Athletes Foot and Other Skin Conditions

About Athlete’s Foot/Tinea Pedis/ Fungal Infection of the Feet

Athlete’s foot is caused by a fungal organism called Trichophython. The fungus can be found on floors and in socks, shoes and clothing, and can be spread from person to person via contact with these objects. As a fungal infection, it can also be spread unwittingly to other areas of the body, such as the underarms and groin, should the affected person scratch their feet and then touch themselves elsewhere. In addition, because athlete’s foot can cause cracking and blisters, it can provide opportunity for other infections.

Almost 70% of the population will be affected at some time in their lives, although it is more common in adolescent and adult males and, generally, is not seen in children below the age of 12.

Signs

Itching of the feet is thought by many to be the hallmark of athlete’s foot. While perhaps the most annoying and distracting part of the disorder, it is by no means the only symptom, and since it is not always present, should not be relied upon for self-diagnosis when athlete’s foot is suspected. Instead, look for other telltale symptoms – changes in the skin between the toes, generally the last two toes – in particular, a whitish discoloration, as well as dryness, redness, peeling, blistering, cracking and scaling. Athlete’s foot may also present as redness, scaling or blisters along the sides or soles of the feet. The ‘trademark’ itching may be present in varying degrees, or it may be absent altogether.

Other notes:

This condition can respond to over-the-counter remedies; however, not every foot rash or itch is athlete’s foot. Many other disorders can mimic some or all of the symptoms of athlete’s foot – these include psoriasis, dry skin, disturbances of the foot’s sweat mechanism, allergies to products used in shoes or insoles, or to detergents used on socks, as well as any number of other conditions. You don’t want to aggravate an irritation that has nothing to do with athlete’s foot. The best way to be certain that your condition is properly diagnosed and effectively treated is to see a podiatrist.

What causes it?

Everyone has probably heard that athlete’s foot is caused by walking around barefoot in locker rooms and shower facilities. And to a certain extent, that’s true. Bare feet can, and do, come into contact with the culprit fungus in these areas. Fungus loves a warm, moist environment, and the constant humidity and dampness of a shower or locker room provides a great medium on which it can lurk. However, athlete’s foot is not as contagious as it’s made out to be, and in many cases, an infected family member can use showers, bathrooms and more, and never infect others living in the same household. In fact, many instances of athlete’s foot have nothing to do with showers, rest rooms, pools or the like; instead, they can be caused by fungus that develops and/or spreads due to:

• Not washing and drying feet thoroughly after athletic activity, or not washing/drying at all after feet become wet in any situation (being caught in a rainstorm, or after any activity that makes feet sweat, such as a long walk, or standing for a long period of time) – also, continuing to wear the same shoes and socks after they have gotten wet, regardless of having washed and dried the feet.
• Wearing athletic shoes (or any shoes) that have become too worn; shoes that are regularly exposed to sweat will become a breeding ground for mold spores.
• Not rotating shoes (athletic, dress or casual) between wearings; rotation allows shoes to dry and inhibits the growth of mold spores within the shoe
• Wearing others’ shoes or socks
• Not changing socks when changing shoes
• Using the same shoes for athletic and casual wear
• Wearing heavy shoes and socks that make feet sweat
• Wearing socks and/or shoes made of man-made (not breathable) fibers which do not allow for air circulation
• Not wearing stockings, socks or some sort of foot covering when trying on shoes in a shoe store

Treatment

Rather than taking a chance on self-diagnosis and home remedies, your best bet is to make an appointment with the podiatrist who can examine your feet and give you a diagnosis, so that treatment can begin and relief can occur. (This will also help lessen the probability of secondary infections, or of the fungus spreading elsewhere on the body, which has a higher chance of taking place if the patient waits too long). The podiatrist may recommend a topical over-the-counter antifungal agent or more severe cases, oral anti-fungal prescriptions may be necessary. If a secondary bacterial infection is present, an antibiotic may also be needed. More extensive treatment may be required if the patient’s problem has progressed to the point of having open lesions.

Who is most susceptible?

