Sweaty feet (plantar hyperhidrosis)

The medical name for sweaty feet is plantar hyperhidrosis. Plantar hyperhidrosis tends to begin in childhood and early adolescence¹.

 

Plantar hyperhidrosis effects around a quarter of people who suffer from focal hyperhidrosis (like palmar hyperhidrosis)¹.

 

Plantar hyperhidrosis can pose many difficulties: when wearing socks or stockings the wetness can be very uncomfortable; in addition your feet can lose traction when walking barefoot or wearing sandals or high-heel shoes². Plantar hyperhidrosis can also contribute to medical conditions: it can cause localised maceration of the skin which can lead to skin infections; it can also predispose people to tinea (athletes' foot).

 

Treatments for sweaty feet

 

1st line: Antiperspirant with high aluminium content

 

It is good to start with a clinical strength antiperspirant e.g. Driclor or Rexona Clinical Protection (which contain around 20% aluminium). These can be bought from a supermarket or over the counter at a pharmacy. It is best to apply them at night prior to bed since you tend to sweat less overnight and it is more efficacious. It can result in localised irritation of the skin which might limit its use.

 

2nd line: Iontophoresis

 

After trying the clinical strength antiperspirant it is good to get clinically assessed and the doctor will plan your next treatment. For plantar hyperhidrosis Iontophoresis is a good option. Iontophoresis uses electrical current to enhance percutaneous absorption of ions. This leads to either blockage of the sweat ducts or disruption of eccrine sweat glands. The cost of the machines vary from $400-$1000. Treatment requires daily treatment for around 20 minutes initially for up to a month (until symptom relief) then maintenance treatment a couple of times a week.

 

3rd line: PBS listed anti-hyperhidrosis treatment

 

Another option that will be discussed after clinical assessment at a clinic that specialises in hyperhidrosis is PBS listed anti-hyperhidrosis treatment. If indicated it is conducted on the same day as your clinical assessment. The effect of the injections usually lasts less than for palms and axilla at 4 months and the dose is higher given the larger surface area³. Patients usually notice a difference 4 days post-treatment however the full effect usually takes one to two weeks. Topical anaesthetic cream is applied to the area to be treated and ice (cryoanaesthesia) is used prior to each injection to minimise the discomfort.

 

3rd line: Anticholinergic medication

 

Another option that will be discussed after clinical assessment at a clinic that specialises in hyperhidrosis is Anticholinergic medication. Anticholinergic medication work systemically and by blocking transmission of the chemical messenger (acetylcholine) responsible for excessive sweating. It can cause a range of side effects e.g. dry mouth, constipation, impaired taste, blurred vision and urinary retention so the dose needs to be adjusted to minimise these while maximising the effect on sweating.

 

Please note: these are only guidelines and your treating doctor will discuss the plantar hyperhidrosis treatment(s) most appropriate for you.

 

What to do next? Get in touch!

 

Do you or a loved one suffer with sweaty feet? We can help. Contact us now if you have any questions or to book an appointment for assessment and hyperhidrosis treatment at one of our sweat clinics.

 

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References for sweaty feet (plantar hyperhidrosis):

1. Lear W, Kessler E, Solish N, et al. (2007). An epidemiological study of hyperhidrosis. Dermatol Surg; 33: S69-75.
2. Keller S, Bello R, Vibert B, Swergold G and Burk R. (2009). Diagnosis of palmar hyperhidrosis via questionnaire without physical examination. Clin. Auton Res; 1-7.
3. Grunfeld A, Murray C and Solish N (2009). ...Hyperhidrosis. Am J Clin. Dermatol; 10(2): 87-102.

 

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