 Injections of botulinum toxin have successfully induced cessation of sweating (anhidrosis) of the soles of the feet and led to resolution of pitted keratolysis.These injections are typically reserved for refractory cases of pitted keratolysis that have failed to respond to environmental modifications and antibiotics due to the high cost and pain associated with botulinum toxin injections.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.