Anyone can be susceptible to athlete’s foot, given the right (or wrong) conditions. However, more often than not, it is particular behaviors which encourage fungus growth. Fungus prefers a warm, moist environment, so anyone whose feet are subjected to such an environment (such as those mentioned above in “what causes it?”) could be considered to have a higher risk .

Most importantly, athlete’s foot risk goes up for those who fail to wash and dry their feet thoroughly before putting on their shoes. This is an open invitation for athlete’s foot fungus.

How can it be prevented?

Preventing athlete’s foot is as easy as following a few simple precautions and using common sense. Fungus loves a warm, dark, damp environment, so promote dryness, light and air circulation instead. Keep feet clean and dry at all times. Dust an anti-fungal powder into shoes and/or socks (follow the directions on the container) to inhibit growth of spores. This is particularly effective in the summer, but can be done all year round.

Walking barefoot around the house, wearing sandals whenever possible, and at other times, wearing shoes made out of leather or canvas – that “breathe” – will also increase air circulation and inhibit mold growth. Choose socks that wick perspiration away from your skin.

Do not work out in a pair of shoes and then wear them for the rest of the day, or even over the next several hours. It’s an invitation to infection. Instead, carry an extra pair of shoes and socks with you. Even better, keep a spare pair of each at work and in your car. That way, should your shoes and socks become wet at any time (rainstorms, etc), slip them off, clean and dry your feet thoroughly, and change to a dry pair of shoes and socks. Don’t leave shoes that have become wet, damp or sweaty in your gym bag, your locker, your trunk, or anywhere they will not dry thoroughly and receive good air circulation.

Athletes, health club members, students and others who use public facilities can minimise their risk of infection (or re-infection) by wearing foot protection (flip-flops or other quick-drying sandals that provide separation between feet and the shower/locker room/rest room floor), and by discarding heavily used sports shoes which may have a high density of fungal spores. Remember – even expensive running or workout shoes (and even dress shoes or casual footwear) can harbor fungus if they aren’t changed often enough. Your podiatrist can advise you on how often various types of shoes should be discarded and new ones purchased.

When shoe-shopping, wear or bring along the kind of socks or hose you intend to be wearing with that shoe, and make sure you wear them while trying on the shoe. Avoid putting your bare foot into a tester shoe that other people have worn.

Finally, while it may be the ultimate tribute to friendship that two people can borrow each other’s clothes, the same generosity should NOT extend to footwear. Never wear someone else’s socks and/or shoes. It’s inviting athlete’s foot trouble. Why seek out problems?

Corns and calluses are areas of thickened skin that develop to protect the skin. It is normal for the skin to become thick when it is exposed to excessive pressure. By becoming thick, it prevents the soft skin from breaking down. However, the thickened skin is made of keratin (like hair and nails) and so it has no ability to cause pain. But the thickness puts pressure on the soft skin below it and around it which causes the pain.

The difference between callus and corn is the shape. Callus is larger in size and usually occurs on the sole of the foot. Corns are small and cone-shaped, and are usually more painful then callus. They commonly occur on the toes.

Corns and calluses are not contagious but may become painful if they get too thick. In people with diabetes or decreased circulation, they can lead to more serious foot problems.

Causes

• Corns can occur from tight fitting shoes rubbing on the toes or squeezing the toes together. High heels, mens slim business shoes and ballet flats are just examples of some common tight shoes.
• Corns and callus can also be caused by the way you walk. Your foot movement can cause certain points on your feet to get exposed to more pressure.
• People with certain deformities of the foot, such as hammer toes, or bunions are prone to corns and calluses.
• Sometimes with ageing, your fat pad on the sole becomes thinner, and less cushion can lead to more pressure.
• Joint conditions like arthritis can cause the joints to become misshapen and develop more pressure on the skin.

Symptoms

Corns and calluses typically have a rough, dull appearance. They may be raised or rounded. Corns or calluses sometimes cause pain when walking or when using shoes.

