Good! There are many reasons to wear breathable fabrics, such as cotton or bamboo, some of which are because you can get infections in the skin of your feet from being too moist. Normal amounts of sweating due to just wearing socks, walking around, running, etc is expected, but when the wetness doesn’t go away, you are at risk for fungal and bacterial infections: pitted keratolysis is a skin infection caused by excessive wetness of the feet.

What is Pitted Keratolysis?

It is basically a bacterial infection in one of the outer most layers of the skin (dermis) on your feet (it can rarely occur on your hands too).  The infection causes pits, or craters, in the skin on various areas of the feet, and most frequently  on areas that bear the most weight, such as the heel and forefoot (the pads) of your feet.  The enzymes that the bacteria produce, eat away at the keratin in the skin, and cause those pits/craters in the skin.  When the feet are exposed to excessive warm, moist areas (such as sweaty socks….especially polyester and other synthetic fabrics) the bacteria grows and thrives in that environment and without treatment, it stays around indefinitely.

Who is most at risk?

Diabetics and those with immunosuppression from either chronic disease or due to medications, are at higher risk. Also, those that have chronically sweaty feet, or frequently wet feet, are at high risk.

How do I treat it?
Treatment is usually pretty easy, actually. Once your HCP has diagnosed pitted keratolysis, topical antibiotic creams (such as erythromycin or clindamycin) applied twice daily for 7-10 days usually clears up the infection completely in 3 weeks (all lesions and odors will clear up). In some cases, patients are given oral antibiotics if they do not respond to topical treatments.

How do I prevent it?
Some patients are able to prevent pitted keratylosis simply by switching to natural fibers (cotton or wool) that help wick sweat away from the feet, instead of wearing poly blend socks. Also, wearing appropriately sized shoes that don’t overly restrict feet and cause excess sweating can be helpful. Some patients find their symptoms do not return if they apply roll-on antiperspirant to the soles of their feet to prevent excess sweat; if that doesn’t work, you can have your feet injected with Botox to prevent the sweat from occurring. Basically keeping dry feet, are keeping pitted keratolysis free feet!

Wear natural fiber socks and keep your tootsies as dry and happy as you can, in shoes that fit, and get them open to the fresh air whenever you have the opportunity (and won’t offend people!) But if you have any symptoms even close to these, it is best you see your HCP to get treatment as soon as possible, to prevent the infection from required extended treatment, and just to get your feet fresh ASAP!

Yours in Good Health
B