Patient Education

Sweaty Feet (Hyperhydrosis)

Description

Some medical conditions of the foot are painful. A few may even be life- threatening. But some conditions are just downright embarrassing. Take sweaty feet: no one would really classify it as life-threatening (unless, of course, your life depends on your ability to keep your socks dry), but having sweaty feet (and sometimes the smelly feet that can accompany the condition) can make people feel self-conscious, uncomfortable, and isolated.

There are a few different things that can cause excessively sweaty feet. Primary hyperhydrosis, for example, refers to excessive sweating, usually on the face, hands, underarms and feet (although it may occur throughout the body) that is unrelated to other causes (like heat, exercise and some medical conditions). Although there isn’t really a known cause for primary hyperhydrosis, it seems to have a genetic link. Secondary hyperhydrosis means that your excessive sweating is being caused by some other condition, such as anxiety, menopause, heart problems, lung problems, cancer, hyperthyroidism (overactive thyroid), stroke or diabetes. Some medications, heat, or exercise may also contribute to secondary hyperhydrosis.

Symptoms

Excessive sweating on the soles of your feet is the primary symptom of hyperhydrosis, although you may notice a great deal of sweating on the palms of your hands, your face, and under your arms. Hyperhydrosis can also make you more susceptible to athlete’s foot, plantar warts or smelly feet, so you may notice symptoms of these conditions as well.

Diagnosis

While you may be embarrassed to let people in on your sweating problem, your podiatrist is a friendly professional who won’t think any less of you when he or she finds out about it. In fact, your podiatrist can help you reduce the sweatiness of your feet and get you back to feeling normal again. To diagnose hyperhydrosis, your podiatrist will probably ask you about your symptoms, such as where and when your sweating occurs, and whether or not it seems to be connected to any other condition such as anxiety or another medical problem.

There are a few tests to see if the soles of your feet are sweating more than usual. The starch-iodine test involves applying an iodine solution to the soles of your feet. Then, once the solution dries, your doctor sprinkles starch on your feet. (This can also be used as an enjoyable diversion at parties, especially if said party starts getting kind of dull.) If the combination of starch and iodine turns dark blue, then excessive sweating is present in the area. Your podiatrist might also use special paper (placed against the sole of your foot) to absorb sweat. The paper is then weighed to determine how much water you’re exuding.

Treatment

Again, excessive sweating isn’t really a life-threatening condition, so it’s important to weigh the benefits of treatment against possible side effects. Fortunately, there’s a variety of treatments to choose from.

Your podiatrist may suggest antiperspirants, which most often contain aluminum chloride hexahydrate, which blocks the pores. Over-the-counter medications such as Drysol, Dehydral and Xerac can be quite effective at treating sweaty feet. If over-the-counter options don’t work for you, your podiatrist may consider prescription medications such as glycopyrrolate or propantheline bromide. These oral medications prevent stimulation of your sweat glands.

Iontophoresis is effective for some patients. It involves putting your feet in a shallow pan of water. The podiatrist will then use a machine to send a low voltage current through the water to temporarily shut off the sweat glands in your feet. You’ll likely need the treatment every other day for six to ten sessions, and about once a week after that. You can purchase the machine, but only with a prescription from your doctor.

If all other treatments fail, your podiatrist may recommend surgery to excise the sweat glands or destroy the nerve sending signals to the glands. However, in nearly 80% of patients, this procedure can lead to compensatory sweating elsewhere on the body, so you should undertake it only if all other methods have failed, and only if you fully understand the risks.

In the meantime, wearing cotton socks and leather shoes might help keep your feet dry and prevent unpleasant associated conditions, like athlete’s foot, or worse, really really stinky feet.