Self-Care

If the corn or callus isn’t painful, its not necessary to remove it. But most often, it can feel alot more comfortable once they are removed. Identifying the cause of it is important to prevent future occurrences. A podiatrist will discuss with you what is the most likely cause in your case.

Immediate relief of corns can be given with the use of a cushioned donut pad to alleviate the pressure. They can be purchased from the chemist. Avoid using medicated corn pads to treat corns, as they can cause more pain due to the acid irritating the normal skin.

When to Visit a Podiatrist

If corns or calluses are causing pain and discomfort or inhibiting your daily life in any way, you should see a podiatrist for instant immediate relief.   Also, people with diabetes, poor circulation, or other serious illnesses should have their feet checked.

Diagnosis and Treatment

The podiatrist will conduct a complete examination of your feet. Corns and calluses are diagnosed based on appearance, location, history, footwear, biomechanics, foot shape and lifestyle. The podiatrist will identify what is the cause of your corns or calluses.

Corns and calluses are most effectively removed with a surgical blade, providing relief immediately. A podiatrist will use the blade to carefully shave away the thickened, dead skin in the clinic without an anaesthetic. The procedure is painless because the skin is already dead (like hair and nails). Additional treatments may be needed if the corn or callus recurs.

Prevention

• Wear properly fitted shoes. If you have any deformities of the toe or foot, talk to your podiatrist to find out what shoes are best for you.
• Gel or cushion pad inserts may decrease friction points and pressure. Your podiatrist can help you determine where pads might be useful.
• If your foot biomechanics is causing the pressure, then orthotics can help to re-distribute the pressure .
• Using a pumice stone or skin filer regularly after the shower helps to reduce the thickness.
• Moisturising nightly also helps to soften the hard skin.

Cracked heels are a very common foot problem, often referred to medically as heel fissures. They are caused by dry skin and made more complicated if the skin around the edge of the heel is thick. They can be painful to stand on and the skin can bleed.

Causes

Some people tend to have a naturally dry skin that makes the skin easy to crack. The thickened dry skin (callus) around the heel that is more likely to crack is often due to mechanical factors that increase pressures in that area (eg the way you walk).

Factors that can also be involved in the cause of cracked heel skin include:

• prolonged standing
• being overweight
• open back on the shoes
• some medical conditions predispose to a drying skin (eg diabetes)
• skin conditions (eg psoriasis)

Self care

• Applying a strong moisturizing cream twice daily is really important to get on top of this problem. A pumice stone can be used to reduce the thickness of the hard skin. It is important to avoid open backed shoes or thin soled shoes.
• Never try to reduce the hard skin yourself with a razor blade or a pair of scissors. There is a risk of an infection developing and taking too much off.

Podiatry treatment

• Investigating the cause of the problem, so this can be addressed
• Removing the hard thick skin by debriding it (often the splits will not heal if the skin is not removed). This may need to be done on a regular basis. Regular maintenance may be the best way to prevent the problem.
• If very painful, strapping may be used to ‘hold’ the cracks together while they heal (a maintenance program after this to prevent recurrence is very important).
• Prescription and advice regarding the most appropriate moisturizer or emollient.
• Advice about footwear and self care of the problem.
• Orthotics may be used to alter the way you walk to prevent the thick skin from developing (these are indicated in cases of heel callus and are not suitable for all cases).

A heel cup may be used to keep the fat pad from expanding sideways. This is worn in the shoe and can be very effective at prevention if used regularly.

Dry skin, especially on the feet, is a problem that most people experience at one time or another. Sometimes dry skin occurs on widespread areas of the body, secondary to other health issues. Or perhaps only the feet are affected, resulting in cracked skin or calluses on the heels or soles of the feet. Dry skin, also known as xerosis, can simply be a cosmetic problem or it may lead to symptoms such as itchiness, a skin rash, or even pain and secondary infection.

Other skin conditions that result in dry, thickened skin include athlete’s foot (tinea pedis), leg vein problems (venous stasis), psoriasis, and skin rashes caused by allergy or irritants. A common cause of dry, scaly skin and accentuated skin lines on a child’s feet is the condition atopic dermatitis.

