If you’ve noticed a strong foot odour that won’t go away, along with small pits or craters on the soles of your feet, you may be dealing with a common but often overlooked condition called pitted keratolysis.
As podiatrists, we frequently see this condition—especially in people who spend long hours in enclosed footwear. Our team has extensive experience treating common foot skin conditions, so the good news is that it’s very treatable once properly identified.
What Is Pitted Keratolysis?
Pitted keratolysis is a bacterial skin infection that affects the outer layer of the skin on the soles of the feet. It’s caused by bacteria such as Corynebacterium, which thrive in warm, moist environments—think sweaty feet in tight shoes.
Signs and Symptoms
Pitted keratolysis has some distinctive features. Here’s what to look out for:
- Small pits or holes in the skin
You may notice tiny, shallow depressions on the weight-bearing areas of your feet, such as the heels, balls of the feet, or toes. These pits can sometimes merge into larger, crater-like areas. - Strong foot odour
This is often the most noticeable symptom. The bacteria produce sulphur compounds, leading to a persistent, unpleasant smell even after washing. - White, soggy-looking skin
The affected skin may appear pale or whitish, and soft or “macerated” (waterlogged), especially after removing shoes or socks. - Excessive sweating (hyperhidrosis)
People with sweaty feet are more prone to developing pitted keratolysis. - Mild discomfort (occasionally)
While usually painless, some people report slight itching, burning, or tenderness when walking.
What Causes It?
From a podiatry perspective, the root cause is almost always moisture + bacteria.
Common contributing factors include:
- Wearing enclosed or non-breathable shoes for long periods
- Synthetic socks that trap sweat
- Poor foot hygiene
- Excessive sweating
- Occupations requiring boots (e.g., construction, athletes, military)
How Is It Treated?
Treatment is generally straightforward and very effective when followed consistently.
- Topical antibacterial treatments
Your podiatrist may recommend:- Topical antibiotics (e.g., clindamycin or erythromycin creams)
- Antibacterial washes (such as benzoyl peroxide cleansers)
These target the bacteria causing the infection.
- Managing sweat (key to preventing recurrence)
Controlling moisture is essential:
- Use antiperspirants (for feet) containing aluminium chloride
- Apply foot powders to keep skin dry
- Change socks at least once daily (or more if needed)
- Footwear changes
This is one of the most important long-term fixes:- Choose breathable shoes (leather or mesh)
- Rotate shoes daily to let them dry out
- Use moisture-wicking socks (e.g., wool blends)
- Good foot hygiene
Simple habits make a big difference:- Wash feet daily with soap
- Dry thoroughly, especially between toes
- Avoid staying in damp socks or shoes
- In persistent cases
Simple habits make a big difference:- Stronger topical or oral antibiotics may be prescribed
- Assessment and treatment for underlying hyperhidrosis
When Should You See a Podiatrist?
You should seek professional advice if:
- The odour is persistent and embarrassing
- You notice visible pits or skin changes
- Over-the-counter treatments aren’t working
- The condition keeps coming back
Early treatment can prevent worsening symptoms and recurrence. If any of these apply, our team of podiatrists can assess your condition and recommend the right course of treatment.
Final Thoughts
Pitted keratolysis is common, treatable, and nothing to be embarrassed about. With the right combination of antibacterial treatment and moisture control, it usually clears quickly.
If you’re unsure whether what you’re experiencing is pitted keratolysis, a proper assessment can help you get the right treatment sooner rather than later.
Book an appointment online with our team at our Highett or Mentone clinic, or contact us to find a time that suits you.