[The Physician and Sportsmedicine]


Foot Odor: How to Clear the Air

Michael L. Ramsey, MD


Foot odor is seldom discussed around the water cooler. But many people suffer from this embarrassing and at times frustrating problem, particularly active people whose feet sweat a lot. Fortunately, foot odor can usually be controlled with simple measures (table 1).

Table 1. Foot Odor Treatment at a Glance

  • Wash briskly with antibacterial soap, including between the toes
  • Dry skin well (a hair dryer may help)
  • Wear absorbent socks and change them frequently
  • Wear shoes that "breathe"
  • Allow shoes to air out at least 24 hours after use
Over-the-Counter Products
  • Antiperspirants can decrease moisture
  • Tea soaks may help
  • Benzoyl peroxide 5% or 10% gel applications may decrease bacteria
Prescription Agents
  • Drysol (aluminum chloride hexahydrate 20%) at bedtime
  • Drionic* device for reducing perspiration
  • Erythromycin 2% or clindamycin 1% solution twice a day
When to Consider Other Treatment
  • If above measures fail to cure foot odor in a few weeks
  • If the odor is accompanied by skin changes
*General Medical Co, 1935 Armacoast Ave, Los Angeles, CA 90025; (310) 820-5881

Odor Origins

Foul feet can often be traced to bacteria. The warm, moist environment inside shoes--especially athletic shoes--promotes bacterial growth on the feet. Two of the most common sources of stench are corynebacteria and micrococci. Successful treatment of foot odor depends on eradicating these organisms. This means that odor-fighting measures like activated-charcoal shoe inserts and foot powders don't get to the root of the problem.

Helpful Home Remedies

Several home remedies can help decrease foot bacteria. The most practical and long-lasting approach to eliminating odor is to avoid the warm, moist conditions required for bacterial growth. Scrub your feet thoroughly when bathing, preferably with an antibacterial soap. After rinsing, dry your feet thoroughly--a blow dryer can help. You can also apply an underarm antiperspirant containing aluminum chlorhydrate or aluminum chloride to your feet. Spray formulas are generally the easiest to apply. It helps to go barefoot or wear socks or sandals by themselves whenever possible, thus allowing air to reach the feet more easily.

Socks should be made of cotton or other absorbent materials, and they should be changed frequently. You can take an extra pair of socks to work or school for changing during the day. Wear socks whenever you wear shoes.

Shoes that have a noticeable odor are best thrown out if practical, although some can be salvaged by washing with a soapy detergent and bleach. Alternate shoes so that they can air out between uses, at least 24 hours if possible. Look for shoes that "breathe," or ventilate, well, which depends on their construction and materials. Leather usually breathes well, but ask a salesperson about the breathability of specific shoes.

Sweating and odor may be reduced by soaking your feet daily in black tea, which contains tannic acid. One method is to brew two tea bags in 1 pint of boiling water for 15 minutes. Then add the tea to 2 quarts of cool water and soak your feet for 20 to 30 minutes. Some people report great improvement after 7 to 10 days of daily tea soaks.

Prescription-Strength Relief

If these measures fail to eradicate the odor within a few weeks, it may be time to see a doctor, who can prescribe stronger remedies. One very effective agent is aluminum chloride hexahydrate 20% solution (Drysol). Initially, it should be applied to the feet overnight for 3 to 7 nights, until perspiration is noticeably decreased, and one to three times weekly thereafter. Wrapping the feet with plastic wrap during overnight application aids in effectiveness. Drysol should not be applied to broken or irritated skin because the active ingredient and its alcohol solvent may cause further discomfort. Applying a skin lotion in the morning may minimize the irritating effects of Drysol.

Another method of reducing sweating is the use of electric-current devices. These machines pass a small electrical current through the skin and effectively diminish perspiration. Such devices can stop sweat for several weeks.

Antibiotics applied to the skin are occasionally necessary to cure foot odor if drying measures fail. Erythromycin 2% or clindamycin 1% solutions are effective in killing most odor-producing bacteria on otherwise healthy feet, and they can be applied at morning and bedtime. Alternatively, benzoyl peroxide 5% or 10% gel may be applied in a similar fashion, and unlike erythromycin and clindamycin, it is available without a prescription. Keep in mind, though, that benzoyl peroxide may bleach colored fabrics.

If these measures fail to vanquish foot odor in 3 to 4 weeks, or if your skin appears abnormal, you may be dealing with other, possibly more serious, skin problems. Athlete's foot infected by bacteria is common and requires more aggressive treatment, which may include different antibiotics. Pitted keratolysis (care-a-TOL-a-sis) is an innocuous but foul-smelling infection that causes small pits in the weight-bearing areas of the feet in addition to a distinct, pungent odor. Fortunately, it usually responds to the medical treatment described above because pitted keratolysis is caused by the same bacteria that are responsible for most cases of foot odor.

Remember: This information is not intended as a substitute for medical treatment. If you have health concerns, consult a physician.

Dr Ramsey is an associate in the Department of Dermatology at Geisinger Medical Center in Danville, Pennsylvania, a fellow of the American College of Dermatology, and an editorial board member of The Physician and Sportsmedicine.




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