Are antiperspirants and other topical cosmetic products containing aluminum (Al) safe to use? Or should you avoid such products as is often led to believe?

These questions have been asked frequently as the deodorant industry has grown to achieve approximately $18 billion in annual revenues and aluminum in deodorants has gotten a bad rep.

Since topical aluminum chloride hexahydrate application to the feet is generally considered a “simple, safe, and inexpensive therapy”, that requires continuous application since “results are often short-lived, and they may be insufficient”,  it’s critical to find out if using aluminum in this manner is hazardous to our health.

• Source: AAFP.org. Palmoplantar Hyperhidrosis: A Therapeutic Challenge.

How Antiperspirants/Deodorants Were Conceived

The first deodorant, Mum, appeared in 1888, while the first deodorant and antiperspirant, Everdry, appeared in 1903.

Prior to development of these products, people took care of their sweat and odor issues through careful washing of their affected body-parts and masking odors with perfumes.

Those concerned about sweat piercing their clothing wore items like dress shields or special pads that protected clothing from sweaty armpits.

The initial antiperspirant products were not very well received by society and sales were low. Around 1912, a young woman began marketing an antiperspirant that her father, a surgeon, had developed to keep his hands from sweating while in the operating room.

The active ingredient in this product was Aluminum chloride, and she named it “Odorono” (Odor? Oh No!).

Marketing for Odorono was also initially slow, until the woman joined forces with an advertising professional who decided the key to the product’s success would be to focus on underarm perspiration and body-odor tied to the vanity of women.

This marketing strategy worked, vaulting the sales of Odorono to over $1 million by 1927.

The increase in sales of spurred others to develop competing products, and the basis of the current multi-billion dollar industry was formed.

Deodorants and antiperspirants were mostly advertised to women at the beginning of the industry, and it would take another two-decades to get men to believe that they had the same deodorant problem that women had.

It was found that Aluminum chloride (AlCl3) could be harsh to both exposed skin and clothing, so alternate compounds that elicited similar properties were developed, the most common being Aluminum chlorohydrate, which is largely used in modern antiperspirants.

How Aluminum Works in Antiperspirants

The way Al works in antiperspirants is that Al salts in the products (i.e., chlorohydrates, etc.) form insoluble Al hydroxide polymer gel plugs within sweat ducts, temporarily preventing sweat from reaching the surface of the skin (SCCS, 2014, June 18).

By keeping sweating down, the Al salts prevents the ordinarily odorless sweat from being fermented by bacteria that inhabit the surface of the skin. Thus preventing foot odor.

• These bacteria thrive in the warm and moist environments provided by folds of the skin, and the byproducts of their metabolism give rise to what is known as “body-odor”.

How Safe are Toiletry Products Containing Al?

There has been much thought put into whether Aluminum-containing antiperspirants are safe for human use. The concerns have included possible Al toxicity, to Al antiperspirants causing breast cancer, to the products causing renal-failure, to them contributing to the onset of Alzheimer’s disease.

A 1974 study published in Environmental Health Perspectives examined over 800 references on Aluminum since the mid-1950s. This review encompassed the occurrence of Al in soil, air, water, plants, products, and air/water pollution, and examined the biology and toxicology of Al, along with its medical and therapeutic uses.

The study noted that applied to the skin in antiperspirants, Al compounds act as protein precipitants with a low cell-penetration capability. As such, the Al remains bound to proteins in the stratum corneum, and presents no significant pathological changes.

• The study concluded that there is no need for concern by the public or producers of Al or its products concerning hazards to human health derived from well-established and extensively used products.

• It also stated that there have been no reports of either acute or chronic poisoning from the use of Al and its compounds in the processing of foods and beverages (Sorenson, John R. J., Campbell, Irene R., Tepper, Lloyd B., & Lingg, Robert D. 1974, August).

A 2001 study published in the Journal of Food and Chemical Toxicology examined the dermal absorption of Al from antiperspirants.

The study concluded that a small fraction of Al is absorbed through the skin from Al-chlorohydrate products applied to both underarms, compared to the Al typically absorbed by the gut from food over the same time period—saying that antiperspirants do not significantly contribute to the body-burden of Al (Flarend R., Bin T., Elmore D., & Hem S.L., 2001, February).

Aluminium penetration of the skin is very shallow.

This study also concludes that:

“Contact sensitivity to aluminium is very rare. [..] Less common is sensitivity during continuous application of aluminium-containing antiperspirants, topical aluminium application..”

