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Monday, March 20, 2006

Bromidrosis: Stinky feet




Bromidrosis inspired Frank Zappa to record Stinkfoot. Perspiring is the natural way to control our internal temperature and is normally odourless. The secretions contain sodium chloride, potassium, urea and lactate. On the palms and sole of the foot are the eccrine sweat glands. There are approximately 125,000 sweat glands on the sole of the foot and excrete about on average one midi of moisture each day.



Excessive skin perspiration is called hyperidrosis (or hyper hydrosis meaning extra water). This affects about 25% of the population. Overproduction of sweat can be idiopathic (no known cause) or related to general illness. Eccrine glands are slow to respond to temperature regulation but instead react quickly to mental or emotional stimulation. Sweaty skins are moist, cold and clammy to the touch with white soggy skin in-between the toes. Either gender may be affected or it often commences with the onset of puberty, subsiding in some people, after the age of 25.



Burning pain, itching and blisters may also be reported. In very severe cases excess perspiration soaks socks and destroys shoes. People with wet skins are more prone to fungal and viral skin infections. Some people suffer from Fowl smelling sweat which is caused by a breakdown of bacteria on the skin surface or infection of the hair follicles. Alteration to bacteria around the apocrine sweat glands makes under arms smell and other private areas, a bit pongy.



Eccrine bromidrosis (that is the polite word for smelly sweat) is caused by microbiological degeneration of skin cells softened by excessive eccrine sweat. Apocrine bromidrosis affects adolescents upwards, eccrine bromidrosis is common to all ages and gets worse in warmer weather. No one bacterial species seems responsible with many of the resident floras capable of generating volatile acids.



Isobutyric acid smells like sweaty socks and isovaleric acid smells like sweaty feet.



Brevibacterium produces methanethiol gas which smells like cheddar cheese. Treatment for both hyperidrosis and bromidrosis involves first reducing the flow of sweat. Good foot hygiene is important and the feet should be washed at least once per day in warm water with mild soap for hyperidrosis and medicated soap for bromidrosis. Dry the skin carefully with a soft towel especially in between the toes. The use of bland talcum powder, such as would be suitable for babies, should be applied to the clean feet in mild cases but medicated powders may be recommended in severe hyperidrosis and bromidrosis. The powder helps absorb excessive sweat and gives a friction free surface for toes to pass over each other.



Reduction or perspiration can be achieved by the use of topical antiperspirants such as aluminium chloride soln (often on prescription). But care should be taken not to use cosmetic deodorants for this purpose. First check with the pharmacist because antiperspirants stem the flow of fluid but deodorants only neutralise their smells. Important preventative measures include wearing non-occlusive footwear made from natural materials. Cotton socks are absorbent, fungistatic and bacteriostatic and should be changed twice per day. Socks should be washed daily in non biological detergents. Things to avoid include high caffeine intake, eating spicy foods, overeating and stressful situations. Research from Holland indicates mosquitoes prefer the feet and lower leg. One theory is mosquitoes prefer sweaty skins which contain corynerform bacteria. This particular bacterium gives Limburger cheese its distinctive smell.



As a footnote to finish some authorities think the cheese was developed because dairy workers used to sweat over their labours. Makes you wonder what future generations will miss now these industries have become so scrupulously cleaned up. Now if you do suffer from foul smelling feet and the problem does not improve with simple measures then please consult your physician or pharmacist.



Reviewed 2/01/2016

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