Foot Odor and Smelly Feet
Foot Odor (Bromodosis)
Smelly feet, medically referred to as Bromodosis, is an extremely common medical condition. The feet and hands contain more sweat glands than any other part of the body (about 3,000 glands per square inch). Feet smell for two reasons: you wear shoes and your feet sweat. The interaction between your perspiration and the bacteria that naturally live on your skin and thrive in your shoes and socks generates the odor. Any attempt to reduce foot odor has to address both your sweating and your footwear.
One of the easiest ways to control foot odor is to regularly keep your feet clean and neat. This means using a mild soap and scrub brush to wash your feet at least once a day. As important as it is to wash and scrub your feet, it’s equally important to dry your feet completely after washing them, paying extra special attention to drying between all of your toes.
It’s also very important to regularly trim your toenails as the debris that can collect underneath them often is loaded with odor producing bacteria and fungus.
It’s imperative that you change your socks at least once a day but in a hot environment, when exercising, or in any situations where you feet may become more sweaty, change them more frequently. Wet socks become a breeding ground for odor-producing bacteria. When wearing socks, choose moisture-absorbing materials such as natural fibers or sports socks that are moisture-wicking.
It’s also very helpful to alternate the shoes your wear from day to day, even if it’s just two pair. This allows each pair to fully dry out from the sweat and moisture that remain after a long day of wearing your shoes. If your shoes have removable inner soles, taking them out and allowing them to air-dry more thoroughly can help prevent moisture accumulation in the shoes. When the insides of your shoes are damp, they allow bacteria to grow on your feet more often. Sometimes, using an antifungal foot spray on the insides of your shoes or even an unscented Lysol brand air freshener will help to kill any bacteria that are surviving on the insides of your shoes and their inner soles. Be sure to allow these to thoroughly dry after spraying before putting them back on.
Wearing open-toe shoes and sandals during hot and humid weather and going barefoot indoors when it’s appropriate allows your feet to stay dry and helps to control the development of foot odor.
Sometimes, smelly feet can also be caused by an inherited condition called hyperhidrosis, or excessive sweating, which primarily affects men. Stress, some medications, fluid intake and hormonal changes also can increase the amount of perspiration your body produces.
In making a diagnosis of hyperhidrosis, it’s first important for your podiatrist to take a thorough medical history. Very often your podiatrist will run lab tests to see if your excessive sweating is the result of another medical condition such as an overly active thyroid (hyperthyroidism) or low blood sugar (hypoglycemia).
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If an underlying medical condition is contributing to the problem, that condition will be treated first. If no clear cause can be found, treatment focuses on controlling excessive sweating. Sometimes you may need to try a combination of treatments. And even if your sweating improves after treatment, it may recur.
Medications that can be used to treat hyperhidrosis include:
- Prescription antiperspirants. Your podiatrist may prescribe an antiperspirant with aluminum chloride (Drysol, Xerac Ac). It’s usually applied to the affected skin before you go to bed and then you wash the product off first thing in the morning when you get up, taking care to not get any of it in your eyes as this product can cause significant skin and eye irritation. If your skin becomes irritated, tell your podiatrist as a hydrocortisone cream might help.
- Prescription creams. Prescription creams that contain glycopyrrolate may help hyperhidrosis that affects the face and head, but they are not as effective in the foot.
- Nerve-blocking medications. Some oral medications block the chemicals that permit certain nerves to communicate with each other. This can reduce sweating in some people. Possible side effects include dry mouth, blurred vision and bladder problems.
- Antidepressants. Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis.
- Botulinum toxin injections. Treatment with botulinum toxin (Botox, Myobloc, others) temporarily blocks the nerves that cause sweating. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last 6 – 12 months, and then the treatment needs to be repeated. This treatment can be painful, and some people experience temporary muscle weakness in the treated area.
Other hyperhidrosis treatments include microwave therapy and sweat gland removal, but these are typically done in other areas of the body and are not used in the feet. In severe cases that do not respond to any of the above treatments, many patients opt to have a sympathectomy. During this surgical procedure, a surgeon cuts, burns or clamps the spinal nerves that control sweating in your hands or feet. In some cases, this procedure triggers excessive sweating in other areas of your body (compensatory sweating). Surgery is generally not an option for isolated head and neck sweating. A variation on this procedure interrupts the nerve signals without removing the sympathetic nerve (sympathotomy).
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