[2][3] Excessive sweating of the feet and use of occlusive footwear provide an environment in which these bacteria thrive and therefore increase the risk of developing pitted keratolysis.

Skin biopsy specimens are not usually utilized, as the diagnosis of pitted keratolysis is often made by visual examination and recognition of the characteristic odor.

Treatment of pitted keratolysis requires the application of antibiotics to the skin such as benzoyl peroxide, clindamycin, erythromycin, fusidic acid, or mupirocin.

[citation needed] These superficial erosions are found under the toes and on the soles of the feet, and especially at the pressure bearing points such as the heel.

[citation needed] Pitted keratolysis is associated with excessive sweating of the palms or soles (palmoplantar hyperhidrosis.

[5] Irritation is generally minimal, though occasionally burning, itching, and soreness are experienced with pitted keratolysis.

[5] One review suggested a treatment approach requiring modification of risk factors (e.g., keeping feet clean and dry) and treating the underlying bacterial infection.

Injections of botulinum toxin have successfully induced cessation of sweating (anhidrosis) of the soles of the feet and led to resolution of pitted keratolysis.

[5] Pitted keratolysis can be reduced and eventually stopped by regularly applying a liberal amount of antiperspirant body powder to the inside of the shoes and socks of the affected person.

The infection is more common in people who live in tropical climates and walk barefoot, and those who spend a lot of time wearing occlusive footwear (e.g., tight shoes, rubber boots),[5] such as in the military where wet shoes are worn for a prolonged period of time without removing and proper hygiene.