Q: I live with someone who has really smelly feet. Why does this happen and what can they do about it?
Stinky feet are normal, especially for people who sweat a lot as a result of exercise, hot weather or shoes that don’t breathe. Stepping up foot care might be all someone needs to quell the smell. But that doesn’t make it easy to bring up.
“I see it all the time,” said Dr. Nicholas Butler, a podiatrist in Beachwood, Ohio. “People will even be embarrassed to come see me about it.”
If someone has bromhidrosis, the technical term for smelly feet and general body odor, sweat and bacteria are probably to blame, he said.
Sweat glands help regulate body temperature, and we have more of them in places like armpits, palms and the soles of the feet. But sweat alone doesn’t have an odor, Dr. Butler said. Bacteria feed off perspiration, producing acids that can make feet smell like cheese, sulfur or vinegar.
Why are some feet smellier than others?
If someone’s feet are moist all the time, even when they’re not active, or if they’re seeing condensation on the floor when they walk barefoot, there might be an underlying issue, Dr. Butler explained. For instance, plantar hyperhidrosis, a condition where hyperactive sweat glands cause excessive foot sweat, might be the culprit.
“The more you sweat, the wetter it is,” said Dr. Alicia Canzanese, a podiatrist in Glenside, Penn., and damp feet cause more than just bacteria buildup.
Swampy feet create an ideal environment for fungal infections, like athlete’s foot or toenail fungus. Some fungal infections cause odors, but many people who have them might be dealing with fungus and bacteria. In those cases, treating the fungal infection alone might not kill the smell, said Dr. Lori S. Weisenfeld, a podiatrist in New York City.
People going through hormonal shifts, like teenagers and pregnant women, can also sweat more in their feet, said Dr. Kosta P. Antonopoulos, a podiatrist in Sioux City, Iowa.
How can you get rid of the smell?
If there aren’t any symptoms of infection — like itching, redness, dryness or cracked skin — small adjustments should help, Dr. Butler said.
Keep feet and toenails clean.
Many people, especially some children and teenagers, Dr. Canzanese said, don’t take the time to clean their feet. Dr. Antonopoulos recommended scrubbing your feet at least daily, including between your toes. Use fragrance-free soap, he said, because while scented soaps might mask the odor, they’re more likely to irritate the skin.
Dirt, bacteria and debris trapped under your toenails can make feet stink, Dr. Canzanese said, so keep them trimmed. And dry your feet thoroughly before putting on your socks, she said.
Try antiperspirant or deodorant.
Dr. Canzanese suggested swiping a combination antiperspirant-deodorant stick directly onto the soles of the feet. Use a clear solid that doesn’t have any scents or dyes, she said, to reduce the risk of irritation.
Just make sure to designate a stick that is only for feet. “You don’t want to accidentally use the foot one for your armpit, especially if you’re prone to athlete’s foot,” Dr. Canzanese said.
Change socks and shoes.
Wearing closed-toe shoes without socks “is a recipe for getting very stinky feet,” Dr. Canzanese said. And swapping out socks during the day, along with wearing those made mostly of cotton or wool can absorb moisture, she said.
Rotating shoes every other day can go a long way, too. “When you have the same pair of shoes — day in, day out, day after day — they don’t really get time to dry in between,” said Dr. Jessica Milliman, a podiatrist in Ashtabula, Ohio. But cycling through a few pairs, and opting for mesh-top or open-toe shoes that promote airflow, can keep feet drier.
Disinfect your shoes.
Dr. Milliman also recommended washing the shoes, spraying them with a disinfectant like Lysol, and letting them dry, so that bacteria doesn’t have much opportunity to build up, she explained. In lieu of machine-washing, Dr. Antonopoulos suggested replacing insoles every few months and noted that there are odor-control options.
When is it time to see a doctor?
If someone still has smelly feet after a few weeks of meticulous foot care, “I tell people, ‘You need to go in to see your local podiatrist,’” Dr. Butler said.
Visible skin changes — like rashes, small indentations or persistent peeling or itching — are also signs to see a doctor who can diagnose other odor-causing skin or nail conditions, Dr. Canzanese said. Pitted keratolysis, for example, is a fungal infection that causes small skin indentations and is treated with topical antibiotics.
If plantar hyperhidrosis is the reason for swampy feet, a podiatrist can recommend options like prescription antiperspirants specifically made for the feet. They might also suggest botox injections or iontophoresis (the use of an electrical current on the skin of your feet).
Whether its excessive sweat accompanied by bacteria, fungus or something more, a doctor can help. In the meantime, clean, dry feet are a positive step forward: “We have a zone where we thrive best,” Dr. Weisenfeld said. “Same with bacteria.”