• Aluminium and its compounds occur naturally in bauxite rock and other types os stone and comprise about 8% of the Earth’s surface. Aluminum chloride is derived from aluminum hydroxide. Source: Wikipedia.

Breast cancer

According to the American Cancer Society, an email campaign evolved saying that compounds in antiperspirants were contributing to the incidence of breast cancer in women.

The absorption of these compounds through razor nicks from under-arm shaving was the pathway for this issue.

This organization has declared that there is no clear link between Aluminum-containing antiperspirants and breast cancer, due to the very low absorption of Al into the skin from these products (citing the study referenced in the paragraph above) (American Cancer Society, 2014, October 14).

Alzheimer’s

According to the Alzheimer’s Association, during the 1960s and 1970s a possible link between Al exposure and Alzheimer’s disease was claimed.

The Alzheimer’s Association contends that these links are false and that experts no longer believe that exposure to Al (to include antiperspirants) causes Alzheimer’s disease (Alz.org, 2014).

What Government Sources Say

The U.S. Food and Drug Administration has ruled extensively on Al-antiperspirants. In 2003, the agency concluded that small amounts of Al can be absorbed from the gastrointestinal tract and through the skin.

• However, the accumulation of Al resulting from usual exposures to antiperspirant drug products (application to the underarms once or twice daily) and subsequent absorption is considered minimal (HHS. 78 Fed. Reg. 110, June 9, 2003).

A 2014 study by the European Commission’s Scientific Committee on Consumer Safety (SCCS) examined the safety of AL exposure through food and the use of cosmetic products.

• The study noted that a wide-range of Al compounds are used in a host of different consumer products. Pertaining to antiperspirant products, the SCCS concluded that in the absence of better data to estimate skin penetration of Al, no firm conclusion on internal exposure to Al following use of Al-containing cosmetics can be drawn (SCCS, 2014, June 18).

In Summary

The use of antiperspirants and deodorants got off to a slow-start in the last century, and only took off when slick marketing campaigns appealed to the vanity of people (targeting women first, then also men).

By the first decade of the 21st Century, the industry was a multi-billion dollar per-year seller of products.

There have been multiple efforts to study the effects of Aluminum exposure in various consumer products; including antiperspirant products.

None of these studies, including efforts by government agencies, have conclusively connected exposure to Al from consumer products to cancer, Alzheimer’s disease, or other human malady.

The conclusion was that antiperspirants do not contribute significantly to the overall body-burden of aluminum.

Add that up with another conclusion researchers drew:

“The most effective topical treatment for palmoplantar hyperhidrosis is 20 percent aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol (Drysol)”. Stolman LP. Treatment of hyperhidrosis. Dermatol Clin. 1998; 16:863–9.

And you know what to use when suffering from excessive sweating (of the feet). Here’s more info the best antiperspirants for the feet.

References

• Alz.org. (2014). Alzheimer’s Myths.
• American Cancer Society. (2014, October 14). Antiperspirants and Breast Cancer Risk. Retrieved from
• Antiperspirant Drug Products for Over-the-Counter Human Use-Final Monograph; Food and Drug Administration, HHS. 78 Fed. Reg. 110 (June 9, 2003) (to be codified at 21 C.F.R. pts. 310, 350, & 369).
• Flarend R., Bin T., Elmore D., & Hem S.L. (2001, February). A preliminary study of the dermal absorption of aluminum from antiperspirants using aluminium-26 [Abstract]. Food Chem Toxicol, 39(2), 163-168. DOI:10.1016/S0278-6915(00)00118-6
• SCCS. (2014, June 18). Opinion on the safety of aluminum in cosmetic products. Retrieved from Scientific Committee on Consumer Safety.
• Sorenson, John R. J., Campbell, Irene R., Tepper, Lloyd B., & Lingg, Robert D. 1974, August). Aluminum in the Environment and Human Health. Environ Health Perspect, 8, 3–95.

Image: Nesster Flickr

Foot odor is essentially caused by bacteria. Other factors, that often worsen the smell are poor hygiene, medical conditions, diet, skin problems, inappropriate footwear and emotional and physical stress.

Just like with sweating in general, fresh sweat doesn’t smell. Often people think that the sweat directly causes the foul odor. In fact it’s the sweat and in lesser degree skin flakes eaten by the bacteria on your skin and in socks and shoes that produce the smell.

While feasting on the sweat these micro-organisms produce isovaleric acid. Which is the direct cause of reeking of your stinky feet. Inhibit the bacteria and the amount of sweat and you will be able to prevent foot odor.

