Warning: Stinky Feet Disease Might Be Your Body's Hidden Health Signal

Stinky feet disease affects millions worldwide, with about 800 million adults at risk because of diabetes alone. Most people don't realize that unpleasant foot odors could be their body's way of signaling deeper health issues.

Chronic smelly feet and bromhidrosis feet represent more than just an embarrassing condition. Our feet contain about 250,000 sweat glands that serve as early warning systems for various health conditions. On top of that, this medical condition substantially affects people's quality of life and often leads to anxiety and social withdrawal.

This complete guide explains the hidden meanings behind persistent foot odor, from common bacterial causes to serious health conditions. You'll learn practical solutions and medical insights that help you understand when that uncomfortable smell might need a doctor's attention.

What Is Bromhidrosis? Understanding the Medical Condition Behind Stinky Feet

"Bromhidrosis can affect all age groups, races, and both sexes. Bromhidrosis is more common in adults than children as sebaceous glands and apocrine sweat glands do not become active until puberty." — Dr Martin Keefe, Dermatologist, Christchurch, New Zealand

You might have wondered why some people's feet smell worse than others. Beyond just bad odor, there's a medical condition called bromhidrosis – from Greek words "bromos" (stench) and "hidros" (sweat). This isn't your everyday smelly feet situation. It's an excessive, unusually foul smell that disrupts daily life.

The science of foot odor

Your feet have about 250,000 sweat glands that pump out 300-400 mL of sweat every day. Here's something interesting - sweat doesn't actually smell. The unpleasant odor shows up when bacteria on your skin break down this sweat into smelly compounds.

Foot odor happens through two main processes:

First, bacteria (especially Staphylococcus epidermidis) break down leucine in sweat and create isovaleric acid – this is what makes feet smell bad. Second, brevibacteria eat dead skin cells and turn the amino acid methionine into methanethiol, a gas that smells like sulfur.

Some people have a specific type of bacteria called Kyetococcus sedentarius that creates sulfur compounds. This makes their feet smell like rotten eggs. About 10-15% of people with really smelly feet have this issue.

Difference between normal foot odor and bromhidrosis

Regular foot odor doesn't last long and gets better with simple hygiene. But bromhidrosis is different - it's a long-term condition where the smell stays and becomes much stronger.

Doctors diagnose bromhidrosis when foot odor starts to affect someone's confidence, social life, or overall wellbeing. People with this condition often feel anxious, lose self-esteem, and avoid social situations.

Bromhidrosis comes in two types:

1. Apocrine bromhidrosis: This involves apocrine sweat glands in armpits, private areas, and breasts. These glands kick in after puberty, which explains why kids rarely get really smelly feet. Apocrine sweat starts clean and odorless but turns smelly when bacteria break it down into volatile acids.

2. Eccrine bromhidrosis: This happens in eccrine sweat glands found all over your body, including feet. Bacteria break down keratin that's been softened by eccrine sweat. Eating certain foods (garlic, curry, onion, alcohol) or taking medications like penicillin can make it worse.

How prevalent is this condition?

The numbers vary a lot between different groups. Studies show about 6% of Chinese people have this condition, while it affects up to 90% of Caucasians and 99.5% of people with African heritage.

Men get it more often than women because their apocrine glands are more active. Armpit bromhidrosis only shows up after puberty and rarely affects older people. Foot bromhidrosis can happen at any age but kids get it more often.

Culture plays a big role in diagnosis. Asian countries might consider even mild body odor serious enough to diagnose, while other places might see the same level as normal.

Your genes can make you more likely to get bromhidrosis. Research shows a strong link between this condition and your earwax type, both tied to a specific variation in the ABCC11 gene.

The original form of bromhidrosis comes from overactive sympathetic nerves, not illness. Secondary bromhidrosis can stem from health issues like hyperthyroidism, endocrine problems, mental health conditions, and menopause-related hormone changes. Other conditions like diabetes, liver disease, and kidney problems can also lead to stronger body odor.

Teenagers deal with overactive sweat glands because of hormone changes. Pregnant women sweat more due to hormonal shifts. People who stand all day, feel stressed, or have certain medical conditions tend to have sweatier – and often smellier – feet.

The Hidden Causes of Chronic Smelly Feet

That unpleasant smell coming from your feet has more to do with biology than you might think. Getting into these reasons can help fix the actual problem instead of just covering up the smell. Here's what could be making your feet smell bad.

