Feet are probably the hardest working part of our body and carry us through thousands of steps every day – all while wearing sneakers, work boots and the occasional pair of heels that we immediately regret.
But despite all the pressure we put on them, they rarely get any appreciation. In fact, they usually only attract our attention when they make their presence known – through their scent.
Foot odor is one of those problems that people often apologize for before even taking off their shoes in my doctor’s office. They laugh awkwardly, tell me they’re embarrassed, and claim they’re the only person with the problem. They’re not.
If you’ve ever discreetly checked to see if the smell is coming from your own shoes before blaming it on the rest of the room, then you’re in very good company. Up to one in five of us suffer from chronically smelly feet – and most others experience it at some point.
The first thing you need to know is that sweat itself doesn’t really smell.
Your feet contain approximately 250,000 sweat glands, more than any other part of the body, concentrated over the soles. It is completely normal for each foot to produce up to half a liter of sweat per day, especially in hot weather or during exercise.
The problem starts when that sweat becomes a buffet for bacteria.
Our skin is naturally populated with bacteria that are usually completely harmless. On the feet, however, they feast on the abundance of sweat and dead skin cells, breaking them down into compounds that produce that unmistakable cheesy smell.
Foot odor is one of those problems that people often apologize for before even taking off their shoes in my GP practice, writes Dr Raj Arora
Feet contain approximately 250,000 sweat glands, more than any other part of the body, concentrated on the soles of the feet
If you’ve ever wondered why your sneakers seem to smell worse than your sandals, it’s because bacteria absolutely love warm, dark, and moist environments. A sweaty foot stuck in a shoe all day is basically their dream home.
Some people are simply more prone to foot odor than others, which is largely due to genetics and the fact that they naturally have more active sweat glands.
Teenagers often notice it because of hormonal changes. Sweaty feet can also run in families. Certain medical conditions – such as hyperhidrosis (excessive sweating for no apparent reason), thyroid problems and the hormonal changes of menopause – can all increase sweating, as can stress and anxiety.
If you’ve ever noticed your feet getting clammy before a job interview or a first date, you’re not imagining it.
As for whether men have sweatier feet than women, the evidence is mixed. Foot sweating varies wildly from person to person, and there’s no strong, consistent evidence that one gender is worse affected, so I’d call it a myth rather than a medical fact.
The type of shoes you wear is more important than many people realize.
Synthetic materials, including artificial or ‘vegan’ leather made from plastics, such as PVC or polyurethane, do not allow moisture to evaporate as easily as breathable fabrics such as cotton, canvas or genuine leather.
And if you wear the same pair of sneakers every day without giving them time to dry properly, you create ideal conditions for bacteria to thrive.
Your socks also deserve some attention.
Again, cotton and moisture-wicking sports fabrics are generally much better than synthetic materials that trap sweat against the skin.
And yes, changing your socks once a day really makes a difference. Twice a day can even help if your feet sweat heavily, and it’s always worth changing them straight after exercise.
One of the biggest misconceptions I hear is that smelly feet are a sign of poor hygiene.
Usually they aren’t. Even people who wash their feet every day can experience foot odor if they naturally sweat more than average.
That said, there are a few simple habits that can make a big difference.
Wash your feet daily with soap and water, paying particular attention to the spaces between your toes, where moisture tends to accumulate. Then dry them well, because bacteria and fungi thrive on damp skin.
If your shoes are damp after a long day, allow them to dry completely before wearing them again. Switching between two pairs of shoes can make a noticeable difference.
Foot powders – which typically contain moisture-absorbing ingredients such as talc or corn starch, or antiperspirants designed specifically for feet – can also reduce sweating and are applied directly to the soles.
Many people don’t realize that the same ingredients used in underarm antiperspirants, namely aluminum salts that work by temporarily clogging the sweat ducts, can also work surprisingly well on the feet.
For more persistent cases, or true hyperhidrosis, a doctor may suggest prescription aluminum chloride preparations, iontophoresis (a treatment that uses a mild electric current through water, which temporarily disrupts the signals between nerves and sweat glands), or, for severe cases, ‘Botox’ injections to temporarily disable the sweat glands.
Occasionally, foot odor is actually an indication that something else is going on.
Athlete’s foot is one of the most common fungal infections I encounter in general practice. In addition to an unpleasant odor, it often causes itching, redness, peeling of the skin between the toes or cracked skin.
The good news is that it is usually easy to treat with antifungal creams available at your pharmacy.
Switching between two pairs of shoes can make a noticeable difference in sweating problems
Certain bacterial infections, such as erythrasma, can also produce an unusually strong odor, especially if they are accompanied by pain, swelling, or broken skin.
There is another condition called pitted keratolysis that sounds much more dramatic than it is.
It is a bacterial infection that causes small pits on the soles of the feet, along with a particularly pungent odor.
It is more common in people whose feet remain sweaty for long periods of time, including runners, athletes and anyone who wears closed shoes, such as sneakers or boots, for work.
It is usually treated with a topical or oral antibiotic, in addition to measures to keep the feet as dry as possible.
So when should you see your doctor? If you’ve tried improving foot hygiene, changing your shoes and treating excessive sweating with an antiperspirant, but the odor persists, it’s worth taking a look.
Broadly speaking, ‘excessive’ foot sweating means pulling through your socks or having to change them several times a day.
Also, if you notice pain, swelling, discharge from the skin or between the toes, widespread redness or sores, these could be signs of an infection and are worth looking into straight away. And if you have diabetes and develop a new foot problem, don’t ignore it.
The reassuring news is that smelly feet are incredibly common for most people and are almost always treatable.
So if you’ve ever taken your shoes off under the table and quietly hoped no one noticed, don’t panic. Your feet aren’t trying to sabotage your social life. They just tell you they worked hard.
Give them a little fresh air, a little love and maybe a day off from those faithful trainers every now and then. They will almost certainly return the favor.
