Pitted Keratolysis is a skin disorder that affects the skin of the feet and sometimes the hands. It is more prone in those that wear boots, or have their feet in moist shoes more often. Dermatologists can diagnose the condition and make a treatment plan designed for the individual. Bacteria are the main cause of pitted keratolysis and treating those bacteria is key to treatment. Prevention can be as simple as keeping the feet dry and clean. Not everyone who has smelly feet has this condition, so going to a dermatologist is needed to determine whether it is that or pitted keratolysis.
Main Signs of Pitted Keratolysis
Infection may cause the skin around the foot area to be white or lighter in color than the rest of the foot. It may also appear red or be "pitted" looking, with deep holes in the foot area designed to hold weight. There can be flaking and scaling of the skin. These treatment options are used to rid the feet of the bacteria as well as the hyperhidrosis where the feet sweat profusely and aid in bacteria growth. Medications may need to be given for a long period of time before progress is seen in the condition of the feet.
Sold under the brand name of Eryc, this is a delayed released capsule antibiotic made from 250mg erythromycin and is enteric coated. It is part of the macrolide antibiotic group, and is made from a Saccharopolyspora erythraea strain. The typical dosage is 250mg every six hours before meals when on a once a day prescription or 500mg every 12 hours before meals when on a twice a day prescription.
Clindamycin 1%/Benzoyl Peroxide 5%
Sold under the brand name of Duac, this gel contains clindamycin phosphate, or a solution of 1 percent clindamycin and 5 percent benzoyl peroxide. There is 10mg of clindamycin and 50mg of benzoyl peroxide in each gram of the gel. This medication is applied daily, in the evening hours, after washing and rinsing with warm water. Towel dry and then apply the gel to the soles of the feet. It is sold in a 45 gram tube of gel formula, by prescription.
Given to pitted keratolysis patients for foot sweating, botulinum toxin injections are used in even amounts across the foot area to lower the amount of sweat produced. Only a low dose of the toxin is needed to get a good response. Research in this field shows that that when pitted keratolysis is not responding well to treatment, that the hyperhidrosis may be the reason. At that stage, botulinum toxin injections may be given as to stave off the foot sweat that allows the bacteria to grow.
20% Aluminum Chloride Roll On, or Spray, Antiperspirants
This easy over the counter solution to foot sweat is useful in eliminating the amount of moisture on the feet. The aluminum chloride is the active medication that can lower the foots production of sweat. Spraying the feet or using a roll on on the soles of the feet, allowing the feet to dry completing before using any type of sock or footwear, can help stop the foot sweat that leads to stinky feet.