Bacterial and fungal culprits

Your feet are home to many tiny organisms that make them smell. The main troublemaker is Staphylococcus epidermidis. This bacteria breaks down leucine in sweat and creates isovaleric acid – the chemical behind that typical foot odor.

On top of that, people with strong foot odor often have Bacillus subtilis on their feet. About 10-15% of people with really bad-smelling feet have a specific bacteria called Kyetococcus sedentarius. This creates sulfur compounds that make sweat smell like rotten eggs.

Fungi are also a big part of the problem. These organisms love warm, dark, and moist places – exactly what happens to your feet inside shoes all day. Fungal infections show up in several ways:

1. Athlete's foot – spreads easily in public swimming pools and showers, causing itchy, burning sensations with scaling and redness between toes
2. Fungal nails (onychomycosis) – these are harder to treat than other foot fungi and often come with bacterial or yeast infections

These microbes mix with your sweat and create an environment that guides you toward chronic smelly feet or bromhidrosis.

Hyperhidrosis and excessive sweating

Hyperhidrosis, or excessive sweating, affects about 3% of U.S. adults between 20 and 60 years old. Worldwide, this number jumps to 5% – that's about 367 million people dealing with extreme sweating.

This condition makes your eccrine glands produce more sweat than needed, which creates perfect conditions for smelly bacteria to grow. Hyperhidrosis comes in two types:

• Primary hyperhidrosis: No known cause, usually starts during childhood or teen years
• Secondary hyperhidrosis: Happens because of other conditions like anxiety, thyroid problems, or low blood sugar

People with sweaty feet often end up with wet shoes, get more fungal infections, and have cold feet from all the moisture. The social impact is a big deal as it means that many people feel embarrassed and avoid others.

People who sweat too much are more likely to get smelly feet since the extra moisture gives bacteria plenty to feed on.

Genetic factors that influence foot odor

Your genes are vital in determining whether you'll get chronic smelly feet. To cite an instance, excessive sweating often runs in families. If your relatives have sweating problems, you might get them too.

Bromhidrosis is an inherited condition that makes some people's sweat smell stronger. This genetic trait can make regular deodorants and other treatments less effective.

Your genes also decide which bacteria live on your feet. Some people naturally have more odor-causing bacteria than others, which leads to stronger foot odor even with similar cleaning habits.

Hormones, which your genes control, affect how much you sweat. Teens and pregnant women make hormones that increase sweating, which makes foot odor worse. Stress hormones make you sweat more too, creating a cycle where worrying about foot odor actually makes it worse.

Understanding these factors – bacteria, fungi, sweating problems, and genetic traits – helps you deal with smelly feet properly instead of just hiding the smell.

When Stinky Feet Signal Serious Health Problems

"Bromhidrosis is a clinical diagnosis, but careful history and examination is required to determine the underlying cause. Investigations should be considered in children, if the smell is generalized also involving urine and breath, or if it is of recent onset unrelated to hygiene habits." — Dr Martin Keefe, Dermatologist, Christchurch, New Zealand

Most of us think stinky feet are just embarrassing. But that unpleasant smell might be your body's early warning system. Smelly feet can signal serious health problems that need medical attention. Let's get into how your feet's odor might tell you something important about your overall health.

Diabetes and foot odor connection

If you have diabetes, foot odor can be more than just awkward—it might save your limbs. The numbers are striking: smelly feet show up before about 80% of diabetes-related amputations. This hits home when you realize 169 people in the UK lose limbs to diabetes every week—that's one amputation every hour.

Here's how it works:

• Neuropathy dulls sensation: Diabetes hurts your nerves, making it hard to feel wounds or infections on your feet.
• Poor circulation slows healing: Less blood flow means small injuries take forever to heal.
• Compromised immune response: Diabetes weakens your immunity, making infections more likely.

The biggest problem comes when foot ulcers start to rot, creating a nasty smell from discharge. This odor often means infection—the main reason for diabetes-related amputations. The scary part? Doctors could prevent four out of five of these amputations with quick action.

Watch out for these warning signs and get help right away:

• Cuts or blisters that stick around for days
• Red, hot, or painful skin
• Discharge staining your socks
• Strange foot odor that won't go away

Medical experts say it best: "a few hours can mean the difference between saving or losing a foot".