Common Causes of Dry Skin

Physical Stress: The environment inside a shoe can get very hot — sometimes well over 120 degrees. Heat and humidity changes result in water loss from the skin and ultimately result in the thickening of the top layer of skin.

• Skin Cleansers: Certain soaps can strip protective oils from the skin or leave irritating residues that contribute to dry skin.
• Medical Conditions: Diabetes, hypothyroidism, psoriasis, eczema, poor circulation, lymphodoema, and malnutrition are a few common conditions that may cause dry skin.
• Aging: Hormonal and metabolic changes over time decrease skin cell turnover, resulting in a thickening of the skin’s outermost layer, known as the stratum corneum. Also, as we age, the protective fat pad on the sole of the foot gets thinner. Loss of this cushioning in the heel and ball of the foot can increase skin stress, leading to cracked, callused skin.
• Cold Weather: Dry skin often worsens in the winter months, mostly due to indoor heating and low humidity.

Treatment of Dry Skin

If your feet have calluses, cracked skin, wounds, or rashy, dry skin that does not improve with creams or lotions, an evaluation by a podiatrist is a good place to start — most importantly to identify and treat secondary causes of dry skin, such as athlete’s foot or eczema. Corns and calluses can be safely removed by your podiatrist, which is a great way to improve the appearance of your feet and prevent future problems, such as pain and skin wounds. Also, severe dry skin may require prescription-strength creams.

Prevention

• Use a daily foot cream that contains urea.
• If you are prone to allergies or skin sensitivities, use skin products that are labeled as hypoallergenic or formulated for sensitive skin.

For rough areas on the soles of the feet, use a foot file or pumice stone after bathing or soaking your feet. This routine is very effective at keeping calluses from building up on the soles. For dry skin on the tops of the feet and on the legs, try a loofah sponge or exfoliating skin product.

Eczema is a term for a group of medical conditions that cause the skin to become inflamed or irritated. The most common type of eczema is known as atopic dermatitis, or atopic eczema. Atopic refers to a group of diseases with an often inherited tendency to develop other allergic conditions, such as asthma and hay fever.

What Are the Symptoms of Eczema?
No matter which part of the skin is affected, eczema is almost always itchy. Sometimes the itching will start before the rash appears, but when it does, the rash most commonly appears on the face, back of the knees, wrists, hands, or feet. It may also affect other areas as well.

Affected areas usually appear very dry, thickened, or scaly. In fair-skinned people, these areas may initially appear reddish and then turn brown. Among darker-skinned people, eczema can affect pigmentation, making the affected area lighter or darker.

In infants, the itchy rash can produce an oozing, crusting condition that happens mainly on the face and scalp, but patches may appear anywhere.
Continue reading below…

What Causes Eczema?
The exact cause of eczema is unknown, but it’s thought to be linked to an overactive response by the body’s immune system to an irritant. It is this response that causes the symptoms of eczema.

In addition, eczema is commonly found in families with a history of other allergies or asthma. Also, defects in the skin barrier could allow moisture out and germs in.

Some people may have “flare-ups” of the itchy rash in response to certain substances or conditions. For some, coming into contact with rough or coarse materials may cause the skin to become itchy. For others, feeling too hot or too cold, exposure to certain household products like soap or detergent, or coming into contact with animal dander may cause an outbreak. Upper respiratory infections or colds may also be triggers. Stress may cause the condition to worsen.

Although there is no cure, most people can effectively manage their disease with medical treatment and by avoiding irritants. The condition is not contagious and can’t be spread from person to person.

How Is Eczema Diagnosed?
If you suspect eczema on your feet, see the podiatrist for a confirmation. As eczema can easily be confused with other skin conditions . If suspected by the podiatrist, they may refer you on to see a dermatologist for medicated treatment. While there are no tests to determine eczema, most often a podiatrist can tell if it’s eczema by looking at your skin and by asking a few questions.

Since many people with eczema also have allergies, a doctor may perform allergy tests to determine possible irritants or triggers. Children with eczema are especially likely to be tested for allergies.