This infographic offers a great overview of the causes, treatments, myths and other noteworthy facts regarding (plantar) hyperhidrosis aka excessive (foot) sweating.

Do your feet smell too?

Have a question?

Drop your comment below.

I found this antique book excerpt about a cure for exceptionally stinky feet. It’s from The British Medical Journal edition Sept. 18, 1880.

Since we, in our pharmaceutical dominated culture, have a hankering for remedies from grandma’s era I did some research. Checking if it’s a good alternative to more modern cures.

In the book, a doctor called George Thin, MD, describes how he goes about treating a patient with, in his own words, evil smelling feet.

There are few persons of experience, medical or lay, who have not had the misfortune to discover that certain individuals smell so offen- sively, that it is almost to approach them. In many instances, the evil smell is connected with the feet.

This evil smell is so strong and gross that it fills an area “with a sickening effluvium” that somewhat resembles “putrefying cheese”.

The doctor also describes how the foul odor may linger long after the person with the stinky feet has left the room.

In some cases the smell is so strong and penetrating, that it pervades a room long after the person from whom it emanates (and who may have remained in it only a few minutes) has left.

The doctor expatiates a bit more about the social consequences of such a medical problem before he proceeds with his experimental, yet successful treatment of such extreme cases of foot odor with boracic acid.

He also explains that in case of such extremely smelly feet there’s more to it than just bacteria feeding on the excessive sweat and skin flakes on one’s feet.

The cause of the extreme foot odor

George Thin M.D. notes:

Profuse sweating of the palms and soles is not uncommon, but, in order to produce the specific odor to which I refer, something more than mere profuse sweating is required. The excessive perspiration, when confined by stockings and boots, macerates the epidermis, and, if the per becomes tender. This tenderness is accompanied by redness, slight blistering, or more decided localized eczema.

What is boracic (boric) acid?

Boric acid, also referred to as boracic acid, has anti-bacterial , anti-viral, and anti-fungal properties. As almost all effective antiperspirants, boric acid is a topical astringent.

It is often referred to as sodium borate in the list of ingredients in products.

Boric acid is made from the mineral boron, from sodium salts and from oxygen

During WW1 boracic acid was used to treat wounds of British soldiers. In fact, the ancient Greeks already used it to make cloth fireproof.

The substance is still today used as a mild desinfectant on skin and as an eye wash. Because of its antiseptic properties it’s a common ingredient in baby powder, contact lens solutions, and various cosmetics.

It is popular as a remedy for yeast infections (ladies issues), Athlete’s foot, jock itch, yeast, in the laundry and more.

The substance, in powder form, was and still is sprinkled in corners and crevices of rooms to repel and exterminate mice, insects such as silverfish, cockroaches, termites, fire ants and other vermin.

The chemical boric acid has proven to be a potent topical agent that requires apropriate and cautious use.

Is it safe?

It’s basically toxic but with correct use it’s generally considered safe.

From Wikipedia:   Toxicology

While strictly speaking, Boric Acid is poisonous if taken internally or inhaled, it is generally not considered to be much more toxic than table salt (based on its mammal LD50 rating of 2660mg/kg body mass).

and

The New York Times reported that products containing boric acid are safe according to research but may cause skin irritations in people with sensitive skin and babies.

Is it a good idea to use boric acid on extremely sweaty feet?

While it may generally be safe, is it a good idea to use boric acid on extremely smelly feet?

Feet of which the skin has been broken or otherwise damaged because of maceration?

Probably not.

The general rule of boric acid (liquid or powder) is,

Don’t eat it, Don’t inhale it, and Don’t use it on broken skin.

Drugs.com states

While boric acid, borates, and other compounds containing boron are used medicinally, they are potentially toxic if ingested or absorbed through nonintact skin.

Which is often a problem accompanying very sweaty feet. Maceration of skin, blisters, pitted keratolysis, cracks, in other words, nonintact skin.

Treatment of feet

It’s a commonly used agent to both treat feet and shoes. For shoes often boric acid powder is used. It’s a very potent cure according to some. As this user experience demonstrates.

I was in Mexico visiting my aunt, and I showed up at her door after having spent 24 hours straight on a bus from Guatemala. I was wearing hiking boots and have been known to have sweaty feet. As soon as I took my boots off in her house she pointed me to a container with a white powder.

After washing my feet I applied the powder directly onto my feet and sprinkled some in my boots. For one of the first times in recent years I was not worrying about how stinky my feet were.

