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Dr. Robert A. Kornfeld

Dr. Robert A. Kornfeld

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Smelly Feet? What To Do About It

Posted: 04/21/11 08:04 AM ET

As a practicing podiatrist for over 30 years, I have listened as thousands of my patients over the years have apologized for their foot odor. When I ask them what they do to try and control it, most often the answer is either powder or nothing. Yet, it causes them extreme distress and embarrassment. There are many causes of malodorous feet and the underlying etiology gives rise to excessive perspiration (hyperhidrosis) that is a great breeding ground for bacteria.

Excessive perspiration can often be controlled through antiperspirant therapy. Just because we don't often see TV commercials for foot odor, the first line of therapy would be to "fix" the problem with a roll-on or spray antiperspirant, the same ones used for underarm issues. When these don't work, there are more powerful prescription antiperspirant that may be beneficial. Side effects of some of these products are excessive drying of the skin or skin irritation/sensitivity.

For those patients who are willing to be more proactive, changes in lifestyle and diet can be very helpful in controlling foot odor. Diets high in refined carbohydrates will often serve as food for bacteria and fungus in the body, giving rise to discharge phenomenon. One such discharge is to expel these bacteria and fungus into the skin to slough off with dying skin cells. However, when they collect in the skin of the foot through perspiration and are enclosed in a shoe, the odor can become extreme. Correcting the diet by eliminating refined carbohydrates and balancing protein, healthy fats and complex carbohydrates can be very effective in reducing or eliminating foot odor. Additionally, reducing alcohol consumption and cessation of cigarette smoking will also go a long way to relieve the perspiration and therefore, the odor.

Another cause of excessive perspiration is adrenal stress. The hormones that alert the body to danger can become elevated in patients that are exposed to chronic stress. These patients will experience increased perspiration and hence, succumb to malodorous foot problems. Moderating stress can be accomplished in many ways. Developing a calming meditation practice, yoga, regular exercise, psychotherapy, massage therapy, diet and lifestyle adjustments and herbal and nutritional supplements are all helpful in reducing the stress reactions that ultimately can worsen the odor.

But what if none of the above works? Are patients doomed to suffer with the stress and embarrassment of smelly feet? The answer is no. For these patients, we can inject Botox® (botulinum toxin) to reduce perspiration. Although Botox is primarily used to relieve chronic muscle spasm and facial wrinkles, it is an excellent alternative for disabling the sweat glands and minimizing the release of moisture in the form of perspiration.

The process is fairly simple. Each foot is treated at a separate session. The entire bottom of the foot is divided into a small grid system. An anesthetic injection is then given at the side of the ankle, numbing the entire bottom of the foot. The Botox can then be injected into each of the small grid squares at the level of the skin (usually around 40 to 50 injections per foot). Care is taken not to inject the Botox® into the deeper structures, as this will not stop perspiration and may disable some of the intrinsic muscles of the foot (causing temporary disability).

Other than some possible tenderness in the foot for a day or two, side effects are extremely rare and mild (other extremely rare side effects can be discussed with your doctor). The effects of the Botox can last anywhere between three months and up to one year. Some patients will notice considerable improvement, while others will still need to use a topical antiperspirant in addition to the Botox injections for maximum results.

There are some patients who will notice increased perspiration in the lower leg, however, since it is not contained in a shoe, there is no associated malodor as a result. In addition, some patients will need to come back for a second treatment to address areas that may have been missed in the first session. Results may be noticed in as quickly as a few days or up to a few weeks after injection. And yes, unfortunately, there are those patients who do not improve after treatment with Botox.

Botox represents a viable alternative for the large number of patients suffering with hyperhidrosis of the feet when other therapies have failed to control or reduce the symptoms. It is also used successfully in patients with excessive underarm perspiration as well.

 

Follow Dr. Robert A. Kornfeld on Twitter: www.twitter.com/holfoot153

As a practicing podiatrist for over 30 years, I have listened as thousands of my patients over the years have apologized for their foot odor. When I ask them what they do to try and control it, most o...
As a practicing podiatrist for over 30 years, I have listened as thousands of my patients over the years have apologized for their foot odor. When I ask them what they do to try and control it, most o...
 
