Saturday, April 13, 2024
Common Foot Problems FOOT HEALTH

Cold Sweaty Feet and Hyperhidrosis- How to Treat Clammy Feet in Cold Weather

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Sweaty feet can be frustrating and embarrassing! You may be wondering what causes sweaty feet, especially when it’s cold outside. The excessive sweating that occurs with sweaty feet can lead to dampness and odor, making it uncomfortable to wear certain shoes. 

In this article, we will explore the causes of sweaty feet, how it is diagnosed, and how to manage it.

sweat feet standing in snow

What Causes Sweaty Feet When It’s Cold Outside?

Sweaty feet, also known as “Plantar Hyperhidrosis” occurs due to overactivity of the sympathetic nervous system. 

The sympathetic nervous system is responsible for your “fight or flight” response. 

In some people, the sympathetic response is exaggerated and can cause excessive sweating. 

It doesn’t matter if it’s warm or cold outside, the response will be the same. 

Say you are outside, in the cold, about to give a big presentation amongst a large group of people…

Regardless of the temperature, your sympathetic response may be elevated and your hands and feet may start to sweat. 

Your feet have eccrine glands in them. These glands are responsible for producing sweat to help regulate your body temperature and also help with walking. 

Alma Rystedt describes in her article (1) in the Journal of Neurology & Neuromedicine that sweat production in the hands and feet was important in evolution to help humans with grip strength.  

Unfortunately, if you sweat too much, it can cause adverse effects. 

Our feet in total have approximately 250,000 sweat glands. 

You would think that if you have issues with excessive sweating you would naturally have more sweat glands. However, this just isn’t true. 

According to John McConaghy’s article (2) in the American Family Physician Journal, it isn’t the size or increased number of sweat glands that cause people to sweat. It’s simply an increased sympathetic nervous system response that causes them to sweat. 

sweaty feet on shoes

The Two Forms of Hyperhidrosis (Primary and Secondary Hyperhidrosis)

Primary hyperhidrosis is caused by genetics. 

Mary Lenefsky in her article (3) in the American Journal of Managed Care states that there’s a family history of sweating in 35%-55% of cases of primary hyperhidrosis.

This means that there is an increased chance that if your parents suffer from this condition, there is a higher likelihood that you may have issues with increased sweat production as well. 

Primary hyperhidrosis is seen at a younger age, and can even be seen in babies. Your sweat glands are fully functional even at birth! 

People who suffer from secondary hyperhidrosis usually have issues with excessive sweating due to external factors. It is seen more often in adults. 

Causes of Secondary Hyperhidrosis in the Feet:

  • Steroids
  • Neurologic disorders
  • Endocrine disorders
  • Medications
  • Menopause
  • Hyperthyroidism
  • Diabetes
  • Obesity
  • Sepsis
  • Anxiety 
  • Pregnancy

Diagnosis

Sweaty feet can be diagnosed through a physical examination by your foot doctor. 

Your doctor may perform a test called the starch-iodine test, which involves applying iodine to the feet and then dusting them with starch powder. 

Sweaty areas will turn blue-black, which indicates the presence of excessive sweating. 

In the cold weather, the toes may look pale and feel cold. 

Your doctor will differentiate this from a medical condition called Raynaud disease. 

Raynaud’s disease is a circulatory disorder of the peripheral blood vessels that causes a decrease in blood flow to the fingers and toes in response to cold temperatures or stress.

Management of Hyperhidrosis in the Feet

You may think that a sweaty foot is nothing to be concerned about. However, if your feet become too sweaty, it can impact your day-to-day life. 

It can cause odor build-up and can make it difficult for you to walk around. 

Most people take extra caution in the summertime to care for their sweaty feet, but neglect care in the wintertime. 

If your feet become excessively sweaty, you may be at higher risk for slipping and sustaining an injury.

Shoes

In the wintertime, most people are wearing insulated, water-resistant shoes/boots. This can cause excessive sweating to occur, even though it’s cold outside. 

If you develop too much sweat between your toes, you may be prone to developing a fungal infection.

Fungal infections in between the toes have a macerated (wet) appearance. 

Fungal infections are common foot problems, and can be treated effectively with a prescription antibiotic from your doctor. 

Once in a while, you may develop a bacterial infection in your feet from excessive sweating. 

Pitted keratolysis is a skin infection that can occur due to wet, moist environments. Your doctor will need to prescribe an antibiotic to treat this. 

If you have diabetes, your risk for developing an infection increases. The diabetic foot is vulnerable to infections due to a compromised immune system and blood flow (4)

Solution

Since you will most likely not wear open-toe shoes in the cold, you may want to consider wearing shoes that are breathable to help with sweaty feet. 

Wearing a shoe that has a mesh covering can help improve airflow.  

