Pitted keratolysis: treatment and prevention
Treating pitted keratolysis starts with dry feet. Pitted keratolysis (also called Keratoma sulcatum) creates small pits in the sole’s horn layer, often with a strong odour. The cause is bacterial in heat and moisture, not classic athlete’s foot fungus.
At home first: wash daily, dry thoroughly (including between toes), change socks, air and rotate shoes. Do not only mask the smell. More under smelly feet.
A two-step routine often helps next: treat bacteria in the shoe and slow excess sweat on the skin.
In short
- Self-care: wash, dry well, dry socks, rotate shoes.
- Step 1 in the shoe: PediFris® Classic.
- Step 2 on the skin: less sweat with PediSpray®.
- Doctor: pain, wounds, diabetes, or no improvement; a topical antibiotic may be needed.
By
Judith de Jong, Content owner, PediFris®
Medically reviewed by Sébastian Deqidt, podiatrist
· Updated on 18 July 2026
How the treatment works
Why the spray and powder work for pitted keratolysis
Pitted keratolysis thrives on damp, warm skin. Tackle the bacteria from two angles — on the skin and inside the shoes.
Step 1
Antibacterial skin treatment
PediSpray® (Strong or Regular) on the feet combats odour-causing bacteria directly on the skin and regulates perspiration.
Step 2
Disinfecting shoes
PediFris® Classic powder in shoes has an antibacterial effect and keeps the inside of the shoes dry, thus eliminating the breeding ground for bacteria.
Step 3
Keep dry & prevention
Use the spray and powder daily: this keeps feet and shoes dry and prevents the condition from returning.
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Laura
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17 Jul. 2026
"Great stuff! Works super-fast on pitted soles and the odour disappeared straight away after the firs..."
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Linda Heeren
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03 Jul. 2026
"The only product that really works. "
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Rolf
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03 Jul. 2026
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01 Jul. 2026
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Richard F
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22 Jun. 2026
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12 Jun. 2026
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What is pitted keratolysis?
Pitted keratolysis (Keratoma sulcatum) forms tiny pits or craters in the sole’s outer horn layer. It often comes with a strong smell. Bacteria favoured by heat and moisture attack the surface layer of the skin.
How to recognise it
Pinpoint pits, especially on pressure and sweat zones of the sole.
Often a strong, sometimes sharp odour.
Sometimes a whitish or softer look inside the pits.
Usually little itching; smell and visible change are more typical.
Do not confuse it with athlete’s foot: there, itching, scaling or cracks are often more prominent.
Causes: moisture, heat, shoes
Bacteria need a warm, damp environment. Typical triggers:
Heavy foot sweating.
Closed, poorly ventilated shoes.
Socks or shoes that stay damp.
Sports or work shoes left wet.
More on sweat as a cause: smelly feet.
Home care that usually helps
Start with dryness every day. Then treat the shoe with PediFris® Classic and slow sweat on dry skin with PediSpray®. If pits and odour stay, ask for a medical topical treatment.
Targeting pitted keratolysis?
Treat the skin with PediSpray® and disinfect your shoes with the antibacterial PediFris® Classic powder — tackle the bacterial cause from both sides.
Frequently asked questions about pitted keratolysis
Brief answers regarding causes, contagiousness, treatment, prevention, and safety.
How do you treat pitted keratolysis at home?
Reduce moisture, treat shoes, and ask for medical cream if it persists.
- Wash and dry feet every day.
- Change socks; air and rotate shoes.
- Shoe hygiene (e.g. PediFris® Classic) + less sweat (e.g. PediSpray®).
- If stubborn: ask a clinician for a topical antibiotic.
Can I treat pitted keratolysis myself?
Yes, improvement often starts with regular home care.
Keep feet and shoes dry, change socks often, and treat the inside of shoes. PediFris® Classic and PediSpray® do not replace a prescribed antibiotic cream, but they help cut moisture and shoe bacteria. With pain, wounds or diabetes: get checked rather than experimenting alone.
What cream or natural treatment works for pitted keratolysis?
Stubborn cases sometimes need a prescribed antibiotic cream or gel.
“Natural” steps (dryness, hygiene, clean shoes) improve the environment but do not replace medical advice if it does not clear. Antifungals alone are often not enough, because this is not classic athlete’s foot.
Is pitted keratolysis a fungal infection?
No. It is a bacterial change in the horn layer, not classic foot fungus.
That is why an “anti-fungal only” approach is often incomplete. Staying dry still helps, because moisture favours the bacteria. Compare: athlete’s foot.
Why do I have small pits or holes on the soles?
Often bacteria attacking the horn layer in a warm, damp environment (pitted keratolysis).
Typical: pinpoint pits, sometimes a whitish look, and a strong smell. Not every “hole” is pitted keratolysis; if unsure, ask a clinician.
Is pitted keratolysis contagious or dangerous?
Not like a highly contagious fungal infection, but bacteria like damp environments.
Personal hygiene and dry shoes still matter. It becomes more risky with wounds, severe pain or diabetes; see a doctor sooner then.
How do I stop pitted keratolysis coming back?
Prevention = dry feet + a cleaner shoe environment.
- Dry between toes every day.
- Change socks often.
- Air and rotate shoes.
- If you sweat heavily, keep the spray + powder routine.
When should I see a doctor?
Pain, wounds, infection signs, diabetes, or if self-care is not enough.
Also if you are unsure whether it is pitted keratolysis or something else (for example athlete’s foot).
About the author & sources
Written by Judith de Jong (Content owner, PediFris®) and medically reviewed by Sébastian Deqidt, podiatrist. We base our advice on foot care practice and on the medical sources listed below.
Worried about a persistent complaint, fungal nail, athlete’s foot or excessive sweating? Consult your GP, podiatrist or chiropodist.
Sources
- DermNet: Pitted keratolysis — dermnetnz.org
