Dear Doctor, 

I have had a problem with my feet for a while now. I have an itch and soreness in between my toes. They also smell a lot. I have tried to use a number of medications in vain. What causes the feet to smell and how can I get help.

Sema

Dear Sema,

Itching and soreness between toes most commonly occurs due to fungal infections. Spores of all kinds of fungus prevail in the environment. Dampness over feet due to wearing shoes and socks for long hours, increases susceptibility to fungus infection. Along with socks, shoes also become damp from inside due to sweating when worn for long hours continuously.

The next day, one may wear dry clean socks but commonly uses same shoes again. The dampness persists in the shoes precipitating and aggravating fungal infection. Nylon socks tend to augment the condition. Feet damp due to walking on wet lake side or pool side or after sweating in gyms also makes one vulnerable to these infections. If infected, one can have itching, sores and bad smell from feet. People with uncontrolled diabetes and immune depressed conditions like HIV/AIDS have severe forms of fungal infection.

The infection can be diagnosed easily by taking a scraping from itchy area and examining it under a microscope. Antifungal medicines in form of tablets or dusting powder can cure it completely. Prevention is by keeping feet, clean and dry always and avoiding damp shoes and socks. Wearing cotton socks is also useful.

Itching and soreness can also be due to allergy from using some body care product used over feet or to nylon material of socks. There can be bacterial infection subsequent to scratching the itchy part causing small blisters. One having peripheral neuropathy due to diabetes, alcohol use, etc. can have diminished sensation in feet becoming more vulnerable to minor cuts and abrasions manifesting as small wounds.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital