maintaining a dry foot environment and eliminating the bacterial infection. Keeping feet dry is crucial and can be achieved by wearing moisture-wicking socks, changing socks frequently, and choosing breathable footwear like leather or canvas. Rotating shoes daily allows them to dry completely between uses. Daily washing of the feet with antibacterial soap and thoroughly drying them, especially between the toes, also helps.
Topical treatments are the first-line medical approach for addressing the bacterial overgrowth. Healthcare providers often prescribe topical antibiotics such as clindamycin, erythromycin, mupirocin, or fusidic acid. Benzoyl peroxide gel or cream is another effective option. For individuals with excessive sweating, antiperspirants containing aluminum chloride can help reduce moisture and prevent recurrence. Consistent adherence to these measures is important for successful treatment, which clears the condition within 3 to 4 weeks.
When Professional Help is Needed
While many cases of pitted keratolysis respond to diligent self-care and over-the-counter antiperspirants, there are instances when consulting a healthcare professional is advisable. If symptoms persist or worsen despite consistent home care, a doctor or podiatrist can provide a definitive diagnosis and prescribe stronger topical antibiotics.
Medical attention is also recommended if severe pain, inflammation, or spreading lesions develop, as these could indicate a more complex issue. Individuals with underlying health conditions, such as diabetes or compromised immune systems, should seek professional guidance promptly due to their increased susceptibility to foot issues.