Foot Care – Foot Odour

Hyperhidrosis (sweaty feet)

Humans have 3-4 million sweat glands which can secrete fluids at max 2-3 l/hour. Sweat glands are found in all areas of the skin but those in the hands, feet, axillae and face often secrete profusely without presence of general sweating. This occurs with rising body temperature, exercise and fever. Central control is found in the hypothalamus via unique postganglionic sympathetic fibres. Other causes of hyperhidrosis include:

• Fear and anxiety
• Thyrotoxicosis
• Acromegaly
• Diabetes mellitus
• Lymphoma
• Cancer
• Hypoglycaemia
• Excess alcohol consumption
• Nausea
• Lesions of the sympathetic nervous system, cortex, basal ganglia or spinal cord.

Epidemiology

Incidence: Common Presentation

Symptoms: Teenagers often complain of sweaty hands and feet with associated smell. May also contribute to tinea pedis and foot eczema.

Signs: Segmental unilateral swelling suggests a neurological lesion. Palmar hyperhidrosis or gustatory sweating can be sign of localised autonomic disorder or occur before widespread autonomic impairment e.g. in diabetes mellitus (check for hypotension).