Feet trapped in closed shoes for prolonged periods can lead to sweaty and smelly feet.

QUESTION: I am 41 years old and I need something to change. My feet stink and I am taking strain. It’s very embarrassing and I have quite a complex about it. I have tried so many remedies that have failed or had no impact.

I work as a tax lawyer and spend long days on my feet. I cannot wear open shoes to work, as the dress code is strictly neat and we are expected to dress smartly.

My foot odour has become a debilitating problem. Whether it is day or night, I am so sensitive about the issue that I cannot relax. My thoughts and fears about offending others, even my close friends, make me anxious. It is so bad that I spray deodorant on my socks and shoes. I scrub my shoes weekly and leave them outside overnight to air, but this makes little or no difference.

My hygiene is good and I use good quality soaps and wash my feet regularly. I often place powder in my shoes, too. I thought that the powder would absorb the moisture and counter the smell, but is using powder a good idea or not?

Sometimes my shoes get soggy and don’t dry out completely. I also use different types of socks, and changed to thinner socks as I thought this would make me sweat less. I’ve also used foot creams and spa preparations.

I have noticed that there are some water filled bubbles on the undersurface of my feet after long periods in closed shoes – at times the skin under my feet will peel or flake off.

I have used treatments for athlete’s foot, which had a limited effect on the flaking – although the smell of the ointment was disgusting. Is there an association between bad hygiene and fungal infections?

As far as I can remember, the problem wasn’t as prominent during my school years. My mother says my late father suffered with the same issue, but claims his condition was worse. I have tried to research the topic and am stressed that I might have some underlying medical condition.

As far as I know I am relatively health conscious and only use gym supplements to bulk up a bit.

I know that you might think this is not a big issue, but I am tense when showering after gym or being in a crowded small stuffy room. I just don’t know where to turn any more. You are my last hope.


ANSWER: Thank you for such an honest account of your problem. It is true that we underestimate how dramatic the effect of something like this can be.

People often crack jokes about stinky feet or breath, but it certainly is a cause of much distress.

A systematic approach is needed and a few crucial points must be clarified in getting to the bottom of it. It’s all about environment and habit, and facilitating breeding conditions for fungal infection.


The path to malodour

The feet are often covered for long periods and can sweat profusely. The skin then bathes in this moisture for several hours – often appearing white and wrinkled when the socks are removed, similar to that of taking a long bath.

The natural skin rejuvenation cycle involves dead scales and layers of skin being shed daily. The thickened crust of dead dry, porous skin is often compacted on the heels… this acts like a sweat sponge if not dealt with adequately.

Water retention in the skin under the toes and feet sometimes leads to small blister-like bubbles that later dry out and peel off. This is a clear sign that there is too much moisture surrounding the feet.

We shouldn’t forget that some people sweat excessively and this is part of the body’s autonomic system. Sweaty palms, armpits and feet often accompany anxiety, but can also be genetic.


What causes the smell?

Besides the obvious damp, poorly aerated and mouldy smells, there is a lot more to it. The acidic nature of sweat and the varying pH levels add to the flavour. Dirt and debris of sand and sweat combinations reach pungent levels when accompanied by shedding dead skin cells.

There are odours or gases released by certain organisms that are offensive. However, the perfect cultivating ground is necessary for these to flourish. Some of them thrive in dark, moist and clammy conditions.

They are happy in poorly oxygenated environments.


Give stink the boot

* Air the toes as much as possible.

* Wash your feet with an abrasive cloth or sponge to remove surface debris and old skin.

* Dry your feet thoroughly after washing – especially between the toes.

* Never put wet feet into your shoes.

* Wear cotton socks.

* Remember secret socks also help absorb sweat.

* Change socks more often daily if too moist.

* Alternate pairs of shoes if you can.

* Air your shoes daily when not in use – direct sunlight is crucial.

* Changing inner soles also helps.

* Choose footwear material that breathes – allows air in and out.

* Weekly foot hygiene: toenails and removal of dead skin with a pumice stone.

* Treat fungal infections early.

* Foot deodorisers and alcohol sprays do work if used as part of a good routine.

* Foot powder directly on the skin and lightly dusted is effective.

* Remember, happy feet are dry feet.


Home remedies

* Put tea-tree oil in bath water.

* Rooibos tea soaks.

* Honey treatments – antibacterial.

* Epsom Salts and bicarbonate of soda soaks – remove dead skin.

* Fullers Earth for moisture. - Cape Argus


* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.

He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.

If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.

The advice in this column does not replace a consultation and clinical evaluation with a doctor.