Pitted keratolysis is a bacterial infection on the palms of the hands or, in most cases, the soles of the feet. It will cause shallow, crater-like pits on your skin, so it is easy for a healthcare provider to identify it. Several types of bacteria can cause this condition, with coryneform bacteria being the most common; other strains of bacteria, such as Actinomyces keratolytica, Micrococcus sedentarius, and Dermatophilus congolensis, may also be present in the lesions. These bacteria usually feed on a resilient protein, called keratin, which is responsible for making your skin tough and strong. They then produce proteolytic enzymes that cause crater-like pitting. The good thing is that the condition isn't contagious, but you need to look for a right pitted keratolysis treatmentoption to correct it.

What Causes Pitted Keratolysis?

In order to identify a suitable pitted keratolysis treatment, it is important to understand exactly what causes this condition. Oftentimes, it is caused by a cutaneous infection with Kytococcus sedentarius which is once known as Micrococcus sedentarius; and species of other bacteria may also have a role to play in the infection. These bacteria thrive under appropriate conditions and disturb your skin's natural pH balance. They produce proteinases that eventual destroy the stratum corneum, which in turn makes you see pits on your skin. If you leave it untreated, you will notice bad odor coming from these wounds, which is usually due to the production of sulfur-compound by-products, such as thioesters and thiols sulfides. So to identify the bacteria causing pits in your case, you should go to see a doctor and have the test he may suggest.

Treatment

It is important to understand that your condition may not improve and persist if you leave it untreated. It can actually last for many years and exhibit spontaneous episodes of remissions and exacerbations. Here's what you can do about it, and to select a right pitted keratolysis treatment, you may need advice from your doctor.

1. Home Remedies

The first thing you have to do is to keep your feet dry. These bacteria grow in warm, moist environment, so you need to make it difficult for them to multiply.

You need to take active measures to prevent foot friction and avoid occlusive footwear. It is a good idea to wear cotton socks to keep your feet from getting dry and provide enough ventilation to avoid providing bacteria a moist environment to thrive. Sometimes, wool socks are better because they can whisk moisture away from your skin. Be sure to keep your socks clean and wash them at a temperature of 140 degrees Fahrenheit (60 degrees Celsius) to kill bacteria. 

Dry your feet properly after taking a bath and be sure to scrub your feet well using an antibacterial soap. Use your regular antiperspirant spray used for spraying underarm to keep your feet dry. You can even try an OTC acne medication that contains 10% benzoyl peroxide to clear the infection.

2. Medical Treatment

Sometimes, you cannot keep your palms or soles from sweating due to a condition called palmoplantar hyperhidrosis. Therefore, you will first have to treat that condition to treat pitted keratolysis. Your health care provider may prescribe a strength antiperspirant containing aluminum chloride to resolve the issue.

You may consider applying topical fusidic acid ointment on the affected area for relief. It usually produces results in 2-3 weeks.

You may also want to discuss your problem with your doctor if your symptoms are severe. Your doctor may choose a two-week course of oral azithromycin or erythromycin to clear stubborn lesions. Using topical clotrimazole is another way to clear the infection.

In addition, your doctor will consider your situation and use some other treatment options such as antibacterial soaps, systemic antibiotics, and even injectable botulinum toxin.

How to Prevent Pitted Keratolysis

Instead of looking for a pitted keratolysis treatment, you should pay more attention to steps that keep this infection from developing in the first place. Take the following preventive measures to avoid pitted keratolysis.

• Don't share your footwear or towels with others.
• Be sure to change your shoes every day and dry them well before wearing.
• Don't wear your boots for extended period.
• Wash your feet at least twice a day and dry them well.