Treatment for Pitted Keratolysis

Pitted keratolysis often exhibits spontaneous episodes of exacerbations and remissions, and the condition can last for many years if left untreated. Effective treatment of this disorder requires the removal of the moist and warm environment that promotes the growth of bacteria.

Pitted keratolysis treatment is generally quite simple and straight forward. The initial step is of course to treat any co-existing excessive sweating in the palms or soles, also called palmoplantar hyperhidrosis. Sometimes such common sense steps as thorough foot drying and ventilation are enough to clear up the infection. In most cases, a course of topical fusidic acid ointment over two to three weeks is sufficient to clear up the condition. In recurrent or severe cases, a two-week course of oral erythromycin or azithromycin should clear up even the most stubborn lesions completely. Topical clotrimazole is also commonly used to eradicate pitted keratolysis.

An over the counter pitting keratolysis remedy many sufferers swear by is applying acne medication containing 10 percent benzoyl peroxide to the area of infection.

Your health care provider may also recommend a prescription-strength antiperspirant containing aluminum chloride to address any excessive sweating issues. In rare and severe cases of this disease, your physician may suggestion treatment with injections of botulinum toxin.

Did your health care provider prescribe something different? Let us know in the comments!


- Comments -

  • Becky johndon

    I am 37 & have had this since I was 15-I just didn’t know what it was. Went to podiatrist.She prescribed topical clindomycin gel 1%,Hypercare brand 20% FATaluminum chloride hexahydrste solution for the hyperhidrosis on my feet-nystatin for fungal involvement (she wanted to prescribe something else but insurance wouldn’t pay, & she prescribed oral eurythromycin, but YET AGAIN, the insurance refused & instead I took Ciproflaxin for 10 days. Well, because I am applying clyndomicin every day and it is killing most of the bacteria, the horrible smell is almost completely gone, and I’ve been using the Hypercare nightly for a month–I seem to nONeed to keep using it every day.put on at night & cover w socks-well my feet barely sweat at all anymore. My socks used to reek at the end of the day (& my shoes) but they r completely dry at the end of the day. Great, right? Well, NO bc I’ve been doing this for o ctetbahet ,ver two months & tha weee underlying Pitted Keratylosis has NOT gone away. The second I stop the topical antibiotics the bacteria is going to flower again & the stench will be back- plus the PK looks Gross. What else can my podiatrist & I try? She was even mystified that it was refusing to go away-standard & even aggressive treatment & it is NOT working. Help? Ideas? Experiences? Desperate here…

    • Darin Williams

      I had an episode of this. I put it off for some time. I cured it in 72 hrs. Given that it is a bacterial infection, I soaked my feet until they were “pruny” in original listerine, followed by 10% benzoyl peroxide. I also used a small heater to dry my feet thereafter to dry my feet. I have researched the issue extensively, this worked quickly and easily. Wanted to share the info.

      • jackie

        after soaking in Listerine you soak in peroxide? just want to make sure I do this right

        • Michael Clapton

          For over 10 years I have battled with the dreaded pitted disease. Over the years I met with numerous GP doctors and none of the medication or cream ever worked. Having been a regular visitor on this site, I also tried all of the home treatments, changed my shoes every day, wore wool socks, dried my feet with a hair dryer etc. You name it, I tried it! And still no major improvements…..

          Then I logged on again, and somebody suggested fusidic acid cream.

          Honestly, this cream has changed my life!

          Smell cleared within 5 days and my feet human looking within 10 days.

          In the UK this is a prescribed cream and you will need to tell your GP that this is what you want. Don’t let them go down another path if it is the dreaded pitted you have.

          Apply 3 times a day and see the difference. Life changing.

          Thank you to whoever suggested this cream!!!!!

          • Jo

            Do you know what the cream was called? I’m in the U.S. For work an wondering if I can get some over the counter as getting miffed at being fobbed off by doctors in the UK telling me it’s fine!!

  • Findlay

    I have this problem and the doctor gave me permi tabs ( potassium permanganate PB) the dont seem to be working. Is there any home remidies? I have used 2 tea bags in a tub of water to keep the smell away. The acid in the tea keeps the smell away.

    • Sue

      Try mixing Apple cider vinegar and green mouthwash and soak your feet in there everynight. Your feet will look like shrek but it really works.

