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Sweaty Feet (Plantar Hyperhidrosis)

 

Many people who have sweaty palms also suffer from excessive sweating of the feet. Sweaty feet can ruin shoes, limit the types of footwear that can be worn (including sandals and flip flops), and result in foot odor and fungal infections. Patients may try to treat the condition by applying foot powder after bathing. Leather shoes and wool socks should not be worn. Rubber and synthetic materials should be avoided.

Iontophoresis

This treatment involves placing the feet in two pails of water that contain a conductor. A device (brand names Drionic®, Idrostar, MD-1A) applies a low electric current to the feet. As the current passes through each foot, minerals in the water clog the sweat glands, limiting the amount of sweat released. Each session lasts 20 minutes and is repeated four to six times per week. Frequent treatments are necessary. Some people have experienced good results with this treatment while others see no effect.

Oral medications

There are no medications for the specific treatment of primary hyperhidrosis. However, the condition can be treated with some success with systemic anticholinergics. Ditropan® (generic name: oxybutynin) is one that has been the most promising, but some patients cannot tolerate the dry mouth and drowsiness associated with it. Robinul® (generic name: glycopyrrolate) is sometimes effective but also causes dry mouth or a dry throat. These two medications also can cause dilated pupils, constipation, urinary retention, and heart palpitation.

Beta-blockers (Inderal) have systemic anti-sympathetic effects that are helpful in decreasing the body's sympathetic response. They have been useful in some cases of stress-related hyperhidrosis. They also decrease palpitation and tremors and are mostly useful when taken two hours before a stressful situation.

Anti-depressants (Zoloft®) and anti-anxiety medications (Xanax) can be effective. Depression does not cause hyperhidrosis, but hyperhidrosis can cause depression.

Probanthine® (generic name: propantheline bromide), which is often used to treat high blood pressure and some arrhythmias, causes a systemic decrease in sympathetic response. It should only be administered after a patient undergoes a thorough physical examination.

ETS Surgery

Although surgery to treat excessive sweating in the palms, face, and armpits is successful, it is not recommended by the Hyperhidrosis Center team for plantar hyperhidrosis.

Topical Treatments

Glutaraldehyde can be applied to the feet and is effective in treating plantar hyperhidrosis. But it can cause severe browning of the skin and brown staining of clothing. It can be irritating and expensive but can be applied two to four days each week. Other topical agents, such as Drysol (or other brands of aluminum chloride with ethyl alcohol) or Odaban are generally not effective for plantar hyperhidrosis.

Talc/Baby Powder

Some patients use talc or baby powder to absorb the sweat, but powder is messy and can cause a coating of white on the feet.

Laser Ablation

Laser ablation is not effective in controlling primary hyperhidrosis in the feet.

Weight Loss

Hyperhidrosis can be aggravated by obesity, so weight loss can help. However, most people with hyperhidrosis do not sweat excessively due to obesity.

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