11/15/2004    David E. Gurvis D.P.M.

Hyperhidrosis and Malodorous Feet (James M. Petko, DPM)

RE: Hyperhidrosis and Malodorous Feet (James M.
Petko, DPM)
From: David Gurvis, DPM

An “Old Wife’s” remedy, I learned from an
orthopedic surgeon. This can be a stand alone,
or added to the Drysol regimen. Tannic Acid,
found in BLACK tea can reduce sweat production.
Each evening, for 5-10 days, have to pt. perform
the following. 2-3 tea bags per pint of water,
simmered for 30 min. Add two quarts of cold
water, and soak for 30 minutes. Adjust formula
as needed for the size of the soaking container.
Remind the pt it is only necessary to cover the
bottom of the feet and between the toes to be
effective. This concentration may stain some
people’s feet brown, but I have not found this
too often. The tannic acid can slow down sweat
production for as much as 6 weeks after 5-10 days
of treatment.

Remember, reducing sweat productions can be very
difficult and frustrating. I have had a few rare
patients have Botox injections. They work, they
are VERY painful, and expensive. Surgery is an
option, but from what I have read, not always
successful in the long run either.

If you try this, make certain the pt is
instructed to buy BLACK tea, nothing else has a
hi enough concentration of tannic acid, and green
tea, herbal tea, etc, has none.
ODOR is, in my opinion, easier to control than
the hyperhidrosis. I have, for years, used a
product called On Your Toes. I stock it in the
office, or the pt can order from
http://www.footodor.net/. In my opinion, it can
last up to 3 months (rarely the six months
advertised) after 3 days application. ( I have
no financial relationship with this company).

David E. Gurvis D.P.M.
Avon, IN
Deg1@comcast.net

Other messages in this thread:

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11/16/2004    Steven Kaufman DPM, Bryan C. Markinson, DPM

Hyperhidrosis and Malodorous Feet (James M. Petko, DPM)

RE: Hyperhidrosis and Malodorous Feet (James M.
Petko, DPM)
From: Steven Kaufman DPM, Bryan C. Markinson, DPM

The management of hyperhidrosis can be
frustrating, but when malodor is present as
well, sometimes management of the hyperhidrosis
alone will not suffice. For the malodor problem
I have had great success with a ten-day course
of oral erythromycin at 1000mgs per day.

Bryan C. Markinson, DPM
New York, NY

A treatment I learned for this about 15 years
ago from the "old timer"
who sold me his practice was the use of a dilute
formaldehyde solution
applied to the plantar surface of the feet. A
single application in most cases eliminates the
odor and reduces sweating for 3-6 months. There
is a bit of technique to this as well as
knowledge of the proper dilution.

In lieu of making your own dilute formaldyhyde
solution, Pedinol makes
a couple of products. Lazerformalyde (roll-on)
and Formalyde-10 (spray). These are not quite as
concentrated as what I use at the office but
they can be quite effective in treating these
problems. (I prefer the roll-on).

As an aside I have also found these products
handy when treating
plantar multiple plantar warts on very sweaty
feet to limit the spread and on occasion prior
to more definitive treatment to reduce the
chance of reoccurrence. A patient presents with
numerous warts and very sweaty
feet. I will treat them with this for 1-2 months
before undertaking any other treatment and in
some cases many of the warts resolve by the time
and show signs of regression.

Steven Kaufman, DPM
Milwaukee, WI

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11/14/2004    Ivar E. Roth DPM/MPH

Hyperhidrosis and Malodorous Feet (James M. Petko, DPM)

RE: Hyperhidrosis and Malodorous Feet (James M.
Petko, DPM)

I have been able to greatly reduce this problem
with two products that
I invented and sell. Dr. Roth's foaming foot wash
and foot spray should do the job and here is why.
The foot wash is to be used BEFORE the shower on
a dry foot. The tea tree-based product with
Eucalyptus oil is powerful with fungus and
bacteria. Use it every day in conjunction with
the foot spray which is used AFTER the shower on
a DRY foot. The formula again uses Tea tree, but
has zinc phenosulphonate to keep the feet dry.
Usually I recommend that the spray be used again
in midday to insure dry feet. If you have a
compliant patient she will be happy.

Ivar E. Roth DPM/MPH
Newport Beach, CA

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11/12/2004    Bob Kornfeld, DPM, Paul Busman, DPM

Hyperhidrosis and Malodorous Feet (James M. Petko, DPM)

RE: Hyperhidrosis and Malodorous Feet (James M.
Petko, DPM)

The question to ask when topical antiperspirants
do not work is what is the mechanism? In a
majority of cases, adrenal stress is the
underlying cause. It is important to evaluate
adrenal hormones and to query your patient about
her lifestyle. There are many things that can
help to moderate stressors. When addressed in
this way, you will find her hyperhidrosis well
managed.

Bob Kornfeld, DPM
Lake Success, NY

Check her shoes. Are they man made leather? Over
the years I've had many patients whose
perspiration reacted in some way with synthetic
materials to produce truly terrible odors. Real
leather shoes may alleviate this. Well
ventilated sneakers are a good choice too.

Paul Busman, DPM
Troy, NY