Many people have sweaty feet. This is usually due to footwear - particularly nylon socks or plastic shoes. In particular, sweaty feet tend to smell due in part to the overgrowth of bacteria which thrive in the moist and warm conditions.

Conservative treatment of sweaty feet is usually effective by following such advice as regular washing of feet, antiperspirants, cotton socks, light leather or open shoes.

Fairly often this can relieve the smell to an extent but often does not get over the moisture of the sweating and further treatment is needed.

Iontophoresis works in 80-90% of people and has no side effects. However, many return visits are needed which does not suit some people.

Botulinum toxin is effective in many people. As the skin on the feet is thick and multiple injections into the foot can be painful - (30 - 50 or more might be needed on each foot for each treatment), this cannot really be done without a brief general anaesthetic or nerve block. Now we use a heavy sedation/light general anaesthetic. These injections last 4 - 9 months and we are finding more people getting relief using this method. Further injections can be carried out, and as with all Botulinum Toxin treatments the effects tend to last longer with second and subsequent injections.

Sympathectomy of the lumbar sympathetic chain is possible but not advisable. The lumbar sympathetic chain controls ejaculation in the male and orgasm in the female - loss of these is not usually acceptable to cure sweaty feet!