How do I deal with smelly feet?

Q: I have an embarrassing problem and I need your help. My feet really smell. I have tried all sorts of medication and foot soaks but nothing seems to help. As a lady, I find it very distressing and it is affecting my self-esteem and confidence. How can I get rid of this bad smell?

A: Bromodosis, or foot odour, is a common complaint amongst the general population. It is a simple result of sweat on the feet mixing with germs on the skin and shoes. Sweat in itself is odourless, however, when it comes into contact with bacteria (and fungus) it can result in production of foul smelling gases from the feet.

Feet have one of the highest concentration of sweat glands in the body (almost 250,000 glands per foot). This means that feet often sweat daily (regardless of the weather). The quantity just varies from day to day. On a hot day, the feet can produce up to the equivalent of a bottle of soda of sweat! Teenagers and pregnant women may have sweatier feet than the rest of the population due to hormonal factors.

Abnormal sweating: There is a medical condition known as ‘hyperhidrosis’. This refers to excess production of sweat on the feet (and often hands as well). This medical condition predisposes one to foot odour.

Shoe size/fitting: wearing shoes that are too tight or shoes that put the feet under unusual stress can lead to excessive sweating and foot odour. Shoe material: Wearing plastic shoes predisposes one to foot odour. Shoe type: Shoes that are closed and do not have an absorbent lining are often associated with foot odour Shoe dryness: If sweat soaks into your shoes and they do not dry before you wear them again, you will definitely get foot odour (even though you are cleaning your feet daily). In addition, wearing shoes that have not dried after washing can also be associated with smelly feet. Shoe storage: Putting used shoes in a dark cupboard prevents them from drying out completely. Ideally, shoes should be placed in an open place with good air circulation

Long toenails: Toenails can harbour dirt and bacteria and if not cleaned properly, can contribute to foot odour. Foot fungal infections: Fungal infection mainly attacks in between the toes (although it can affect nails and even the soles of the foot). It can be associated with foot odour. Dead skin on the feet: Scaly dead skin on the foot can be associated with foot odour. Socks

Wear cotton socks with your shoes. These days, ladies shoes (even heels) can be worn with special ‘hidden socks’. These socks are available in most clothes and shoe shops across the country. Avoid nylon and polyester socks as they do not absorb sweat and can predispose to odour.

Wash your feet daily and always dry between your toes. Clip your toenails and keep them short. When cleaning your feet, remember to clean under the toenails as well (daily). File/brush off any dry dead skin on your feet, as it can be an ideal home for odour forming bacteria. Exfoliation of the feet should be done at least 2-3 times a week using a pumice stone. Shoe breaks: Do not wear shoes all day. Make sure you spend several hours of your day walking barefoot.

Alternate shoes: Never wear the same shoe for two days in a row. Always allow the shoes to dry before you wear them again. Where possible, remove the insoles to allow the shoe to dry completely.

Clean shoes after use: Where possible, use antiseptic wipes to clean the insides of your shoes after wearing them. After that, leave the shoes out to dry. Shoe types: Wear leather, canvas or aerated sports shoes instead of plastic material footwear.

Where possible, alternate between open and closed shoes Surgical spirit: After you shower, dry your toes and dab surgical spirit between them.

This little trick has been known to keep the skin odour free. If need be, you can dab the entire foot with spirit. Mouthwash: Soaking your feet daily in mouthwash may reduce your foul odour (the same effect can be achieved with vinegar soaks or surgical spirit).

Vinegar soaks: Mix one part vinegar (white vinegar or apple cider vinegar) and two parts water and soak your feet for at least 10 minutes daily. Foot powder: After bathing, dry your feet and dust them with either talcum powder or baking soda. This keeps them dry.

Foot antiperspirant: Over the counter antiperspirant roll-ons used on the armpit can also be used on the feet. Never wear the same pair of socks more than once. Even if the socks do not smell after the first use, they still have bacteria. Opt for cotton, bamboo or other natural fibre socks over synthetic fibres like nylon and polyester. When to see a doctor

If you have tried all the above with no improvement, visit your doctor. He/she will assess your feet and determine if there may be another underlying cause of your odour.

Prescription foot roll-on: if over the counter antiperspirant roll on does not work, your doctor may prescribe an aluminium based prescription one.

Anti-fungal: if you have fungal foot infections, these must be treated in order to eliminate foot odour. This can be done using anti-fungal powder or cream. Severe infections may need anti-fungal tablets.

Iontophoresis: this is a type of medical treatment given by soaking feet in water and passing mild electric current through the water.

This therapy temporarily blocks sweat glands. This treatment should only be done by trained health professionals.

Botox: Excessive sweating may be reduced by injecting botox into the feet. This should only be administered by a doctor. These injections temporarily reduce sweating for three to four months after which repeat treatment is needed.

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