Apparently her husband was in the Mexican army and upon walking into the rancid barracks recommended that his COs put out bowls of boric acid for the soldiers to rub their feet with. It worked so well he got a promotion on his first day. cheers, J.

Treatment of shoes

To treat your shoes you can use boric acid powder or wash them with a solution of borax, vinegar and water.

Elissa Altman, editor of “Baking Soda, Banana Peels, Baby Oil and Beyond” recommends to use 1/2 cup of borax, 1/2 cup of vinegar and 2 cups of water to kill lingering bacteria.

If your shoes can’t be washed you could spray this solution in a fine mist in shoes and let it dry completely before wearing the shoes.

Conclusion

Does it work better to desinfect footwear from bacteria and as an astringent than other foot powders and antiperspirants?

Since it’s a weak acid it may not be such an effective astringent (thus antiperspirant) compared to more potent antiperspirants.

Although the cooling and tightening effect of boric acid may be average it seems to be an effective shoe sanitizing agent. If you do want to use it as a topical for feet, don’t forget to check if the skin on your feet is whole and not damaged.

As for effectiveness, it often also depends on what works best with your body’s chemistry. What works well for some people may not work for others.

Are there antiperspirants for feet? This is what I asked myself a while ago. You may have pondered this question too. When searching for products it almost seems like they all are dedicated to use on armpits, neck and face.

But yes, they do exist although most over the counter products are not dedicated to use on feet. Still, varying in strength and action there are quite a few rather effective products available.

In fact there are various ways to control excessive foot sweating and odor. A quality antiperspirant is one of them and is an essential part of a multimodal approach.

They are generally the first resort of treating plantar hyperhidrosis, a condition in which you have overactive sweat glands located on your feet.

Years ago I was, as they say, gellin. Squishing and slipping in my shoes, white macerated skin from the sweat and bacteria eating my skin alive. Sometimes it hurt and it always smelled really bad.

My first encounter with an effective cure was a prescription solution from my physician; aluminum chloride. There’s a wide range of non-prescription antiperspirants that contain this stuff too.

I have compiled a list of products designed to reducing the amount of perspiration and controlling the unpleasant odor. There are 3 in particular that I recommend.

If you want to find a solution for your sweaty feet, deodorants or, even better, antiperspirants can help

I will delve in their active ingredients, how they work, which product is best, and also essential to success, how to use.

Types of antiperspirants /deodorants

There’s a difference between deodorants and antipersiprants.

• Deodorants reduce odor, usually through an antibacterial action.
• Antiperspirants reduce sweating, often by closing sweat glands.

Some of the foot deodorants also double as an antiperspirant but you will want to make sure you read the label carefully to make sure.

If your foot sweating is serious you will want a product that has at least antiperspirant action. This will reduce the wetness and slipperiness of your feet and subsequently foot odor.

These products generally come in sticks or sprays. Sprays allow for easier application between toes.

If you want to prevent your feet from sweating and causing offensive odors, then you will want to skip the deodorants and look at antiperspirants for your feet.

Active ingredients

Quality antiperspirants for the feet contain metallic salts. Ancient peoples such as the Romans and Greeks already used aluminum salts as wound dressings because of their  astringent properties.

• Astringent action: causing the contraction of skin cells and other body tissues.

Nowadays these substances are still used to contract tissue. Either to seal harmed blood vessels or to inhibit sweat glands. The following are two commonly used types of metallic salts.

Aluminum zirconium (tricholorohydrex) has a multimodal method of action. In other words, it helps reduce out-of-control sweating of the feet in several ways.

• Your skin absorbs the substance, where the aluminum and zirconium ions trigger the skin cells to swell. This constricts the sweat glands, once closed they can’t release sweat. Besides this effect the substance also absorbs perspiration that does take place.

Commercial “clinical strength” antiperspirants containing aluminum zirconium are are a little stronger than typical antiperspirants. They are often applied at night and work for many people suffering from sweaty feet.

• Other antiperspirants have a slightly different method of action. Once applied to the skin the sweat from the sweat ducts pulls in the antiperspirant. It then fills up the sweat ducts (forms a plug) blocking them, thus preventing sweating from being secreted on the skin.

Aluminum chloride (hexahydrate) is another commonly used, generally effective active ingredient. If you need the strongest antiperspirant one that contains this ingredient will be your best option as dermatologists refer to aluminum chloride as “a particularly effective antiperspirant”.

Prescription-strength Drysol is an example of such an antiperspirant for the feet. However, Drysol is often linked to skin irritation whereas clinical strength brands such as seem to cause less skin irritation.

