DEAR DOCTOR,

My 8-year-old son seems to have smelly feet. Every time he gets back from school and takes off his shoes, it is bad. He wears cotton socks and we change them every day but it is the same thing. Is this something that can be dealt with? Is it a health issue and if so, what causes it and how do we get rid of it?

ANITA

DEAR  ANITA,

Smelly feet or bromodosis is a common problem. Does your son have itchy feet along with being smelly? The most common cause is sweat being built up on feet. Feet have many more sweat glands, as compared to rest of the body, which helps in keeping the body moist and cool.  Dampness occurring over the feet is the most common cause for smelly feet. This occurs due to shoes and socks being worn continuously for 6 to 8 hours or even longer. Build-up of sweat results in growth of bacteria, which give rise to bad odour. Shoes and socks worn continuously make the feet damp, which can give rise to fungal infection. This also results in bad smell, which is more evident when shoes are removed. In case of fungal infection, intermittent itching can occur along with bad smell.  Nylon socks aggravate the problem, by preventing the skin from breathing properly. It is good that you give your son fresh cotton socks to wear every day, but shoes may be repeated. The inside of shoes also becomes damp due to continuous use. Same shoes are repeated the next day, thus aggravating the dampness.

Poor foot hygiene is yet another cause for "smelly” feet. The dead skin built over heels, dampness and or grime between toes, become sites for bacteria and or fungus to grow. Standing for long hours or any stressful situation can cause feet to sweat more and smell bad.

Some individuals have a genetic tendency to sweat more (primary hyperhidrosis). Such individuals can also have smelly underarms as well as feet.

The best way to avoid smelly feet is to keep the feet as clean and dry as possible. Clean the feet regularly with a soft soap. Use a gentle scrub to remove the dead skin of sole and heels regularly.   Let your son use fresh, cotton socks every day. Arrange a second pair of shoes to be worn alternately with existing one. When used on alternate days, the damp shoes will become absolutely dry. Another option is to let the inside of the shoe out after removing them, so that it dries very well. Keeping the feet soaked in lukewarm water mixed with baking soda (about one tablespoonful of soda in one litre of water) for about 20 minutes is also beneficial in curing bad smell. If it is not mandatory to wear closed shoes in school, they can be replaced by open shoes or sandals.

Rubbing some antiseptic solution on sides, between toes and on heels helps to clear any infection. Use of antiperspirants or deodorants or some antifungal powder on feet is also helpful.

 Dr. Rachna Pande, Specialist internal medicine

E-mail rachna212002@yahoo.co.uk