Smelly feet: causes, best remedies and when to see a GP

You take your shoes off at a friend's house and wish you hadn't. Or you've started leaving your trainers outside the bedroom door, and washing your feet twice a day hasn't changed much.

Smelly feet are very common, and the cause is simple: bacteria on your skin feeding on sweat that's trapped in your shoes. Most cases clear within two to three weeks of a better daily routine. When they don't, there's usually a treatable reason behind it, most often a skin infection or heavy sweating.

If you've already tried the basics, you can see a GP at Harley Street for £150, with assessment, diagnosis and a prescription the same day if you need one.

Why do my feet smell?

Your feet have around 250,000 sweat glands between them, more per square centimetre than almost anywhere else on the body. Sweat is odourless when it leaves the skin. The smell comes from bacteria, particularly Brevibacterium and Staphylococcus epidermidis, which feed on sweat and dead skin and release strong-smelling compounds such as isovaleric acid, the sharp, vinegary note. Brevibacterium is the same family of bacteria used to ripen some cheeses, which explains the familiar cheesy smell.

So the thing to remember is this: feet rarely smell because they're dirty. They smell because they spend twelve hours a day warm, damp and closed in, which is exactly what these bacteria need. Change the conditions inside the shoe and the smell usually follows.

Some people simply sweat more from their feet than others. Hormonal changes, particularly during puberty and pregnancy, stress and certain medicines can all increase foot sweating, and synthetic shoes and socks that don't wick moisture away make it worse.

Why do men's feet smell more?

On average, men sweat more than women, and teenage boys often have the worst of it because puberty switches sweat glands into a higher gear. Men are also more likely to spend long days in closed work shoes or trainers. That said, plenty of women have smelly feet too, and pregnancy can bring it on for the first time.

What gets rid of smelly feet at home?

These steps work best done together, every day, for two to three weeks:

• Wash your feet with soap every day, including between the toes, then dry them thoroughly. The drying matters as much as the washing, because bacteria multiply faster on damp skin.
• Change your socks daily, or twice a day if you sweat heavily. Wool, cotton or moisture-wicking sports blends are best.
• Alternate between at least two pairs of shoes so each has 24 hours to dry. Leather breathes better than synthetic, and trainers with removable, washable insoles help.
• Put a roll-on antiperspirant on the soles of clean, dry feet before bed. The aluminium chloride in it blocks sweat ducts, and it's one of the most effective home measures.
• Try a soak: half a cup of salt per litre of warm water, or two black teabags brewed in a pint of water and cooled, for 20 minutes a day for a week or two. The tannic acid in tea is mildly antibacterial and astringent.
• Keep toenails short and gently file away hard skin, which gives bacteria less to feed on.

If your socks still smell after washing, the bacteria are surviving the wash. A hotter cycle and a few days off for each pair of shoes usually sorts that out.

What is the best treatment for smelly feet over the counter?

A pharmacist can advise on all of these, and most cost a few pounds:

Over-the-counter options for smelly feet.

Can smelly feet be a sign of something else?

Usually it's just sweat and bacteria. But a persistent smell despite good habits can point to a skin condition that needs treatment rather than more washing:

• Athlete's foot (tinea pedis), a fungal infection that causes itching, flaking or cracked skin between the toes. The damaged skin gives bacteria more to feed on, which is why smelly toes and itchy toes often go together.
• Pitted keratolysis, a bacterial infection of the soles that leaves clusters of small, shallow pits on the pressure areas, usually with sweaty feet and a strong smell. It's common in people who wear boots or trainers for long hours, and it clears with a prescribed antibacterial treatment and control of sweating.
• Hyperhidrosis, which affects 1 to 3% of people. The feet sweat heavily even when cool and at rest, which soaks the skin and feeds the bacteria.

Rarely, an unusual body odour comes from an underlying metabolic condition, which a GP can look into. If you have diabetes and notice a wound, colour change or new smell from a foot, have it seen the same day.

When should I see a GP about smelly feet?

• Home measures haven't helped after 2 to 3 weeks of consistent use.
• You have itching, cracking or flaking skin between your toes, a possible sign of athlete's foot.
• Your feet sweat heavily even when cool and at rest.
• The smell is affecting your daily life or relationships.
• You notice skin changes, pits, wounds or discolouration on your feet.

A persistent smell despite good hygiene often has a treatable cause. Call 0207 499 1991 to book.

How a GP can help

A GP consultation (£150) starts with a look at your feet, which is often enough to tell athlete's foot, pitted keratolysis and hyperhidrosis apart. From there we can prescribe antifungal or antibacterial treatment and a stronger antiperspirant, and our guide to private prescriptions explains how that works.

For severe sweating that topical treatments don't control, there are specialist options: iontophoresis, which passes a mild electrical current through water to the skin to calm the sweat glands, and in resistant cases botulinum toxin injections into the soles. These are specialist treatments, and your GP can assess whether they suit you and arrange the referral.

It's not the most dramatic medical complaint, but it genuinely affects people's confidence. There's no need to put up with it once the basics have had a fair try.