How Is Eczema Treated?
The goal of treatment for eczema is to relieve and prevent itching, which can lead to infection. Since the disease makes skin dry and itchy, lotions and creams are recommended to keep the skin moist. These products are usually applied when the skin is damp, such as after bathing, to help the skin retain moisture. Cold compresses may also be used to relieve itching.
Over-the-counter products, such as hydrocortisone 1% cream, or prescription creams and ointments containing corticosteroids, are often prescribed to lessen inflammation. In addition, if the affected area becomes infected, your doctor may prescribe antibiotics to kill the infection-causing bacteria.
How Can Eczema Flare-ups Be Prevented?
Eczema outbreaks can sometimes be avoided or the severity lessened by following these simple tips.

• Moisturise frequently.
• Avoid sudden changes in temperature or humidity.
• Avoid sweating or overheating.
• Reduce stress.
• Avoid scratchy materials, such as wool.
• Avoid harsh soaps, detergents, and solvents.

Be aware of any foods that may cause an outbreak and avoid those foods

Itchy skin can be caused by one many skin conditions. Depending on the appearance of the skin, the location, duration, and medical history. Below are common causes of itchy skin:

• Athletes foot (tinea or fungus)
• Dermatitis, which is inflammation of the skin due a sensitivity or allergic reaction to a substance.
• Psoriasis is chronic non-contagious condition of the skin causing thickened inflammed patches of skin. (see psoriasis)
• Eczema is also a chronic non-contagious condition of the skin which is usually caused by a reaction to stress, food, lifestyle condition or foreign substances. (see eczema)
• Insect bites

Speak to the podiatrist for a confirmed diagnosis, so treatment can begin early and effectively.

Warts are the manifestation and growth of a contagious virus (HPV, the Human Papillomavirus) that invades the skin through small cuts or abrasions on its surface. Once inside the skin, the virus can grow and spread, stimulating the rapid generation of cells on the surface of your skin. There are over 60 different strains of HPV. Technically, warts may appear anywhere on the skin, but only those that appear on the soles of the feet are known as plantar warts.

What to look for:

If you see a bump on the sole of your foot that changes over time, suspect plantar warts. Some warts may develop an uneven surface and a cauliflower-like texture over time, or they may acquire black spots or streaky lines. The black dots or lines are characteristic of plantar warts, and are caused by the bleeding of small blood vessels into the tissue. Warts also can bleed profusely when accidentally scratched or cut. Unlike on other body parts where the warts grow out and look like lumps, on the sole of the feet they grow in due to the pressure of walking.

Warts begin as small bumps, but can grow large if left untreated. They can spread to other areas on the foot, or form clusters.

A wart may or may not be painful, depending on its location. Warts on the ball of the foot or the heel, for example, where weight and pressure are brought to bear, may cause the patient great pain.

Only people can pass warts to other people – either from direct skin-to-skin contact or from inadvertently leaving the virus somewhere where others can pick it up. For example, the virus can be spread when one person with plantar warts walks barefoot on ground where others do the same. The virus can also be spread if a patient with plantar warts loans shoes or socks, which have not been washed, to an uninfected person.

Warts can easily be spread to areas around the body other than the feet, such as when the patient touches the plantar wart, and then touches another area of his or her body, such as the hands, face, genitals, scalp, arms, legs, ears. If the wart bleeds (such as when it is nicked or cut accidentally), this creates an ideal avenue for infection of another part of the body, or another person.

Warts are also stubborn and frustrating. They may disappear for a while, and then recur in the same place. They may go away with treatment and then come back – or they may never recur. Children seem to be more prone to warts than adults, leading some medical experts to theorize that as they age, some people can develop immunities to the virus that causes warts.

What it means to you:

Plantar warts (and all warts) are often unsightly and sometimes painful, but not life-threatening. That said, however, it is important to note that there are various lesions of the skin on the foot, including corns, calluses, moles – and even a few rare cancerous growths – that have similar or identical characteristics. It’s best to have a podiatrist examine any growth on your foot to ascertain that it is indeed a wart. Many common warts can be addressed with over-the-counter medications; however, it depends on the specific type of wart, and how far it has progressed. So its best to discuss what treatment is best for you with the podiatrist.