  • Nelida

    My son get this Pitted Keratolysis in Cuba when he was 9 years old. It was cured with acyclovir cream and the injuries disappeared for 5 years(well I’m not sure now but I can confirm later) Now he start with the smell and having this injuries again. I will try clindamycin and cleaning the area with some acne medication. If you know anything better, please let me know. thanks for your story.

  • andy

    I i have had this condition for 30 years finally doctor referred me to a dermatologist who recommended potassium permanganate crystals a few of the crystals in a bowl of water to get a rose wine colour … soak your feet for a bout 15 mins every other day to begin then every other week allow your feet to air dry before putting socks back on or walking … beware the stuff stains so be careful with carpets etc .. got to say it really works well no more problems .. they use it in the army for soldiers with sweaty feet

    • Jane

      Hi Andy, did it go away completely after this treatment? I’ve also had it for almost 30 yrs – done peeling solution, drysol, benzoyl/clinda creams and only found temporarily releaf. Is this a natural treatment?

  • Applied and tested treatment: Apply [tea tree oil]-(not to be confused with tea oil) to the affected area. I have done so and watched my mild form of this fungus disappear. Forget soaking feet in vinegar and tea and all that stuff (which I found to be pretty intrusive of my time and space), although you could still do that also, as I used all forms as well as applying the [TEA-TREE OIL]. Apply once every morning after shower and dried feet and again at night after shower for bed. Also wear cotton socks and stay away from polyester…Good LUCK! Now all i have left is to find how to remove a wart from my toe and I’m all cool. Any suggestions?

    Hello All. I had this [Pitted Keratolysis] condition unknown to me for quite some time(a year?) until one day when my mum was visiting and we were over by a friend where I took my shoes off. She pointed out to me that my feet stunk really bad. I knew that my feet stunk for some time but didn’t know it was to some abnormal level until it was further pointed out to me. there I took my socks off and discovered that my toes were abnormally sweaty and a bad odor emitted from them. I further looked and saw what is now known to me as Keratolysis. I have tried applying stuff such as [Lamsil] (which treats athletes foot) as well as periodically soaking my feet in hot water along with stuff added to that water…I really didn’t like soaking because it took so much preparation, time and space which had to be done daily. The Lamsil seemed to work but i carried on applying it for months and no change! then I finally said this was not working so well, and did further research and found [Tea tree oil](not to be confused with tea oil) to be very effective! try it, it worked for me!

    • Daniel

      I’m going to try the tea-tree oil for sure. For wart removal, if its in a fairly east to get at location, the best thing I’ve ever found was the grey or silver duct/duck tape. Just wrap the area with the wart really well so that the tape won’t come off and leave it there for a week or so. Important thing is to not remove it or quickly reapply it if it comes off. I got rid of two warts with duct tape after trying various pharmacy treatments. Works like magic. The surrounding skin will be in pretty rough shape when the tape comes off, waterlogged and soggy, but the wart will just fall right off when the tape has been on long enough. At least a week, maybe two if you can keep it up, and the wart will just shrivel and fall off.

    • Sue

      Try using what is called a wart stick. You can buy it from Amazon also use Thuja oil that should take care of your wart. It can all be bought at Amazon

  • Twisty

    I’ve had this for years and have finally figured out what it is. This weekend I began treating my feet with the 10% benzoyl peroxide acne cream, but I’m having an issue. the infected areas have become overly tender and it’s now painful to walk. It doesn’t matter what kind of shoes I’m wearing, whether I wear socks, or if I’m barefoot. Any pressure placed on the pitted areas causes pain. Is this normal? I can’t find any information to help relieve my pain.

    • Twisty

      Well, doesn’t matter now. I have a coworker going to school for nursing and she’s seen PK before. She looked at my feet and told me I needed to go to the doctor. She said the infection was deep under the skin and that I needed an oral antibiotic. I’m now on Amoxicillin for 7 days and mupirocin ointment 2-3 times a day until empty. we’ll see how it goes. He’d never heard of it before and wanted to say it looked like a weird case of plantar warts but when I showed him pictures of PK, he agreed with my coworker’s assessment.

      • brian

        I used to have it as bad as you where it hurt to walk sometimes. I just went to the dermatologist and they prescribed me a topical treatment i put on 2 times a day and it cleared up within a month. i forget the name of the prescription. I believe it was clindamycin. works like a charm. i highly recommend it.

