Smelly feet

Smelly feet (foot odor; bromohydrosis) can be embarrassing and uncomfortable. Excessive perspiration known as hyperhydrosis in the presence of bacteria lead to foot odor. Management of both foot odor and perspiration go hand in hand.

Causes

Feet may sweat profusely as they have more sweat glands than any other part of the body. This humidity cannot evaporate (unlike the hands) since they are enclosed in footwear. These two factors along with bacteria that cause the smell. It is not sweat that actually smells, but its alteration by bacteria producing isovaleric acid. A number of conditions may increase the chance for smelly feet, excessive sweating (hyperhydrosis), stress, some drugs and hormonal changes.

Prevention

It is relatively easy to control most cases of smelly feet by taking a number of preventive measures:

  • Good foot hygiene to reduce bacteria
  • Bathe your feet daily in lukewarm water with a mild soap and dry them thoroughly, especially between the toes.
  • Change your socks at least once during the day (change your shoes as well if you do sweat a lot).
  • Dust your feet frequently with a foot powder (without starch). Always wipe between the toes to remove excess moisture, so that it does not ‘clog’ between the toes.
  • Wear thick, soft socks to help absorb the moisture. Natural fiber socks such as wool or cotton and other absorbent materials are better.
  • Avoid the use of nylon socks or plastic shoes – wear shoes that are made of leather, canvas, mesh or other materials that let the feet breathe.

It is best not to wear the same pair of shoes two days in a row – they need time to dry out. Remove the innersoles to help with the drying.

Treatment

If the preventive measures above for foot odor do not help, further investigations by a podiatrist may be indicated.
Stronger medications (such as aluminum chloride hexahydrate 20% solution) may be prescribed. This needs to be applied on the foot every night.
In the office we have a treatment called “perspiration treatment” where we apply a solution for 20-25 minutes under occlusion. In 90% of cases the patients, feet will stop smelling for a minimum of 5-8 weeks. Patients usually come twice a year.
In extreme cases, a surgery is a possibility.