What causes it?

You acquire the wart virus through direct contact with an infected person, or by coming into contact with an infected surface, such as a shower room floor. The virus lives in a warm, moist environment. It’s generally difficult to tell when or where you came into contact with the organism, however, since the incubation period for the HPV can be up to three months, although a wart itself can lie dormant for years.

Treatment

Plantar warts are stubborn, and most of the time, will require a podiatrist intervention before they’ll go away.

There are various preparations on the market which can be used to treat warts. However, it is essential to receive confirmation from your podiatrist before the lesion you want to treat is, in fact, a wart, and not something else. By self-diagnosing and treating without medical supervision, you may actually do yourself more harm than good. Plus, since some of the remedies on the market contain acid, they can irritate, damage and scar normal skin, or worsen a condition that is not a wart.

A podiatrist, upon diagnosing a plantar wart, may recommend an over the counter treatment. If, however, the condition looks fairly entrenched – and plantar warts are known to be very stubborn – several other methods may be used to treat it.

• Because a wart is a virus, the goal of the professional is to remove the affected area that contains the warty skin cells, while keeping damage to the surrounding tissue to a minimum. In this case, the podiatrist may choose one of several methods: Freezing the wart (also known as cryotherapy), however, experience in treating plantar warts has shown this method not to be as effective due to the difficulty of accessing the wart thats deep in the skin.
• Debridement (shaving) of the wart followed by the application of a medicated ointment to destroy the lesion. This usually needs to be repeated several times on a regular bases until the wart is completely gone.
• Curretage. This involves the removal of the wart in a scooping manner under a local anaesthetic. Although it requires longer healing time, it is intended to be a single treatment with complete removal.
• Remedies for warts are constantly evolving. Your podiatrist can discuss up-to-date treatments that are most suitable for you.

Prevention

The best way to prevent a plantar wart is to keep your feet clean, and to keep them away from surfaces on which the HPV might be lurking. Avoid walking barefoot, and wear sandals or some kind of foot covering at pools and in locker rooms and other warm, moist communal areas where people go barefoot. Change your shoes and socks daily, and allow your shoes to dry thoroughly between each wearing. Do not wear the shoes or socks of others, not even those of your closest friends. Wash socks after each wearing. (In this case, it’s the same kind of preventive medicine that is advised for athlete’s foot – another infection that can be picked up in public areas)

Keep your feet clean and dry, and since children are prone to warts, encourage them to do the same, and to follow the above rules as well. Check kids’ feet periodically and report any suspicious bumps, growths or lesions to your podiatrist. Remember that kids are easily frightened by medical procedures, and the earlier a wart is diagnosed, the easier it will be to get rid of it.

If a wart is diagnosed, do not pick, pull or try to snip at it, and don’t try to rub it with a pumice stone or with any kind of lotion. Don’t ignore it, either! Put a band-aid over the area to discourage contact with it and see the podiatrist. If it’s a wart, you’ll have caught it early. If it’s not a wart – well, you’ll still have caught it early, no matter what it turns out to be. Wash your hands carefully after caring for the affected area, and do not touch yourself anywhere before you wash those hands!

Remember that HPV is a highly contagious virus, and that it will spread if not treated. Don’t give it a fighting chance. If you or your children notice a wart – on your feet or on any part of your body – reduce the risk of it spreading while it’s being treated. Avoid brushing, clipping, shaving or combing the area over and around the wart in order to avoid nicking or cutting the wart and causing it to bleed. Don’t use the same nail clipper or file on hands or feet that have warts as you do on hands or feet that don’t.

Psoriasis is a chronic, and recurrent inflammatory disease of the skin characterized by round, reddish, dry scaley patches covered by grayish-white or silvery-white scales. Lesions are most commonly found on the nails, scalp, elbows, shins and feet. In the foot, psoriasis can be difficult to distinguish from Athlete’s Foot, or the nail appearance may be confused with fungal infections of the toenails.