        • sophie

          hello. I have suffered with this for a few years and am in the process of getting my sweat glands removed via private healthcare. this is all well and good but the infection is still there I have ordered Clindamycin Gel 10g online as my doctor ‘cant’ prescribe it. How long did you need to use it before it was effective and should I continue to use it. Also can I use it on my hands as the infection has spread there too.

      • Alex

        Try drysol I’m in the army got it really bad in Afghanistan drysol
        And letting ur feet be uncovered for like two days helps alot
        But u need the antibiotic to kill it

  • Bob

    Hi all
    I had pitted keratolysis for about 20 years and after trying to find a cure had pretty much given up. All I read online was going from ‘ there is no cure just wear sandals’ to ‘ soak feet in tea’ . Neither was promising….

    I gave it one more try and went to a dermatologist here in Japan who ( after prescribing various creams which I knew wouldn’t help as moisture was an issue) finally prescribed me ‘FLOMOX’ ( as the drug is named in Japan). Active ingredient :

    Cefcapene pivoxil hydrochloride hydrate.

    30 days later the symptoms are gone. I’m not saying it will work the same for everyone but talk to your doctor about this ingredients as it worked for me. Remember** Flomox is the name in Japan ** which your doctor probably won’t know which is why I included the name of the active ingredients. Don’t give up trying to cure it! 20 years of embarrassing symptoms gone in 30 days with no follow up treatment required. And if you’re wondering I didn’t need to change any habits such as drying shoes outside every night or throwing away all my (possibly infected) socks etc.

    • will

      A very old post I know but how long did your course of flomox last? I have some, three a day for a week and not a great deal of change. now the course is over will I continue to see improvement? Or do you need to keep taking it until all symptoms are gone? thanks for any help! I’ve suffered for years and as people have said already, the typical prescription of creams is totally useless as the feet are left moist.

  • diamondflamer

    Does anyone here have experience of using clotrimazole cream as a treatment? I am giving it a try. I’ve had this PK for a couple of years now, but always pretty mild until recently when, due to a foot injury, I can only wear a couple of pairs of shoes in my collection and they’re not the kind I can wear with socks. I just read here about clotrimazole as an effective treatment and happened to have some cream containing it already so thought I would give it go twice a day and try my best not to wear shoes as much as possible. I am going to try treating my shoes with tea tree oil to kill any of the bacteria in them so it doesn’t transfer back to my skin. I will report back.

  • josh

    my dermatologist told me to use this mixture:

    acid salicyl 10.0 g
    isopropanol 70% isopropanol ad 100.0 g

    It was about 5-6 euros in the pharmacy.

    My expirience is:
    Bad smell vanishes immediately.
    Dead skin will peel off.
    After initial success (using it daily for about 2 weeks)
    I use it 2 or 3 times about every 2 months.

    Be careful: wash hands thoroughly. If not, skin there may peel off too.
    Use it on your own risk.
    greetings, josh

  • ben

    I use a benzoyil acne wash in y feet than I let dry and use a pumice stone to smooth it out but it still comes back. Idk what to do anymore please help!

  • Jim Campbell

    I’ve had this off and on since I was a kid. A couple of practices have helped to clear it up for me.

    1) wash feet with soap 2x a day. Really lather your feet up, and wash each foot at least 1x for at least 30 seconds.
    2) Apply a topical antibiotic at least 1x a day. I use clindamycin phosphate gel (1%)
    3) Wear cotton or wool socks and get out of your shoes when you can.
    4) Apply benzoyl peroxide cream at night.

    Stay with this for at least a month. PK won’t go away easily. Stay with it!

    • Jane

      Hi Jim, I’ve had this too as a child and still battle. Have you had to re-treat it once you cured it or did it go away completely?

  • Eddie

    I have been having trouble with this evil little annoyance for the past four years. I visited a number of G.P.s who could not identify this skin disorder and went down the route of regular shoe and sock changes, rigorous drying and going without shoes as much as possible. None of these ideas had the slightest effect.

    Recently I visited another doctor and she instantly identified Keratolysis Pitting and prescribed clindamycin in a topical anti-biotic lotion form. The effects were startling. Noticeable after one day and all symptoms cleared within a week. I would definitely endorse the treatment – you get to keep all your shoes too!!

