When smelly feet are more than just sweaty
Everyone's feet sweat, and most people's shoes get a bit whiffy from time to time. But if your feet have a strong, lingering smell that doesn't go away with washing, or the skin on your soles looks pitted or patchy, a bacterial skin infection may be to blame.
Our skin is home to more than 200 species of bacteria and fungi, called the normal flora. Usually they're harmless. But when feet stay warm and damp for long periods, some of these bacteria can multiply and infect the outer layer of skin.
Two bacterial infections are especially common on the feet, and both are linked to excessive sweating (hyperhidrosis) and smelly feet (bromodosis): pitted keratolysis and erythrasma. Both are treatable, and the right routine makes a big difference.
Pitted keratolysis
What it looks like
Pitted keratolysis affects the soles of the feet, especially the weight-bearing areas such as the heel and ball of the foot. Look for:
many small, shallow pits or craters in the skin, sometimes joining together
skin that looks white and soggy, especially after your feet have been in socks and shoes all day
a strong, unpleasant smell
What causes it
Sweat lets bacteria that normally live on the skin infect its outer layer. The bacteria break down the top layer of skin, creating the pits, and produce the smell. It's common in people who sweat a lot or wear closed boots for long hours, such as farmers, tradespeople, miners and athletes.
Treatment
Scrupulous foot hygiene: wash your feet thoroughly with soap and water every day. See [How to wash your feet properly].
Change your socks two to three times a day.
Wear open shoes whenever you can, and rotate your shoes so each pair dries out between wears.
Astringent foot soaks to dry the skin, such as Condy's crystals or black tea soaks. Ask us how to prepare these safely.
Antiseptic spray: a hypochlorous acid spray helps treat the bacteria.
Reduce sweating: options include iontophoresis and, for some people, medication from your GP.
See your GP if it hasn't improved after 6 weeks. They may prescribe an antibiotic cream or tablets.
Erythrasma
What it looks like
Erythrasma usually appears between the toes, most often between the 4th and 5th toes. Look for:
well-defined pink, red or brown patches
skin that may be scaly, cracked or soggy-looking
mild itch, or no symptoms at all
Erythrasma often occurs alongside tinea (athlete's foot), and the two can look very similar. That's one reason a tinea cream on its own sometimes doesn't fully clear things up. Read more about [tinea and athlete's foot].
Treatment
Scrupulous foot hygiene, paying particular attention to between your toes.
Dry thoroughly between your toes after washing. A hairdryer on the cool setting works well.
Astringent foot soaks every day.
Antiseptic spray: a hypochlorous acid spray between the toes.
Antifungal cream as well, if tinea is also present.
See your GP if it hasn't improved after 6 weeks. They may prescribe an antibiotic cream or tablets.
Everyday tips for sweaty feet
Whether or not you have an infection, these habits help keep sweaty feet healthy and fresh:
Wash and dry your feet properly every day, including between the toes.
Change your socks at least once a day, and more often if your feet get damp.
Choose socks that wick moisture away from the skin.
Have two or more pairs of work shoes or boots, and let each pair dry out for a day between wears.
Go barefoot or wear open shoes at home when you can, if it's safe for your feet.
When to see a podiatrist
Book in if your feet have a strong smell that doesn't improve with good hygiene, you notice pits or patches on your skin, or you're not sure whether it's a bacterial or fungal infection. If you have diabetes or poor circulation, see us sooner.
At Esperance Podiatry, Rebecca can work out what's causing the problem and recommend the right treatment for you. No referral is needed. Call (08) 9072 1514 to book.