Psoriasis can cause a characteristic pitting appearance on the nails. Pustular psoriasis is a form of the disease characterized by small pustules or blisters filled with clear or cloudy fluid.

Psoriasis can affect the joints of the feet and lower extremities, leading to painful arthritis. Anti-inflammatory medications, steroids, and other medications are common treatment for psoriasis.

Although there is no cure for psoriasis, a podiatrist can help with the management of psoriasis. By assessing your lifestyle, work, footwear, and foot condition, the podiatrist can discuss ways of reducing aggrevating factors. Further more a podiatrist can improve the appearance of the psoriasis on the skin or nails through shaving, filing and buffing.

Excessive sweat and odor are two foot problems that usually occur together. It is normal for feet to sweat because this is one way the body regulates temperature and keeps us from overheating. However, the excess moisture from sweating plus the heat inside a shoe provide a perfect environment for bacteria and fungi, which cause the dreaded odor.

The more feet sweat, the worse foot and shoe odor tend to be. Sweaty feet can be a problem for children and adults alike, although older adults sweat less because sweat ducts decrease in size as we age. Besides odor, other foot problems can occur from excessive sweating, including:

• Warts
• Athlete’s foot
• Toenail fungus
• Rashes, such as eczema
• Bacterial skin infections

Prevention is treatment

The best way to control foot odor is to keep feet as dry as possible. Its important that socks are changed daily and where possible, allow the feet to air out. Washing feet soon after arriving home from work or doing a work out. If changing socks daily isnt enough, then attempt to change them twice a day. It may not be realistic for most people to change their socks during the day or to remove their shoes frequently to allow their feet to air-out. But some over-the-counter products can help keep feet drier and reduce foot odor. They include:

• Antiperspirant products for the feet
• Foot and sneaker powders for absorbing sweat and odor
• Odor-absorbing insoles that are inserted into the shoes
• Sneakers with breathable mesh tops
• Socks made with performance materials which wick moisture away from the skin better than cotton, keeping skin drier

In some cases, sweating is not easily controlled with chemist products and is more than just an occasional annoyance. When sweating is excessive and becomes a concern, it is referred to as hyperhidrosis. Hyperhidrosis can be stress-related, which is why it’s sometimes referred to as emotional sweating. Stress-related sweating often occurs at the palms, underarms and soles of the feet. This pattern of sweating, which happens even when you’re not overheated, is common in young people and may last into adulthood.

How does someone know when they are dealing with hyperhidrosis instead of normal sweating? If the sweat and odor are not helped to any degree with chemist products and they have become a source of embarrassment or stress, it may be hyperhidrosis. An example of hyperhidrosis is someone who needs to change socks often or who goes through shoes frequently due to odor. In this case, a podiatric evaluation would be advisable to rule out other less common causes of hyperhidrosis, such as diabetes, hyperthyroidism or chronic fatigue syndrome.

People who suffer from hyperhidrosis are more prone to develop certain skin problems and secondary infections on their feet. Symptoms to watch out for include:

• Redness or painful areas of the soles
• White, wrinkled skin (a sign of excessive moisture and possible fungal infection)
• Changes in skin texture, such as pitting (small craters)
• Odor that does not improve with chemist remedies
• Any itching or scaling skin (may be signs of athlete’s foot or atopic dermatitis)

To help alleviate odor and protect the skin against the irritating effects of sweat, try an Epsom salt soak. Dissolve approximately two tablespoons of Epsom salt in a foot tub of cool or warm water and soak feet for 10 to 15 minutes. This can be done daily or as needed.

Traditional medical treatments for hyperhidrosis typically include topical, prescription-strength antiperspirants such as Drysol. A newer treatment for hyperhidrosis involves botulinum toxin (Botox) injections to the soles, which can minimize excessive sweating for up to a year. Another treatment, iontophoresis, uses a foot-bath device to deliver a low-level electrical current, at home or in a medical facility. The current can decrease sweat-gland activity.

Speak to the podiatrist if you are concerned about you feet smelling or sweating excessively, so they can provide you with a personlised care plan.