By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

REDUCING SWEAT AND BACTERIA GROWTH KEY TO TREATING "SMELLY FEET"

Question: My husband is a wonderful man, but he has really smelly feet. He bathes every day, sometimes twice, so it is not because he is dirty. What can be causing this, and what can be done to make it better? I have tried a number of things, but nothing helps much or for long.

Answer: Many very clean people have very stinky feet. This is because the root cause of the problem is not dirt but bacteria. People who have sweaty feet are prone to having foul-smelling foot odor because damp feet, covered by socks, inside shoes provide the perfect environment for bacteria to grow in -- dark, warm and moist. Having said this, however, I should add that poor personal hygiene can make a foot order problem even worse.

There are a number of bacteria that can cause foot odor problems. Two of the most common are Corynebacteria and Micrococci. It’s important to understand that these bacteria are not infecting the skin itself but are feeding on waste materials in the sweat and on other organic material on the surfaces of the skin, sock and shoe. It’s what doctors call an overgrowth of bacteria.

So now, what do we do about this overgrowth and the foul-smelling odor its produces? There are many products available to help minimize foot odor, but most of them are ineffective in the long term, since they treat the odor and not the sweat. To really get rid of smelly feet, you need to keep your feet dry.
We know that your husband bathes regularly, but he needs to be scrubbing his feet with antibacterial soap and then drying them very thoroughly, including between the toes. Some people even dry their feet using a blow dryer. Wearing cotton socks to absorb the sweat and changing socks frequently can also be helpful.

Frequently, shoes are a major part of the problem. Wearing sandals or shoes that let the feet “air out” and stay dry can decrease the odor. If this is not possible, you should rotate your shoes so that each pair dries out completely between wearing. In some cases, using a boot dryer on shoes can be helpful. If your shoes are washable, clean them frequently in detergent, bleach and hot water.

Some people use underarm antiperspirants on their feet to help decrease the sweat production. Some people soak their feet daily for 20 to 30 minutes in a strong black tea solution. The tea, which contains tannic acid, has proven helpful for some people in providing relief from foot sweating and odor, when used daily for 10 days. Another over-the-counter remedy that decreases bacterial growth on the feet is benzoyl peroxide gel. Be careful in using this gel, however, as it can bleach and discolor dark garments.

Finally, if all of the above have failed, there are prescription medications that your family doctor or a podiatrist can prescribe to treat foot odor. These include medications that dry the feet and topical antibiotics to kill the bacterial overgrowth.

So don’t despair, smelly feet can be treated. Although a foot odor problem is not often cured, following the proper treatment will make it a lot easier to live with.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.