  • Put coconut oil (virgin) on your feet every night

  • Junior

    Hi I think I must have had the worst of this infection possible ( just wish I,d have taken photos of it 2 weeks ago) I work as a driver and must wear safety boots all day long so what I done was brought an extra pair of socks to work with me and purchased a bottle of bacteria killer, the stuff you put on your hands when going into the hospital and nursing homes etc half way threw the day, of with the socks apply the bacteria cleaner and don’t hold back.then when I got home washed the feet right away with anti_bacterial soap and nail brush thourghly dry,then more bacteria killer and don’t hold back, a couple of hours later more bacteria killer then before going to bed wash feet again with the soap dry thourghly and more bacteria killer , get up in the morning apply more bacteria killer then do this as often as possible and so on 2 weeks later I,m not fully cured but by god I can now walk on my feet and my feet are starting to look and feel great again . Hope this helps some one out there.

  • Michael

    I had suffered with this for 10 years. Came out of the blue, I ignored it but was very obvious on my heels when wet, and my feet definitely smelled more when sweating. I went to my GP in the UK and mentioned fuscidic acid but she instead prescribed Trimovate Cream ( which contains clobetasone butyrate, calcium oxytetracycline and nystatin) which she thought would work better being both anti fungal and bacterial in the one cream.

    This stuff smells horrible but within two weeks of daily applications it is completely gone. I didn’t even need to rub my heels down with a pumice stone/ ped egg and now my heels are smooth and don’t smell.

    I came back to this site as I had previously looked for help to find what was going on with my feet and after ten years had just given up hope, but it’s been about 3 months since it’s cleared up and no return issues even with plenty of running and exercise.

    Good luck everyone, M

  • Ava McI

    I didn’t know what the heck was going on! My feet sweat a lot but I hadn’t noticed much of an odor, just an itchy, burning, scaly, patchy, weird looking and painful area on my foot and in between my toes. I treated it for athlete’s foot for over two weeks with little relief. Went to the primary care doctor who diagnosed this condition. He prescribed an oral antibiotic called Erythromycin. He also told me to use an antibiotic cream such as neosporin. Be warned about the prescription medication though…it’s not cheap. Another thing I did was soak my foot in Listerine. It’s a germ killing antiseptic that’s cheap and soothing to my foot.

  • Jessica

    My doctor had absolutely no ideas what to do so we looked online to see a) what PK is and b) how to treat it. I was bathing far more than regular, and there is no way of me ventilating my feet other than before and after work. I work in food service so proper fitting shoes are a must. My doctor gave me a gel consisting of clindamycin phosphate & benzoyl peroxide (1%/5%), then a container of hypercare 20% solution..i saw the doctor 2 weeks ago and I’m just really afraid that this treatment won’t work. I have to shower daily but am trying to be in water as little as possible. Has anyone been prescribed this stuff and how quickly did you see results?

  • Robert

    Here’s the cure for PK.
    made by Actavis, Clotrimazole and Betamethasone
    Dipropionate Cream USP.
    I had PK for 35 years and kept treating it like athletes foot. Went to doctors and was given this and it cleared my feet in less than a week. It’s been 3 years now and still have had no problems with PK. “yea!”

  • I stumbled upon this site was wondering if i have this.i dont have multiple crators though just one little one and my foot odor is just terrible. Its got to the point to where i dont even want to go to school or anywhere for matter because people look at me differently.3 years ago i went to a 3 month camp which required to have shoes on literally all day eveyday.i think thats where all this started.i just want to know how i can get this to go away. Its ruining my life :(

  • Ryan

    I had quite a bad case of PK and treatmentsrecommended online all failed.

    I decided to go with my initiative after hearing that acne cream is often the cure.

    What I did was to get some Oxytetracycline (often in acnetreatments though only available on prescription) crushed them up and with a little water and talcolm powder made a paste. I applied it onto the soles of my feet and 48 hours after my soles had gone a blue/purple colour. At first I was quite worried but the next day the colour had gone and within a week my feet were back to normal. Haven’t had it since!
    At first I thought the purple was bruising but actually I now believe it to be a colour generated by the death of the bacteria that causes PK.

    Although not yet a written treatment, I may be the man to have discovered the cure. If you are a doctor, give it a go and thank me later.