Thyroid disorders

Your feet might also tell you about thyroid problems through weird smells. People with hyperthyroidism sweat too much—especially on their feet—which lets bacteria grow like crazy. These bacteria create that distinct smell many hyperthyroidism patients know too well.

Hypothyroidism brings different issues. Low thyroid hormones make your heart pump less effectively, cutting blood flow to your body. Your hands and feet get cold from poor circulation. But foot odor can still pop up due to other effects.

Thyroid issues often show these foot symptoms:

1. Swollen feet: Push on them and the skin dips in—a classic thyroid red flag.
2. Itchy skin: Not just feet but hands, body, and scalp too.
3. Recurring infections: Thyroid problems make you more likely to get athlete's foot and toenail fungus.
4. Strong foot odor: With hyperthyroidism especially, extra sweat lets smelly bacteria thrive.

These symptoms hanging around? A doctor's visit might catch thyroid issues early.

Kidney and liver dysfunction signs

Kidney and liver problems can create unique body odors, including in your feet. People with bad kidney failure often smell like ammonia (some say fishy) because urea builds up—something healthy kidneys usually filter out. When kidneys can't clean your blood right, these substances leak through sweat and change body odor.

Liver disease has its own musty, sulfur-like smell called fetor hepaticus. This happens when your liver stops filtering toxins from blood properly. These substances escape through body fluids and skin, making distinct odors. Unlike bad breath, brushing won't fix fetor hepaticus—it sticks around as a sign of serious illness.

Liver problems can make your feet:

• Swell up from extra fluid
• Feel hot because temperature control goes haywire
• Smell weird from poor detox

Here's something interesting: diabetic ketoacidosis makes a fruity smell from ketones, but not everyone can pick up this scent. Still, any unusual foot odor that hangs around with other symptoms needs a doctor's look. Catching kidney or liver problems early makes a huge difference in treatment success.

Note that not every smelly foot means you have a serious disease. But stubborn odors that hygiene can't fix—especially with other symptoms—deserve professional attention.

The Foot-Body Connection: How Your Feet Reflect Overall Health

Did you know your feet do more than help you move around? They work as sophisticated diagnostic tools for your overall health. These complex structures contain 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. Your feet support your entire body weight and often signal first when something isn't right with your body.

Your feet as early warning systems

Your feet are one of the best early warning systems for health conditions. The way your feet line up directly affects your spine. This can lead to knee, hip, and back pain, especially with problems like flat feet or overpronation.

Your feet are a great way to get insights into your circulatory health. Changes in skin color, unusual sensations, or numbness often suggest conditions like peripheral artery disease or diabetes. These symptoms usually show up in feet first because they sit farthest from the heart and spine.

Your body sends blood to vital organs and the brain before extremities when facing threats. This makes feet especially vulnerable to circulation problems. While this vulnerability can harm foot health, it helps detect serious conditions early.

Some foot warning signs that need quick medical attention include:

• Persistent foot pain, numbness, or swelling (possibly suggesting diabetes, arthritis, or circulatory problems)
• Sores on feet or toes that won't heal (potential warning of peripheral arterial disease)
• Slower growth of toenails or hair on feet (circulation issues)
• Cold sensation in one foot compared to the other (possible circulatory deficit)
• Weaker pulse in the feet (cardiovascular concern)

Neuromuscular conditions like Parkinson's and multiple sclerosis often first show up through changes in foot function. These changes later affect mobility and balance. Regular foot checks play a vital role in proactive health monitoring.

The microbiome of your feet

Your feet's microbial community stands out as one of the most unique in the human body. Feet create a varied microbial environment with areas that differ in skin thickness, anatomical features, sweat gland distribution, pH levels, and oxygen availability.

Healthy foot skin usually contains several bacterial families including Corynebacteriaceae, Micrococcaceae, Propionibacteriaceae, and Streptococcaceae. Common fungi found on feet include Malassezzia, Cryptococcus, Aspergillus, and others that naturally live in this ecosystem.

This delicate balance can easily shift toward dysbiosis – a disruption in the foot microbiome. Such disruptions might trigger conditions like pitted keratolysis, fungal infections, viral infections, or even protothecosis. People who deal with chronic smelly feet or bromhidrosis often find the root cause in this microbiome imbalance.

Your foot microbiome's connection to overall health goes beyond local issues. Like your intestinal tract, your skin maintains symbiotic relationships with helpful bacteria. These relationships support beneficial microbes while fighting harmful ones. Scientists can use this connection to develop new treatments, including potential probiotic therapies for both foot conditions and systemic health.

