Patients with hyperhidrosis report physical discomfort with wet clothing and shoes. Skin maceration from constant wetness can lead to bacterial and fungal overgrowth. This overgrowth can then lead to intertrigo in the axillae as well as bromhidrosis (foul-smelling sweat), pitted keratolysis (an infection of the plantar surface characterized by pits or craters), and gram-negative bacterial macerative infection of the feet. Excessive sweat can stain and eventually destroy clothing and shoes. Patients may spend thousands of dollars yearly on dry-cleaning and clothing replacement.