Question: For many years I have had a terrible problem with foot sweating and smelly feet. Is there a treatment for this?

Dr. Hibberd’s answer:

Focal hyperhydrosis of the feet can often be managed easily. Changing to breathable footwear can help considerably. Be sure to clean and dry your toes and feet after showering. Trim your nails and maintain appropriate foot hygiene. Be sure to use an "antibacterial" soap and avoiding wearing shoes without socks to reduce odors. Try a topical antifungal powder to see if it helps; if not see your doctor for more individualized advice.

Avoid synthetic footwear to avoid trapping moisture. Cotton socks and leather footwear are far preferable to plastic/synthetic footwear that traps moisture. Be sure to also change the insoles of your shoes to minimize fungal growth.

An evaluation for unrecognized athlete’s foot is usually a good idea, and treatment may take several weeks or months to be effective, depending upon the treatment. People with athlete’s foot often have smelly feet, especially after exercising. Remember that anti-perspirants will temporarily plug the sweat glands while deodorants do not stop the sweating, but smell pleasant.

Oral medications to reduce sweating can cause side effects. There are surgical techniques and Botox sometimes works, but I discourage this. Botox use in hands and feet may cause excessive pain and weakness, and should not be used generally. Laser management is hit and miss and I discourage this also. Iontophoresis may be a reasonable option for some. This application of a small electrical current to an immersed foot will deactivate sweat glands in your feet after six to 10 treatments, but needs treatment monthly to maintain its effect.