Learning about your foot's microbiome helps treat persistent conditions like stinky feet disease and reveals broader health patterns. Scientists have found strong connections between gut microbiome and skin health, including foot skin, through what they call the "gut-brain-skin axis".

Diagnosing Bromhidrosis: Medical Tests and Home Assessment

Stinky feet can make you wonder if you need to see a doctor. Medical professionals call chronic foot odor "bromhidrosis." You might need a diagnosis when the smell starts to affect your confidence, relationships, or daily routine. Let's break down when you should get help, how to check your feet at home, and what happens at the doctor's office.

When to see a doctor

Your feet need medical attention if the smell stays despite good hygiene habits. The NHS suggests visiting a doctor when self-treatment doesn't work or the odor disrupts your daily activities.

Medical care becomes urgent if you notice these warning signs with your foot odor:

• Your feet show infection signs like redness, swelling, or unusual warmth
• Red lines spread from affected spots
• Foot wounds or sores don't heal
• A strong smell appears suddenly without changes in your cleaning routine

Diabetic patients need extra caution with these symptoms because they face higher infection risks that could turn serious. Small foot issues can quickly become major problems, especially when you have diabetes, skin conditions, or obesity.

Self-assessment techniques

A good look at your feet starts the self-check process. Set a mirror on the floor to get a full picture of your feet's bottom. Look for anything unusual, cuts, or infected sores that might cause the smell.

Your foot odor assessment should include:

• Time patterns - Does exercise trigger the smell, or is it always there?
• Strength - Can others smell it, or just you?
• Changes - Has the odor type or intensity shifted lately?
• Other signs - Do your feet sweat too much, itch, or hurt?

The smell might be affecting your life quality if it makes you feel self-conscious, keeps you from social events, or causes daily stress. These emotional effects signal that it's time to get medical help.

What to expect during a medical examination

Talking to a doctor about foot odor helps you get the right diagnosis and treatment. Doctors diagnose bromhidrosis through your health history and a physical check. Here's what they'll do:

1. Ask about your health background, when the problem started, and what makes it better or worse
2. Check your feet - they might want to see you after exercise if there's no smell during your visit
3. Look for causes like fungal or bacterial infections

Sometimes doctors need extra tests if they suspect other health issues. Blood or urine tests can show diabetes, thyroid problems, or kidney issues. Some doctors use special lights (Wood's lamp) to find certain bacterial infections like erythrasma.

Come prepared to talk about your daily cleaning routine, shoe choices, and treatments you've tried. Your doctor will spot what's causing the problem and suggest solutions, from strong antibacterial medicines to surgery in tough cases.

Medical Treatments for Persistent Foot Odor

People need medical help if simple remedies don't work well for persistent foot odor. Healthcare providers have several treatment options beyond simple hygiene measures for patients with stubborn cases of stinky feet disease.

Prescription medications

Doctors typically prescribe stronger medications for chronic smelly feet that don't respond to over-the-counter solutions:

• Prescription-strength antiperspirants containing higher concentrations of aluminum chloride (approximately 20-25%) to reduce excessive sweating. These work best if applied before bedtime for three to four consecutive nights.
• Topical antibiotics such as clindamycin or erythromycin creams to eliminate odor-causing bacteria and treat underlying infections.
• Antifungal medications (like griseofulvin) to address fungal conditions that contribute to foot odor.

The microbial nature of bromhidrosis leads doctors to recommend specialized antiseptic soaps with antibacterial creams. Patients with excessive sweating (hyperhidrosis) may need prescription medications such as glycopyrrolate to reduce sweat production.

Surgical options for severe cases

Severe cases of bromhidrosis feet might need surgical intervention:

Botulinum toxin (Botox) injections block nerve signals to sweat glands temporarily and reduce perspiration by a lot. A 2018 study of 62 adolescent patients showed that 82% rated Botox treatment as either "very good" or "good," which proves its effectiveness for long-term management.

Surgical removal of sweat glands provides lasting relief for patients who want permanent solutions. Options include:

1. Superficial liposuction curettage - An outpatient procedure using small incisions and suction devices to remove subcutaneous tissue containing sweat glands.
2. Upper thoracic sympathectomy - A procedure targeting nerves controlling sweat production, with one study showing a 70.6% satisfaction rate among patients.
3. Electrosurgery - Using insulated needles to systematically remove sweat glands over multiple treatments.

Medical experts recognize these surgical approaches as effective long-term management tools, though they come with potential risks like scarring and recurrence.

Emerging medical technologies

State-of-the-art treatments for smelly feet focus on preventing microbial growth:

Zinc oxide nanoparticle (ZnO-NPs) technology shows remarkable promise. Research at the 29th EADV Congress showed that socks coated with ZnO-NPs reduced foot malodor more than uncoated socks. The Royal Thai Airforce developed these specialized socks that provide antibacterial properties safe for human skin.

Activated carbon cloth products like Zorpads represent another state-of-the-art solution. NASA first explored this material for spacecraft cabin air purification. This highly porous material comes from wood pulp and absorbs odor molecules effectively, making it "much more effective than other technologies on the market."

UV sterilization with specialized light bulbs kills bacteria and fungus that cause persistent odor effectively. Athletes particularly benefit from this method, which requires just 15 minutes of treatment per shoe weekly.

The Psychological Impact of Living With Chronic Smelly Feet

Stinky feet disease takes more than just a physical toll - it can devastate people emotionally. Studies show that bromhidrosis affects quality of life by a lot, leading to anxiety, low self-esteem, and social withdrawal. Let's look at how this condition affects people psychologically.

Social anxiety and isolation

People with chronic smelly feet often withdraw from social situations due to psychological distress. Many patients quit their jobs and stay away from family and friends because they feel ashamed and scared. This isolation isn't just a choice - it's how they protect themselves from painful social experiences.

Research shows that "Individual who suffers from bromhidrosis disease has a great negative impact on their self-esteem". This makes people feel vulnerable and triggers anxiety, especially in social settings. Teenagers with plantar hyperhidrosis face severe sweat-related anxiety and feel particularly isolated.

People constantly worry about others noticing their foot odor. They cancel social plans and miss out on life experiences. This stress creates a vicious cycle - studies show that emotional tension makes body odors worse, which can worsen the condition causing the distress.

Strategies for coping with embarrassment

People who deal with the psychological burden of bromhidrosis feet can try these approaches:

• Cognitive reframing: Note that most people can't smell their own body odor, and anxiety makes people more sensitive to tiny scent changes
• Professional support: See both podiatrists for physical treatment and therapists for emotional support
• Selective disclosure: Talk to trusted people to reduce isolation and build support networks

Doctors monitor psychological symptoms to help with emotional and behavioral issues that might make bromhidrosis worse. Therapy helps break the anxiety-sweating cycle since fear often leads to more sweating.

Building confidence despite the condition

Building self-esteem starts with understanding that this medical condition doesn't define your worth. Many patients wonder if they're "being punished" or "did something wrong in life to deserve it". Seeing bromhidrosis as a treatable medical condition helps separate identity from symptoms.

Podiatrists say that "most patients find this condition embarrassing or not worth the appointment—but that couldn't be further from the truth". Professional treatment helps with physical symptoms and gives psychological relief through active management.

Medical intervention combined with psychological support ended up creating the best foundation to recover from both physical symptoms and emotional effects of smelly feet.

Case Studies: When Treating Foot Odor Revealed Underlying Diseases

Medical practitioners sometimes stumble upon surprising findings while treating what looks like routine foot odor cases. These findings show how bromhidrosis can be the first sign that points to deeper health issues.

Patient stories and outcomes

A 24-year-old woman needed medical help because of what she called "increasingly problematic foot odor" that lasted several months. She didn't worry about her condition until her coworkers started complaining about the smell. Her physician's examination revealed small pits in the skin on her soles—a clear indicator of pitted keratolysis. The condition cleared up completely after treatment with aluminum chloride 20% topical solution plus topical clindamycin and new footwear.

A 34-year-old man's story involves a visit to his family doctor with overwhelming foot odor that became unbearable each time he removed his cowboy boots. The doctor saw macerated skin and many crateriform pits on both feet. This led to a diagnosis of pitted keratolysis complicated by hyperhidrosis. The patient's condition improved after treatment with topical erythromycin and aluminum chloride.

Some cases prove even more striking where foot odor signals life-threatening conditions. Quick investigation of persistent foot odor helped some diabetic patients find that there was previously undetected foot ulcers. This early intervention saved them from potential amputations.

