A persistent burning sensation in the soles and genital area, without visible lesions, that does not improve with antibiotics is often neuropathic rather than infectious. Causes may include peripheral neuropathy, diabetes-related nerve changes, vitamin deficiencies, or nerve irritation. It is essential to consult a doctor or neurologist for proper evaluation, which may include blood tests, nerve studies, or other investigations to identify the underlying cause. Treatment is usually targeted at the root cause. It may include medications for nerve pain, lifestyle adjustments, and supportive care such as proper foot care. Self-medicating with antibiotics is unlikely to help and should be avoided.