In many cases, strong body odor can result from excess sweating, although there are other contributing factors. Read on to find out.
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Bromhidrosis is strong body odor, a common disease that seriously affects quality of life. It is defined as an unpleasant stench. It transmits strong non-verbal signals and thus causes great social embarrassment, especially if the patient has selective anosmia , the inability to perceive that odor.
Perspiration itself has no stench. Only when sweat comes in contact with bacteria on the skin can it arise. It can often be treated or prevented through changes in hygiene habits, although there are also medical approach options. We detail more about this condition below.
What is bromhidrosis or strong body odor?
According to studies in the International Journal of Cosmetic Science , bromhidrosis is due to the biotransformation of odorless natural secretions into volatile odorous molecules and is related to excessive sweating. That is, the disorder appears more frequently in those people who sweat more.
In the armpit, the Microbiome concludes that Corynebacterium spp. of the resident microflora is important in this biotransformation. Obesity can also be a contributing factor to bromhidrosis. The underlying mechanism is the change that molecules undergo when they are metabolized by microorganisms.
The stench appears when perspiration comes in contact with bacteria on the skin.
Causes of body odor
Sweat glands are divided into eccrine glands, which are found throughout the body, and apocrine glands, which are found in the armpit, breast, and groin region. These are the two great varieties of this tissue and all human beings possess both.
The apocrine glands are not activated until puberty. This is why strong body odor is not usually a problem in young children, but also appears as a sign of growth and development.
An important mechanism is the interaction of the secretion of the axillary apocrine sweat glands with the bacteria, generating unsaturated fatty acids that have a particular odor. The presence of this stench is also important for the diagnosis of bromhidrosis .
While the bacterial metabolism of apocrine sweat is what causes odor in general, eccrine sweat can also become offensive. For this second situation, the triggers are usually the intakes of certain foods, such as garlic and alcohol.
You may be interested: Tips to avoid excessive sweating
How to combat strong body odor?
Conservative treatment measures have been tried and failed when the patient consults their GP for strong body odor. Currently, medications and surgery are the most widely used approaches for bromhidrosis .
Surgery: sympathectomy
Surgery is the most preferable method for bromhidrosis and is used in severe cases. However, postoperative complications and scar formation remain the problems of surgical treatment.
It is reserved for those patients who are refractory to medical therapy and in whom hyperhidrosis is having a significant impact on their activities of daily living. According to studies by the Annals of Surgery , endoscopic thoracic sympathectomy is the last resort for the treatment of palmar, axillary, and craniofacial hyperhidrosis . It works by disrupting the fibers of the sympathetic ganglia.
Botulinum toxin
The main mechanism of action of botulinum toxin for bromhidrosis is the inhibition of acetylcholine release from the sympathetic nerves that innervate the eccrine sweat glands . Treatment is very effective on the palms of the hands and soles of the feet, although pain during injections can be a limiting factor for use.
The dose for intradermal injections depends on the area. In the armpit, for example, 50 to 100 units are used. The downside of botulinum toxin treatment is that the effect wears off after a while, so multiple applications may be needed over a year.
Antiperspirants with aluminum compounds
While most standard supermarket antiperspirants contain aluminum chloride, stronger agents should contain aluminum hydrochloride. Agents with these substances inhibit the growth of smelly bacteria.
These metal salts also reduce sweat by blocking the excretory ducts of the sweat glands, minimizing the source of water that favors bacterial growth. Topical therapy should be applied once a day, usually at night, when the skin is dry.
Aluminum antiperspirants are the best option for bomhidrosis if surgery is not considered.
Read also: Deodorants: with or without aluminum salts?
Recommendations for the patient with bromhidrosis
Both hyperhidrosis and bromhidrosis are common and distressing conditions, as they complicate social relationships and bonding with others. Sensitive management and appropriate referral can help minimize the impact on the patient’s quality of life , both individually and functionally.
Regular washing and underarm waxing are helpful. Fragranced antiperspirants are a first-line treatment in managing body odor. These reduce the volume of sweat and are also antibacterial.
