From the Guidelines
To treat severe foot odor (bromhidrosis), start with daily foot hygiene and consider antifungal treatments, as fungal infections are a common cause of foot odor, as suggested by the British Association of Dermatologists' guidelines 1. When managing severe foot odor, it's essential to address the underlying causes, which can include fungal infections, bacterial growth, and poor foot hygiene.
- Daily foot hygiene is crucial, including washing feet thoroughly with antibacterial soap and drying completely between toes.
- Applying antiperspirant specifically formulated for feet, such as Certain Dri or Drysol, can help reduce sweat and moisture.
- Changing socks at least once daily and choosing moisture-wicking materials like cotton or wool blends can also help.
- Alternating between different pairs of shoes to allow them to dry completely between wears is recommended, as shoes can harbor fungal elements and contribute to foot odor 1. For persistent odor, over-the-counter antifungal treatments such as Lotrimin (clotrimazole) or Lamisil (terbinafine) can be applied twice daily for 2-4 weeks, as fungal infections often cause foot odor.
- Foot soaks with vinegar (one part vinegar to two parts water) for 15-20 minutes twice weekly can help reduce bacteria.
- Foot powders containing zinc oxide or talc like Gold Bond can absorb moisture throughout the day. If these measures don't improve the condition within 2-3 weeks, consulting a healthcare provider is necessary, as prescription-strength antiperspirants containing aluminum chloride hexahydrate or oral antibiotics may be necessary, as suggested by the guidance on the prevention of foot ulcers in at-risk patients with diabetes 1.
- It's also important to note that fungal infections, such as onychomycosis, can contribute to foot odor, and treatment of these infections is essential to prevent recurrence and improve foot hygiene 1.
From the Research
Treatment Options for Severe Foot Odor (Bromhidrosis)
- The provided studies do not directly address the treatment of severe foot odor (bromhidrosis) but focus on the treatment of fungal infections such as onychomycosis and dermatophytosis.
- However, some of the studies mention the use of antifungal agents such as terbinafine and itraconazole, which may be relevant to the treatment of fungal infections that can contribute to foot odor 2, 3, 4, 5, 6.
- Terbinafine and itraconazole are effective against dermatophytes, which are a type of fungus that can cause infections of the skin and nails, including those that can lead to foot odor 2, 3, 4, 5, 6.
- Combination therapy with terbinafine and itraconazole may be more effective than monotherapy in treating fungal infections, including those that can cause foot odor 4, 6.
- Topical treatments such as terbinafine 1% cream may also be effective in treating fungal infections of the skin, including those that can contribute to foot odor 5.
Antifungal Agents
- Terbinafine is an effective antifungal agent against dermatophytes, with a cure rate of 93.5% in one study 5.
- Itraconazole is also an effective antifungal agent, with a cure rate of 66% in one study 3.
- Combination therapy with terbinafine and itraconazole may be more effective than monotherapy, with a cure rate of 100% in one study 6.
Limitations
- The provided studies do not directly address the treatment of severe foot odor (bromhidrosis), but rather focus on the treatment of fungal infections.
- Further studies are needed to determine the effectiveness of antifungal agents in treating severe foot odor (bromhidrosis) 6.