Lessons learned from clinical experiences

Clinical experiences with bromhidrosis feet teach medical professionals to look deeper than surface symptoms. The strong link between certain metabolic disorders and distinctive foot odors has changed how doctors approach diagnosis. Trained clinicians can recognize characteristic odors from conditions like phenylketonuria, trimethylaminuria (fish odor syndrome), and isovaleric acidemia.

Many patients endured unnecessary embarrassment or inadequate treatment before doctors understood these connections. Modern medicine confirms that older medical textbooks got it right on its coverage of offensive smells that characterized diseases like gout, scurvy, or typhoid.

These case studies highlight why doctors should investigate persistent foot odor instead of dismissing it as poor hygiene. Physicians now know that bromhidrosis might be the first detectable symptom of serious conditions that range from diabetes to kidney dysfunction.

Conclusion

Stinky feet might seem like a minor nuisance, but science shows this common condition needs serious attention. Medical research confirms that persistent foot odor works as an early warning system for health conditions, from diabetes to kidney dysfunction.

Bromhidrosis affects many people silently, and they don't know that effective treatments exist beyond simple hygiene measures. Medical professionals provide multiple solutions. These range from prescription medications to innovative technologies like zinc oxide nanoparticle-treated socks.

Chronic foot odor that affects your life's quality needs medical attention quickly. This becomes vital for people with diabetes, where unusual foot odor comes before 80% of diabetes-related amputations. Your healthcare provider's thorough foot examination can rule out health issues and open doors to targeted treatment options.

Don't accept persistent foot odor as unavoidable - call it your body's potential signal instead. The right diagnosis and treatment can address both physical symptoms and what it all means for this challenging condition. Your feet work as sophisticated diagnostic tools, and listening to their signals today might prevent serious health issues tomorrow.

FAQs

Q1. What are some hidden health issues that stinky feet might signal? Persistent foot odor can be an early warning sign of serious health conditions like diabetes, thyroid disorders, and kidney or liver dysfunction. For diabetics especially, unusual foot odor may precede infections that could lead to amputation if left untreated.

Q2. How does bromhidrosis differ from normal foot odor? Bromhidrosis is a chronic medical condition causing excessively foul foot odor that significantly impacts quality of life. Unlike occasional smelliness, bromhidrosis persists despite good hygiene and often leads to social anxiety and isolation.

Q3. Can certain vitamin deficiencies contribute to smelly feet? While not the primary cause, some evidence suggests zinc deficiency may contribute to body odor, including foot odor. However, smelly feet are more commonly linked to bacterial growth, excessive sweating, or underlying health conditions.

Q4. What role does genetics play in chronic foot odor? Genetics can influence your susceptibility to chronic smelly feet. Some people inherit a predisposition to conditions like hyperhidrosis (excessive sweating) or have genes that affect their foot microbiome, making them more prone to odor-causing bacteria.

Q5. Are there any innovative treatments for persistent foot odor? Yes, emerging technologies include zinc oxide nanoparticle-coated socks with antibacterial properties, activated carbon cloth products that absorb odor molecules, and UV sterilization for killing odor-causing microbes in shoes. For severe cases, Botox injections or surgical removal of sweat glands may be considered.

Post: Warning: Stinky Feet Disease Might Be Your Body's Hidden Health Signal
Written by: Ainoa Falco
Date: 26/03/2025
External Sources:

1. Bromodosis (Foot Odor) - Cleveland Clinic - https://my.clevelandclinic.org/health/diseases/17111-bromodosis-foot-odor

   • Relevance: Explains the medical term (Bromodosis), common causes (sweat, bacteria), and treatments.

2. Why Do My Feet Smell? - American Podiatric Medical Association (APMA) - https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=1049

   • Relevance: Provides perspective from foot health specialists on causes and prevention/treatment tips.

3. Smelly feet - NHS (National Health Service UK) - https://www.nhs.uk/conditions/smelly-feet/

   • Relevance: Public health source covering causes, what to do, and when to seek medical help (reinforcing the "health signal" idea).

4. Hyperhidrosis (Excessive Sweating) - Mayo Clinic - https://www.mayoclinic.org/diseases-conditions/hyperhidrosis/symptoms-causes/syc-20367152

   • Relevance: As excessive sweating is a primary cause of foot odor, understanding hyperhidrosis can be relevant to the "hidden signal" aspect.