Sweaty, Sweaty, Smelly Feet!

June 29, 2010
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Some people sweat, and other’s sweat a lot! What makes the difference between these two patient populations is a condition known as hyperhidrosis. Hyperhidrosis literally means “a lot of water.” It is a condition that refers to an increased amount of perspiration (sweating) in a number of locations on a patient’s body including their face, hands, armpits and feet.

The greatest complaint for people with hyperhidrosis of the soles of their feet is the odor left behind. With sweating, moisture accumulates in socks and on shoes of such individuals and eventually odor-causing bacteria build-up resulting in an increase in odor, with subsequent embarrassment.

Although hyperhidrosis may be attributed to neurologic complications or sympathetic overactivity, a large percentage of patients with this condition have no contributing factors and suffer from this “just because.” In patients that have no predisposing conditions prevention is not the goal of treatment, but rather control of their excessive perspiration.

Hyperhidrosis can be very difficult to treat, and patience is a virtue while working with your Podiatrist to find a solution that works best for you! For starters, its best to keep feet clean and to change socks daily to prevent bacteria from colonizing on your feet, your socks or your shoes. Do not spray perfumes or body sprays on the feet in attempt to decrease odor as this can often increase the odor due to chemical reactions between sweat and perfume.

Antiperspirants are the first line in treating hyperhidrosis, as many patients immediately notice a difference and thus, success is achieved! Antiperspirants for the feet come in the form of deodorant sticks that one would use for the underarm; in fact there are some over the counter antiperspirant sticks that are indicated for use on the soles of the feet. Look for products that contain aluminum chloride hexahydrate, as they are most effective in treatment. Your Podiatrist may write you a prescription for such antiperspirants containing as much as 30% hexahydrate for prevention of sweating. Through prevention of sweating, antiperspirants are often successful in decreasing bacterial build-up and eliminating odor of the feet. These products are best applied to the feet twice daily: once in the morning and once in the evening, and are applied to the soles of the feet just as deodorant would be applied to the underarms.

For patients who suffer from hyperhidrosis due to sympathetic overactivity or neurologic complications, prescription medications that act on the peripheral nervous system can be tried. However, it is uncommon that your Podiatrist will recommend or even prescribe such mediations due to the potential side effects these can induce on the body.

Iontophoresis is a completely non-invasive method for attempting to treat hyperhidrosis of the hands and feet that utilizes water to pass a mild electronic current through the patients skin. Although not completely understood, the belief behind this theory is based on a cooperative effect of the electrical current and the water to increase the thickness of the outside layer of the hands and feet. Thus, the ducts for which sweat is released from the body onto the palms and soles become essentially “blocked.” Several treatments, on consecutive days helps patients reach a significant decrease in their perspiration, with subsequent maintenance treatments as needed, usually once every 2-4 weeks.

Finally, a treatment method that has gained popularity over the last 5 years or so is Botox injections. Botulinum Toxin, or Botox (the same material used on the face for decreasing wrinkles) can be injected into the soles of the feet for relief of hyperhidrosis. The toxin works by blocking a hormone in the body that is normally responsible for turning sweat glands “on.” This toxin, by blocking that hormone, turns sweat glands “off” and leads to a reduction in sweating in the areas where it was injected. Your Podiatrist will determine how many injections you will need and based on your clinical presentation, how often follow-up injection should be given. These injections are certainly not a cure for hyperhidrosis, but they control symptoms for a significant length of time; in some patients up to 7 months.

Hyperhidrosis is a difficult condition to treat, but your Podiatrist can guide you through your treatment options and find a combination that works best for you. Having feet that smell like roses is just within your reach!

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