Q. My son is 18 years old. Both his feet are often cold and damp, such that his socks are always wet, regardless of what the weather is like. It is worse when he does not put on socks.
His feet also give out a smell and he has become quite conscious about it.
He has had this condition for several years but it seems to be getting worse in this hot and humid weather. He is a healthy young man who is active in sports and has a good appetite.
What is the cause of such a condition? Is there a cure? If there is a need to consult a doctor, what kind of specialist should he see? Are there any products that he can use to reduce the odour?
A. Anyone can get sweaty feet, regardless of the temperature.
There are more sweat glands in our feet than anywhere else in the body.
Teenagers are especially prone to sweaty feet because hormonal changes make them sweat more.
One is also more likely to have increased foot perspiration if the weather is warm, if he engages in more physical activities, if he is nervous, or has a medical condition called hyperhidrosis.
In hyperhidrosis, the nerves responsible for triggering sweat glands become overactive and this leads to excessive sweating.
Given that sweating is the body's mechanism to cool itself, the increased sweating of your son's feet will cause his feet to feel cool to the touch.
People get smelly feet when the sweat cannot evaporate. Shoes and socks can prevent sweat from evaporating. The entrapped sweat creates a moist environment which encourages bacteria growth.
Sweat also softens keratin, a component of the outer layer of skin. This promotes bacterial breakdown of the keratin, yielding a foul smell.
Poor hygiene, such as infrequent washing of the feet or the failure to change your socks at least once a day, also encourages bacteria growth and cause smelly feet.
Fungal infections can also give rise to smelly feet. In general, the management of smelly feet is aimed at reducing moisture and bacteria on the skin's surface.
Simple measures to maintain good feet hygiene include washing the feet daily, with antibacterial or antifungal soap and a scrubbing brush.
Feet should also be dried thoroughly, especially between the toes. Keep toenails short and clean.
Check the soles of the feet for hard, dead skin and remove it with a foot file. Hard skin can become soggy when damp, which provides an ideal home for bacteria.
Wear proper footwear to allow for better ventilation. Buy shoes made of breathable material such as leather, canvas or mesh. Avoid synthetic material.
Wear socks that are made with good moisture-wicking fibres. Change socks at least once a day.
Change shoes every 24 hours if the feet sweat a lot or if they are wet, to allow the shoes to dry out.
Remove any insoles to help speed up the drying process. Consider the use of insoles with anti-odour or antimicrobial properties.
Medical treatment, such as antifungal medication or antibiotics, may be needed if the smelly feet are due to an underlying infection.
If the underlying problem is hyperhidrosis, treatment options include antiperspirants, which contain aluminium chloride that helps to reduce sweat production.
Botulinum toxin injections may also be beneficial too. It can block the signals from the brain to the sweat glands, which decreases sweat production.
However, this treatment is temporary and usually lasts between three and six months.
Another treatment is iontophoresis, which involves submerging the feet in a bowl of water through which a weak electric current is passed.
Do see your family doctor or a dermatologist to determine if your son's condition requires medical treatment.
DR RAYMOND KWAH Consultant dermatologist at Raffles Skin & Aesthetics Centre at Raffles Hospital
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