Aluminum salts do not stop your feet from sweating, they keep (parts of) the sweat from being released onto the skin

Strengths

In terms of potency you could divide products in 3 categories:

• regular antiperspirants
• clinical strength
• prescription strength

Secret Clinical Strength offered a breakthrough leading to most antiperspirant brands now offering clinical strength

Just looking at the percentage and which ingredient may be a less confusing way to decide which product you need.

In case of serious foot sweating (plantar hyperhidrosis) a strength of 30% aluminum chloride is recommended. For instance by the International Hyperhidrosis Society.

Formulas with concentrations of 20 to 40 percent are typically used for the soles of the feet compared to the 15 to 20 percent concentrations prescribed for other areas of the body.

While over-the-counter antiperspirants may help with mild hyperhidrosis symptoms, products that contain high levels of aluminum-based compounds, are not always effective.

Aluminum chloride and aluminum chloride hexahydrate do offer relief to a certain extent to most sufferers from excessive foot sweating.

Dermatologists acknowledge that clinical strength or prescription strength antiperspirants “work slightly better than regular antiperspirants”.

If such commerically available products are not sufficient you can aquire stronger antiperspirants through prescription by your dermatologist. Do note that OTC products typically are linked with less skin irritation than prescription products such as prescription Drysol.

20% is the maximum amount of aluminum solutions available in an over-the-counter antiperspirant

Also good to know, it’s not only the percentage of active ingredient that determines how well it works. According to dermatologists, correct use also determines how effective the antiperspirant will be.

How to use

These antiperspirants should be applied at night when you sweat the least. This way the substance is better able to block the sweat glands.

When left on during the night, a lasting barrier will form which is less likely to be washed away in your morning shower or by initial sweating that may occur.

If you need more protection put on your antiperspirant at night time and in the morning. When you start, use it for several days on end for maximum effectivness.

• don’t forget to apply on the sides and top of your toes too
• your skin is constantly regenerating so you should keep applying the product otherwise sweating will return.

If you use the antiperspirant according to instructions you should see a dramatic reduction in the sweat that you produce. If not you may need a stronger concentration.

The best brands

The following are so called ‘clinical strength’ antiperspirants.

The strongest OTC antiperspirants you can use for your sweaty feet:

• Odaban Antiperspirant Spray. Has 20% Aluminum Chloride. If you are looking for the strongest commerically available product get Odaban. If you haven’t tried aluminum antiperspirants yet you may want to get one with a lower concentration since this may sting or burn. On the other hand, some users find Odaban to be more tolerable than other brands with lower aluminum concentrations such as Drysol and Certain Dri. This is probably due to the blend. Pros: powerful, spray. Cons: may cause skin irritation since it’s 20%.

• Driclor Roll On 20% Aluminum Chloride. Tip from one Amazon user, to save some money you could get a small squirt bottle and purchase the 75ml Drichlor Roll On instead of the Odaban spray. Pour the contents of the roll on into the bottle and you have more than double the solution for half the money. The Odaban spray is about $14 for 30 ml while the Driclor roll on is about $7 for 75 ml. Both contain 20% aluminum chloride hexahydrate. This does of course does involve some hassle.

Other brands offering clinical strength include Arrid, Gillette, Secret, Dove, Degree, PerspireX and Sure.

Recommended for sensitive skin and injured feet:

• Hydrosal Professional Antiperspirant Gel. 15% Aluminum Chloride (Hexahdrate) Pros: a gel may be less harsh on delicate skin than an alcohol based solution. Some studies confirm this. Cons: gels are less convenient than sprays. Less affordable.

Less potent yet very popular antiperspirants:

Keep in mind that although the following products may have more user reviews and higher sales numbers, they are used for other purposes than combating foot sweating too. Personally I would get a spray or gel for easier application.

• Sweat Block towelettes. 14% Aluminum Chloride (Hexahydrate) 4,5 stars 2038 user reviews.
• Maxim Extra Strong Roll On.  15% Aluminum chloride.  Without alcohol. Probalbly less risk on drying out your skin and cause itch. 4,5 stars, 392 user reviews.
• Certain Dri Roll On.  4,5 stars 772 12% Aluminum Chloride. Comes in a, lower rated, solid stick version too.
  

Prescription strength

If these don’t work, your next step is to get a doctor’s or dermatologist’s prescription for, for instance, Drysol deodorant.

Drysol contains 30% aluminum chloride. It is available in most drugstores however you can’t get it without your prescription.

