Botox helps those with sweaty feet

Q: I am a healthy 21-year-old man with sweaty feet. When my feet become moist, they produce an unpleasant odour. My feet smell in the lecture room and the cinema. It is very embarrassing when I am asked what that smell is.

I sometimes avoid taking off my shoes to prevent people from knowing that I have smelly feet. This affects my social life, especially when I have to turn down house invitations by my friends.

I have used anti-perspirant spray and powder, but they are not effective.

I have thought of covering my feet with plastic bags before wearing socks. However, I am unsure if this crazy method will do more harm than good. Please advise.

A: You are certainly not alone in your predicament. This is a fairly common condition of varying severity.

Perspiration causes an unpleasant smell when it comes into contact with bacteria on your skin.

Excessive sweating on one's feet, coupled with reduced evaporation of sweat due to the wearing of socks and shoes, leads to smelly feet.

Simple measures include changing your socks several times a day or wearing sandals, which provide more ventilation, rather than shoes.

Anti-perspirants which contain aluminium chloride may help in milder cases, but they need to be used regularly and may cause skin irritation in some people.

Iontophoresis and botulinum toxin are other options.

Iontophoresis is a procedure in which a machine is used to deliver a low-level electrical current to the feet while they are immersed in water. This is a safe procedure which can reduce perspiration in the affected area. The effect lasts from several days to weeks, so the procedure needs to be repeated regularly.

This is carried out in a hospital. Home iontophoresis kits are available but are less effective.

Botulinum toxin, which is commonly used to treat facial wrinkles, has been shown to be effective in reducing sweat production in the feet, hands and underarms.

Each treatment session involves multiple injections of the toxin to the skin of the affected area. It can be painful, so anaesthesia with a numbing cream or a nerve block is normally required. The effect lasts for several months.

You should consult a dermatologist to decide which of the various treatment options best suits your needs and lifestyle.

Dr Chris Foo
Consultant dermatologist at Raffles Skin Centre at Raffles Hospital

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