  • Jane

    Hi all, I just found this website and it seems like a great resource. I have battled this for almost 30 years (as long as I can remeber) my dad had it and I think my grandma too. I thought it was just hereditary not something your could catch as all my other siblings & mom never got it.
    I used drysol as well as benzoyl peroxide & clynadamyicn cream. Found temporary results but never fully cured.
    Now my poor little 18m old son I’ve noticed it on his toes as he’s been playing in the water this summer. I’ve been devastated discovering it on my son and wondering if any of prescribed treatments or natural would be safe for a little guy like him. I am determined to find a cure for him, and myself, as I do not want him to live a life to embarrassment and hiding it as I have. Any suggestions for little one would be so helpful! Thank you

  • Nick Edd

    DRICLOR!! Just found this site and I’m amazed I’ve never come across it before. Im based in the UK, and have had the problem ever since I started working and wearing trainers/boots for long periods of the day. I’ve tried most creams my GP has recommended and although there was slight improvement, it took months and it cost me a small fortune in creams. In the end my pharmacist suggested trying a roll-on antiperspirant which you can buy over the counter without a prescription. It is called DRICLOR and I use it in the mornings before I put my Socks on, and of an evening before I go to sleep. I roll it on the affected areas, and within 10-14 days (sometimes longer depeding on how long it has plagued me) it clears up. I must admit it does sometimes reoccur after a while, but I assume thats because it still wear my footwear for long periods of time and it is my body sweat that causes it. Driclor costs me about £6 and lasts a month easy. Probably longer but I’ve never bothered checking. I estimate it takes up 40 seconds of my day max, so if you can include it into your daily routine then you may just rid the dreaded condition! Of course, it also helps to change your socks for something that helps combat sweat, and using shoes which offer abit of ventilation. Driclor works well for me, so if you get a chance its worth a try. It contains Aluminium chloride hexahydrate 20% w/w. I buy mine from sainsburys in the UK, so I’m assuming most pharmacys will sell it. Hope this helps!

  • darcy

    I have had this for a long time. Have visited this site on numerous occasions and tried tea tree oil to teabags, from my personal experience non of this works. One way to get rid of the smell is using an antiperspirant daily and constantly. My doctor always prescribes this and the smell and sweating goes if I continually use it… However I have yet to cure the Pitts and if I stop using the antiperspirant the sweating and smell returns. I have tried various creams via my doctor whilst using the prescribed antiperspirant, which have worked to a degree, but have never cured it totally. From what I can gather, the pitted part is like acne, so have tried a variety of prescribed acne creams as suggested by my doctor along with daily use of the antiperspirant… At the moment I am trying a new prescription along with the antiperspirant called Zineryt… I hope this works and will keep you updated

    • darcy

      I forgot to mention that my DR instantly new it was the dreaded Pitted Keratolysis and he has prescribed me many of the creams mentioned… fingers crossed that this new prescription works.

  • Jaime

    I am a waitress and we have to wear the special non slip shoes. I opted for the easy to put on croc like rubber shoes this summer. I am afraid wearing these and walking in puddles of water by the dish room caused me to get PK. I am a female and already have insecurities about my feet. I have looked on this site and so far have washed my feet as soon as I take my shoes off with anti bacterial hand soap with a little scrubby brush.. and also wash with the acne medicine with the 10% benz peroxide. I am over this and would really like the best remedy out there. PLease people!!!! HELP A GIRL OUT!!!!

  • christian

    I’ve had this condition since I was 15 and its been 10 years. The visual symptoms of the conditions are gone, but the smell remained. Has anyone experienced this? Right now I am taking oral clindamycin and treating it with fusidic acid cream, but the smell has not completely gone away. Please help

  • Dean

    I have had this condition for about 8 years. I work in a yard in boots 11 hours a day and the smell was mortifying with and looked terrible (but clean very well and heal rather quick just do not get a lot of cancer to heal up because of work) I went thru a pair of boots until they were Unuse able after a week. A bloke on this forum recommended a driclor roll on perspiration. Been using that before bed every night and I everything has reduced dramatically. It seems there is no cure to stop PK – but just finding wot works for u to manage it better.. good luck.

  • will

    See the post somewhere above about Flomox antibiotics. It worked for me. It did eventually come back but I’m sure this is because I didn’t change over all my footwear at the time, some of which was quite old and whiffy. Also, always wash all your socks at 60 degrees. Its made a massive difference to me. I’m pretty sure if I took another course of Flomox, continued with 60 degree washes for socks and replaced my old footwear it could be gone forever.

    By the way I can’t stress enough the washing of socks at 60 degrees. It really does help massively. I guess any lower and some of the smell causing bacteria don’t get killed and are there waiting for you when you put them back on “clean”. This single change to my routine has meant I’m no longer embarrassed by my feet! They may smell a bit cheesy but compared to before its like roses!


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