Consult a dermatologist or a physician if your experience with the products does not produce a change in foot odor or sweating.

See your chiropodist if these treatments fail.  You may need and even stronger “industrial strength” antiperspirant such as Xerac-AC®.

This preparation is so strong (and effective) that professional guidance is recommended.

Side effects?

Basically, what you feel after applying these substances is that your skin dries. It may dry out a bit even but the sweating will stop. Or significantly reduce.

Aluminum chloride is known to irritate the skin in some people according to WebMD. It is therefore recommended to strictly follow the instructions.

Some people experience a burning and itching sensation upon use. Others don’t feel anything.

Aluminum zirconium is less linked to side effects but is also known to be less effective.

• Is shrinking and closing off pores and sweat glands safe?
• Yes it is harmless since your body has much more pores and sweat glands. It simply redistributes perspiration the other thousands of square inches of your skin’s surface.

Topical aluminum health hazards?

You may have read warnings about aluminum in deodorants and antiperspirants. These controversial stories may have worried you.

Today, antiperspirants are still claimed to cause cancer and Alzheimer’s. They are claimed to do so by preventing the body from “purging toxins”.

It is true that aluminum can be toxic if swallowed and can also be a skin irritant but these rumors do not have any scientific backing.

There is no convincing scientific evidence for the link between using aluminum topically and diseases such as breast cancer and Alzheimer’s. WiseGeek notes,

As of 2012, no medical or environmental study had proved that aluminum zirconium — a common ingredient in antiperspirant — increases the risk for any disease, including breast cancer or Alzheimer’s disease.

And to zoom out instead of focusing on aluminum zirconium, WebMD states that “antiperspirants have no proven impact on the risk of diseases like breast cancer and Alzheimer’s.”

Additional products

To control foot odor some people insist on using a deodorant that does not have ingredients perceived as harmful. Various of such all-natural, hypoallergenic, organic deodorants exist. How effective these are in case of serious foot sweating remains to be seen.

If you are more into natural or herbal remedies there are are also different brands that stick to 100% natural ingredients such as the Crystal company with their Natural Foot Deodorant Spray and the Gewhol’s Caring FootDeo Spray.

These too are available in roll on, sprays, lotions, creams, and powders. In fact there is much variety when shopping for foot deodorants.

Zinc oxide

You may have heard off zinc oxide as an active ingredient. This substance however is generally used to protect wet skin from getting irritated.

For example to treat and prevent diaper rash in babies. Or when your feet sweat a lot and skin irritation occurs zinc oxide helps protect your feet. So this is not a sweat reducing compound.

Popular products for foot odor control containing the active ingredient zinc oxide include Dr.Scholl’s Deodorant Foot Powder (has baking soda too), Gold Bond No Mess Spray Powder Fresh and Odor Destroyer Deodorant Powder.

Gold Bond Medicated Powder and Spray is great if you also suffer from foot fungus because it uses Menthol as a way to relieve itching and Sodium Bicarbonate to absorb moisture and control odor.

Essential oils

If you, despite aluminum’s proven effectiveness are looking for a botanical alternative I think you should look into this Elite Sportz foot and Shoe Odor Spray. Its active ingredients are essential oils.

It is very well-reviewed and seems to moisturize your feet and take care of your shoes too.

Advertised as the “Only Multi-Functional Moisturising and Deodorising “ALL Natural” Foot Care Product”  it has 7 essential oils and 11 botanicals to reduce smelly feet and soothe dry cracked, callused itchy feet.

Nanosilver foot spray

Not as widely used as aluminum antiperspirants, colloidal silver is popular among some people. Silver Foot Spray is more a deodorant than an antiperspirant. Besides colloidal it has essential oils to fight off bacteria yet no ingredients known to block sweat glands.

In summary

Antiperspirants containing aluminum are safe and effective. They are available over-the-counter or via a dermatologist prescription

Since these are the typical first-line treatment, try an over-the-counter antiperspirant. If you are still having issues with sweaty feet and none of the over the counter products seem to be working for you, see your dermatologist to write you a prescription for Drysol.

The only difference between the over the counter products and the prescriptions is that the prescription products contain higher levels of the active ingredient which is often anything over 20%.

Sweaty feet is a bothersome condition but you can use foot deodorant and antiperspirants to make your life easier. Don’t forget to wear appropriate socks, use the best soap, get quality odor fighting and sweat reducing insoles, and let your shoes thorougly dry.

