Understanding Pitted Keratolysis: Causes, Symptoms, and Treatment

Pitted keratolysis is a dermatological condition that affects the skin, particularly the soles of the feet and, less commonly, the palms of the hands. While not typically harmful, it can be bothersome and affect one's quality of life. In this blog, we'll delve into the causes, symptoms, and treatment options for pitted keratolysis.

What is Pitted Keratolysis?

Pitted keratolysis is a bacterial infection of the skin characterised by small pits or cavities that develop on the affected area. These pits are usually found on weight-bearing areas of the feet, such as the heels and soles. The condition is caused by the overgrowth of certain bacteria, particularly Corynebacterium species, which thrive in warm, moist environments.

Causes of Pitted Keratolysis:

Several factors can contribute to the development of pitted keratolysis, including:

• Warm and humid environments: Pitted keratolysis is more common in individuals who frequently wear closed shoes, especially if their feet sweat excessively.
• Occlusive footwear: Tight or poorly ventilated shoes can create an environment conducive to bacterial growth.
• Hyperhidrosis: Excessive sweating can create a moist environment that encourages bacterial overgrowth.
• Poor foot hygiene: Inadequate washing and drying of the feet can contribute to bacterial proliferation.
• Immunocompromised state: Individuals with weakened immune systems may be more susceptible to bacterial infections, including pitted keratolysis. 

Symptoms of Pitted Keratolysis:

The most common symptoms of pitted keratolysis include:

• Small pits or depressions on the soles of the feet, which may vary in size and depth.
• Foul odour, often described as a cheesy or unpleasant smell.
• Whitish or greyish appearance of the affected skin.
• Itching or discomfort in the affected area.
• Cracking or scaling of the skin, especially around the pits.

Treatment of Pitted Keratolysis:

The treatment of pitted keratolysis typically involves addressing the underlying bacterial overgrowth and improving foot hygiene. Here are some common treatment options:

• Topical antibiotics: Antibacterial creams or gels, may be prescribed to reduce bacterial colonisation on the skin.
• Antiperspirants: Aluminium chloride-based antiperspirants can help reduce excessive sweating, thereby creating a less favourable environment for bacterial growth.
• Proper foot hygiene: Regular washing and thorough drying of the feet, especially between the toes, can help prevent bacterial overgrowth.
• Wear breathable footwear: Opt for shoes made of breathable materials, such as leather or mesh, and avoid wearing tight or occlusive footwear for extended periods.
• Use of antibacterial soaps: Washing the feet with antibacterial soaps can help reduce bacterial load on the skin.
• Foot powders: Applying absorbent foot powders can help keep the feet dry and minimise sweating.

In severe cases or those that do not respond to conservative measures, a dermatologist may recommend additional treatments such as oral antibiotics or topical keratolytic agents to remove thickened skin.

Conclusion:

Pitted keratolysis is a common dermatological condition characterised by small pits or depressions on the soles of the feet. While it is not usually harmful, it can cause discomfort and embarrassment due to its unpleasant odour. Fortunately, with proper foot hygiene and treatment, the symptoms of pitted keratolysis can be effectively managed. If you suspect you have pitted keratolysis, contact us at Foot Corner and see one of our qualified podiatrists for an accurate diagnosis and treatment plan.

We look forward to assisting you on your journey to optimal skin health.

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