You should consider applying cornstarch on your feet before putting your shoes on to prevent excessive sweating.

Also, when you get home every day, make sure you allow your shoes to air dry. 

Pro tip: You can purchase summer soles. These are shoe liners that you can buy to replace your current shoe liners. 

These will help wick away moisture, and they usually come in a pack. 

You can throw them away and replace them as needed. 

Socks

Socks can make sweaty feet worse! 

Nylon socks in particular can cause your feet to sweat more. 

Cotton socks can also trap moisture. 

You should try wearing breathable socks that wick away moisture such as Merino wool socks or Alpaca wool socks. 

You may want to carry an extra pair of socks with you to change in the middle of the day. 

Home Remedies for Sweaty Feet

Vinegar

Vinegar Soaks

Vinegar contains acetic acid, and has antimicrobial properties.

Take 1 cup of white vinegar and mix with 2 cups of warm water and soak your feet for 15 to 20 minutes. 

This is a home remedy that will dry your feet. Do this weekly to help treat sweaty feet and improve odor.

Listerine

Listerine Soaks

Listerine soaks are thought to have antifungal and anti-inflammatory benefits. Although studies are small, it can be somewhat effective in treating sweaty feet. If anything, it has a soothing effect. 

You can mix ½ cup of Listerine, and ½ cup of Vinegar, with 1-gallon water. You can soak your feet twice daily in this solution.

corn starch

Cornstarch/Baking Soda

As I mentioned earlier, you can apply a light dusting of cornstarch on your feet before putting on your socks and shoes. 

You can also apply baking soda to your feet to help with sweating as well. Both absorb moisture and can help with symptoms.

Prescription Medication for Clammy Feet and Toes

Aluminum Chloride 

Your doctor may prescribe Aluminum Chloride 20% (Drysol). This medication obstructs the sweat glands, which will help decrease sweat production. 

This solution can be applied nightly and can help with sweaty feet. Certain side-effects can occur including skin irritation.

Antiperspirant Spray

Antiperspirant spray, such as Gold Bond Antiperspirant spray, is easy to use and is effective for sweaty feet. Many antiperspirant products like this help absorb moisture and have a cooling effect on the skin.

iontophoresis

Iontophoresis

Iontophoresis can be used to treat sweaty feet (5). It involves passing water through the skin via a direct current. Sometimes baking soda or medication may be added to the suspension. 

The feet can be soaked in the solution, where a direct electrical current is applied. Iontophoresis can help block sweat production.  

Here’s a video demonstrating Dermadry’s Iontophoresis machine for sweating https://www.youtube.com/watch?v=CWqHiTd6qJM

botox

Botox

Botox (OnabotulinumtoxinA) injection has been FDA approved for treating excessive sweating in the armpits, but can be used off-label to treat sweaty feet. 

When botox is injected into the feet, it causes the nerve signals that stimulate the sweat glands to become blocked for some time. 

Botox administration should only be done by your physician.

Botox injections can be beneficial to help you avoid developing sweaty feet both in warm and cold weather.

pills

Anti-cholinergic medications

Certain anticholinergic medications such as Oxybutynin and Bornaprine have been shown to reduce sweating when multiple areas in the body are affected (6)

It’s important to speak to your doctor about recommendations for prescription medications, as there are side-effects associated with some of them. 

Conclusion

In conclusion, sweaty feet can be so frustrating to live with. It can persist even in cold weather and can be embarrassing when you have to take off your socks and shoes. It’s important to treat sweaty feet early so that it doesn’t get worse and cause other medical issues.

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feet sweat pin

References

  1. Rystedt A (2016). Hyperhidrosis – An Unknown Widespread “Silent” Disorder. J Neurol Neuromedicine1 (4): 25-33 www.jneurology.com 
  2. McConaghy JR, Fosselman D. Hyperhidrosis: Management Options. Am Fam Physician. 2018 Jun 1;97(11):729-734.https://www.aafp.org/pubs/afp/issues/2018/0601/p729.html
  3. Lenefsky M, Rice ZP. Hyperhidrosis and its impact on those living with it. Am J Manag Care. 2018 Dec;24(23 Suppl):S491-S495. https://pubmed.ncbi.nlm.nih.gov/30589248/
  4. Murphy-Lavoie HM, Ramsey A, Nguyen M, Singh S. Diabetic Foot Infections. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https://pubmed.ncbi.nlm.nih.gov/28722943/
  5. Khademi Kalantari, K., Zeinalzade, A., Kobarfard, F., & Nazary Moghadam, S. (2011). The effect and persistency of 1% aluminum chloride hexahydrate iontophoresis in the treatment of primary palmar hyperhidrosis. Iranian Journal of pharmaceutical research: IJPR, 10(3), 641–645.

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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