Stop worrying about taking off your shoes at a friend or family members house because of the odor. Enjoy being able to wear open toed shoes again and save yourself embarrassment with one of the products mentioned above.

When your feet are really sweaty you may suffer from hyperhidrosis. Hyperhidrosis affects people on their hands, feet, and faces producing an abnormally high amount of sweat on a regular basis.

In this case it could be that commercial, over-the-counter antiperspirants or natural home remedies just don’t work.

You may have tried foot soaks, Certain-Dri or Sweat Block and even doctor-prescribed antiperspirants such as Drysol containing 20% aluminum chloride hexahydrate solution, to no avail.

Most of the several home remedies to help ease the symptoms of this condition, have the same method of action (potency varies per remedy) namely an astringent action. However, if your feet still sweat excessively this may interfere with your work and social activities.

If this is the case more serious, invasive and aggressive treatments may be required to effectively prevent hyperhidrosis. Your doctor will assess if there’s an underlying cause and start treatment. You could be referred to a dermatologist too.

In order to inform you on your options, here are three effective, common treatments for severe hyperhidrosis of the feet.

Iontophoresis

Iontophoresis is done with a device that uses small electrical pulses to create a current across the skin until you feel a tingle.

While you can do this home, many people elect to have this procedure done in a hospital or doctor’s office by a professional technician. Often you start out on a daily basis followed up by weekly visits.

In iontophoresis, your feet will be submerged in water for about a half hour in order to act as a better conductor for the tiny electric pulses they are sending through the skin of your feet.

How does it work?

This process causes your pores to temporarily stop being able to produce sweat in the affected area. This procedure is ongoing and will require many sessions in order to prevent your hyperhidrosis from getting out of control as the effect wears off over time.

Does it have side effects?

The procedure has minimal side effects that are minor skin reactions like blisters,dryness, and general skin irritation. Each visit to treat your feet costs on average about $40 per session.

Some hospitals offer treatment trials for you to find out if it works for you.

Iontophoresis is a topical treatment. Topical treatments are generally recommended as first-line treatments.

Botox injections

Another method of controlling the excessive sweating of feet is using botulinum toxin (Botox) injections. Injections are given under the skin of the feet and work well for some patients.

The Botox injection has to be administered by a trained and certified doctor because Botox can have some severe side effects if used improperly.

A case study published in The Journal of the American Podiatric Medical Association was conducted in 2004 with two patients suffering from plantar hyperhidrosis. This study found that after the Botox injections the patients saw a large reduction in residual sweat even 3 months after the initial injection.

How do botox injections work?

The Botox paralyzes the eccrine sweat glands in your feet causing them to be unable to produce sweat. More specifically, the Botox inhibits the transfer of nerve impulses to the sweat glands.

Another study conducted published this past August compared two sets of patients with idiopathic axillary hyperhidrosis with one group receiving Botox injections and the other getting iontophoresis.

The study published in The Journal of Dermatological Treatment found that those patients that received the Botox sustained reduced sweat production longer and to greater degree than those that underwent iontophoresis treatment.

This treatment requires that several areas of your foot receive an injection usual resulting in dozens of injection sites in each foot.

You will only have to get a session of injections every six months in order to keep your plantar hyperhidrosis in control.

Does it have side effects?

The most common side effect of this treatment is bruising and pain from the injection sites, but after a few weeks this should go away. According to studies, injectable botulinum toxin as a treatment for plantar hyperhidrosis is effective and safe.

This is a costly procedure, usually running upwards of $1000 for each session.

Another downside of this treatment, the effects of the botulinum toxin (Botox) wear off after a while. So in order to keep your feet from sweating this treatment must be repeated every 4-12 months.

Botulinum toxin injections are recommended as second-line treatments.

Anticholinergic medicines

Two types of anticholinergic drugs exist. Systemic and topical. E.g. pills and ointments. Brand names are oxybutynin and Robinul.

Oral anticholinergic medications stop sweating. This is actually a side effect of the drugs. Since these medications can stop all sweating they can not be used by athletes. Side effects such as a dry mouth are common.

Oral medications are sometimes used to treat plantar hyperhidrosis. This line of treatment is however recommended if botulinum toxin injections do not work.

The topical variety in the form of glycopyrrolate solutions is applied to reduce sweating locally. This is commonly applied to the forehead and scalp and not on the feet.

Oral medications are recommended as third-line treatment.

Surgery

Medical professionals often recommend to opt for the so called conservative treatment modalities first.

These include Drysol antiperspirant, iontophoresis, and anticholinergic medicines. If you suffer from severe hyperhidrosis these treatments may not be successful but trying them first is recommended.