 
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HUFFPOST SUPER USER
hellotiki
Born in a log cabin.
01:54 AM on 04/26/2011
"I was built upside down. My feet smell and my nose runs." ---The Great Soupy Sales
11:19 PM on 04/25/2011
Stop eating meat to help general odor.
05:09 PM on 04/25/2011
"Body Mint" - wake up to the proven solution for fresh feet, breath and underarms. Even bowel movements lose their stink. The green-hygiene solution for anyone who is close to another person. Created for our barefoot Hawaiian lifestyle. Try it for your lifestyle and gift it to those who can use it. BODY MINT .... amazing.
02:09 PM on 04/25/2011
Stenchfoot is sooo easily remedied. Besides a thorough washing (and in between toes, of course), make sure you thoroughly DRY your complete foot afterwards. People look at me like I'm nuts when I use the hairdryer on my feet at the health club, but it works. If you wanna go one step further, powder your feet and shoes....and DON'T wear socks multiple days...and don't wear the same pair of shoes every day.
01:49 PM on 04/25/2011
Isn't there an alternative natural remedy? I'm a bit afraid to use botox... I've heard cedarsoles made from cedar wood are a good way to get rid of smelly feed. Can someone confirm this?
11:50 PM on 04/24/2011
ive found the culprit to be wet socks leaking into the lining of the shoes.
usually i wear anti-wicking socks so it takes the sweat and extracts to the outside of the socks.
thus making the shoes smell.
easy fix...just air them out.
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HUFFPOST SUPER USER
oxjr
10:44 PM on 04/24/2011
I am a sugar addict, and discovered I have fatty liver. When I don't control my sugar cravings I can get an ammonia stink from my feet that will literally ruin a pair of shoes.

I have a trick to keep foot odor at bay - multiple shoes and lots of socks. Most of the odor from feet comes from the shoes. Wet glue, leather, rubber and foam mixed with our own natural scents is a nasty pungent smell. By having several pairs of shoes you allow them to fully dry between wearings. Changing socks halfway through the day really helps too. I used to use expensive silver fiber socks but now I use comfy $10 a dozen socks and change them and have better results than the $10 a sock solution.
09:15 AM on 04/24/2011
Irresponsible journalism, Some self anointed expert pushing chemicals. This what bothers me about the "new media" and Huffington Post.

Is this news or an ad? Botox in your feet? Doctors are programmed by the pharmaceutical industry, they don't treat the problem they treat the symptom, if you read the side effects in a PDR, physicians desk reference, you wouldn't take any prescriptions.

The lead up info to "what if this doesn't work" and diet info is informative but is only there to suck you in and sell you chemicals. The medical industry is corrupt and the term "health care system" is is a lie, it does not exist to help people it exists to line the pockets of the rich.
08:01 AM on 04/24/2011
did u know you can check ur level of attractiveness by measuring your finger? HA
http://www.whats-news-dot.blogspot.com/2011/04/attractive-man-has-loooong-ring-finger.html
HUFFPOST SUPER USER
hellotiki
Born in a log cabin.
01:57 AM on 04/26/2011
Should I just let the chicks pull my finger? I hear that chicks dig that.
07:59 AM on 04/24/2011
what about a genetic link?
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southingtonian
"I'm a Capricorn and you can't make me do sh*t.."
05:44 AM on 04/24/2011
vinegar soak
10:35 PM on 04/23/2011
My late significant other used to tell a funny story on himself.

In his youth, he decided that he didn't need to soap up a wash cloth and manually wash his feet. He thought it should be sufficent to just rinse his feet off during the shower or bath.

During this phase, he was dating a girl and spent an evening with her and her parents. Her dad was relaxing and took his shoes off. So did my friend. The next day, the girlfriend informed him that the noxious odor from his feet had amazed and offended her family. They had a discussion about how he washed/rinsed his feet. He started washing, stopped the just rinsing, and the problem went away.

Dear Doctor, have you ever asked a patient HOW they clean their feet?
05:03 PM on 04/23/2011
It's very easy and not expensive. When you get out of the shower and dry your feet, get a Q-tip and apply tea tree oil (can be found at many drugstores, Whole Foods, Trader Joe's, The Vitamin Shop, etc) to your toenails and in between toes, then wipe up any excess with tissue. Takes a minute, and absolutely puts fungus/bacteria in check. All natural, no chemicals.
04:00 PM on 04/23/2011
Diet is the real culprit for all types of external body odor. Cut down on red meat.
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HUFFPOST SUPER USER
ABACADABRA RABBIT
05:44 PM on 04/23/2011
I smelled vegans that stunk so bad I had to get off the bus....

HYGIENE is the real culprit.....
05:20 AM on 04/24/2011
It's not meat, it's internal yeast. Ask a heavy drinker about his "athlete's foot" mere days after putting down the sauce - gone.

This doc's "solutions" will likely cause more problems down the road, ensuring more bucks for the medical industry. Cleanse your internal yeast and watch the stink go away. Stop listening to AMA docs and watch a host of problems go away.
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HUFFPOST SUPER USER
Abesheet
[Self] Discoveries made every day.
12:22 PM on 04/23/2011
Write a song for it.
Smelly feet.. smelly feet... what am i to do to you...
Smelly feet.. smelly feet... it's not your fault..