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My 28-year-old female client has a bad case of foot odor. What do I do?


My otherwise healthy 28-year-old female client has a persistent foot odor. The odor is terrible and embarrassing. Her feet sweat in open shoes such as sandals. All topical treatments she has tried have failed. Any suggestions?


It sounds like your client has hyperhydrosis, which is the condition of excess sweating. The palms and soles are the areas most commonly affected. I suspect that the excessive perspiration on your client's feet is promoting the growth of bacteria that is causing the unpleasant odor. Treatment should be directed at the sweaty feet. She could try a prescription-strength antiperspirant called Drysol applied to her feet at night after drying them well with a hair dryer, and Z-sorb AF Powder (available without a prescription) on her feet during the day. if that does not help, she should use a topical erythromycin solution (a prescription is needed) on her feet twice a day. She should keep her feet dry by changing socks and wearing breathable shoes and sandals. -- Phoebe Rich, MD

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