Surgery is a more invasive treatment, considered only if other modalities do not prove effective.

Opinions on the efficacy and risks of surgery differ greatly.

There are three types of sweat reduction surgeries,  local surgery, ETS surgery and  lumbar sympathectomy.

The ETS surgery is the most invasive, also called endoscopic thoracic sympathectomy surgery.

Also, local surgeries are not done for excessive hand sweating because other nerves in the feet may be damaged, so this is not an option.

Local surgery is recommended as fourth-line treatment. ETS surgery as fifth-line treatment.

 

Endoscopic thoracic sympathectomy (ETS) surgery

Unlike the other procedures this is meant to be a one time permanent solution for plantar hyperhidrosis. It is a day surgery a.k.a. ambulatory surgery meaning you don’t have to stay overnight at the hospital.

Does ETS surgery involve side effects?

Some sources discourage ETS surgery because of potentially “dire side effects”  and the irreversible character of the procedure.

On the National Hyperhidrosis Society website (SweatHelp.com) they write:

“because it [..endoscopic thoracic sympathectomy (ETS)] frequently causes serious, irreversible compensatory sweating (excessive sweating on large areas of the body or all over) as well as other dibilitating effects such as extreme hypotension, arrhythmia, and heat intolerance. In fact, most physicians do not recommend ETS surgery because of the serious negative side effects of the procedure.”

A study published in The Scientific World Journal in 2012, also stated that while patients saw reduced sweating in their feet, their bodies seemed to compensate by producing more sweat in the trunks of their bodies.

Lumbar Sympathectomy Surgery

This procedure is done under general anesthesia. Contrary to ETS surgery the patient is required to stay for one night at the hospital.

A surgeon will make a one inch incision in both flanks of the abdomen so that they can get to the Lumbar sympathetic trunk. Once they have gained access to the trunk it is clipped while the temperature of your feet are monitored.

The goal here is to interrupt nerve signal transmission from the spinal column to the sweat glands.

After this procedure you will typically have to stay in the hospital overnight for observation. This procedure is known to cause soreness in the groin area of the patient and in men can cause sexual dysfunction.

This surgery has a 95% to 97% success rate for relief for patients struggling with excessive foot sweating and the odor that often accompanies prolific sweating. The goal is described with the medical term: anhidrosis which means “the inability to sweat normally”.

Severe plantar hyperhidrosis can be safely and effectively treated by endoscopic lumbar sympathectomy using the clamping method. It can be accomplished on an outpatient basis with low morbidity, complete resolution of symptoms, and a significant improvement in quality of life. PubMed

Some medical professionals state that lumbar sympathectomy is the best and most effective surgical treatment for excessive foot sweating with a much higher degree of success (98%)

In order to find out the price of this procedure you will have to have a consultation with a doctor that is trained in this area.

A leader in this field is Dr.Rafael Reisfeld based in Beverly Hills, CA who has spearheaded research and procedures in the U.S.

This should be used as a last resort to treat your sweaty feet. Do your research and make sure that you talk with your doctor to know all the risks associated with this type of surgery.

Which treatment is best?

If nothing else works you have basically 4 options:

1. Iontophoresis
2. Botulinum toxin injections
3. Lumbar sympathectomy
4. ETS surgery

Again, mixed opinions and study results.

According to this PubMed study, surgery is your best option in terms of success rate.

Thoracoscopic sympathectomy is by far the best curative alternative for patients with clinically significant idiopathic HH. Topical creams containing aluminum hydroxide, use of iontophoresis, and use of off-label botulinum toxin type A (Botox, Allergan, Irvine, CA) injections are all less successful, time-consuming, and often costly.

However, as mentioned before, there may be serious side effects.

Also,

This PubMed study notes:

Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%.

Note: thoracoscopic sympathectomy is also called video-assisted thoracic sympathectomy or endoscopic thoracic sympathectomy

Conclusion

If you suffer from plantar hyperhidrosis there are options for you. Talk with your doctor and find out which solution is the best for you. Don’t suffer through embarrassment with your sweaty feet any longer. You could find relief with one of these treatment methods.

Personally, I would be really hesitant to opt for ETS surgery. Too many drawbacks and horror stories.

I think I would get an iontophoresis device at home and use that religously and hope for the best. (Hidrex iontophoresis machines are powerful and some people have good results with them). Maybe opt for botox injections if that doesn’t work.

What do you think? Have experiences with any of these? Or have questions. Drop a note below.