Unpleasant body odours

Bromhidrosis is the medical term for unpleasant body odours associated with sweating.

2024 is forecast to be the hottest year on record, this will make it extremely challenging to keep our body odours to ourselves.

Men have larger sweat glands than women and are less likely to shave their armpits, these two factors predispose them to a more unpleasant odour.

Most underarm products are a combination of a deodorant and an antiperspirant. Deodorants reduce odours by decreasing the bacterial count, while antiperspirants reduce the volume of sweat produced.

Where sweat originates:

Our bodies have two types of sweat glands. The eccrine glands are found over most of our body and release sweat via our pores onto our skin in keeping with our body temperature. As the sweat evaporates we cool.

The apocrine glands, which begin to function in puberty, are found in the naturally hairy areas of our body. In particular the axilla (armpits), the groin, and pubic areas. The sweat released from these glands is lipid (fat) rich and is thicker and milkier than the sweat released from the eccrine glands. Sweat is normally odourless until it combines with the skin’s bacteria.

The areas of our body where bromhidrosis is most likely to emanate from:

• Armpits
• Groin
• Feet
• Genital/ pubic area
• Back of ears
• Anus
• Umbilicus (Navel)

Why does sweat smell?

Sweat by itself is for the most part odourless. Body odours primarily arise when the bacteria that are naturally present on the skin mix with our sweat, body salts, and fats in the sweat. The body odour is also influenced by additional factors such as:

• The build-up of Staphylococcus hominis on your skin, especially armpits. This bacteria contains an enzyme called C-T lyase which is responsible for converting substances in sweat into the fetid compound, thioalcohol.
• Diet – e.g. Onion, garlic, cruciferous vegetables (cabbage, callaloo, broccoli, cauliflower, kale), red meat, MSG, caffeine, curry, hot sauce, alcohol, chilly, cumin, horseradish, leeks, scallions, asparagus.
• Change in blood hormone levels – i.e. puberty, ovulation, menstruation, pregnancy, menopause.
• Medicines being taken – e.g. tramadol, PPIs (omeprazole, Alocid, lansoprazole, pantoprazole), codeine, pregabalin, gabapentin, fluoxetine, venlafaxine, tricyclic antidepressants, pilocarpine, NSAIDs (Voltaren, diclofenac, Aleve, naprosyn, Motrin, ibuprofen), lithium, bisphosphonates, some HIV medications, L-thyroxine.
•  Medical conditions – e.g. diabetes, elevated uric acid levels (Gout), hyperthyroidism, kidney disease, liver disease, infections, cancers.
• Ambient temperature – the higher the temperature the greater the volume of sweat produced and the increased chance of a worsening body odour.
• Stress levels – Stress influences the volume of sweat produced.
• Body weight – Overweight persons are likely to sweat more and report a malodorous body odour.
• Genetic factors – Your genetics can influence the makeup of your sweat. The more appetizing the contents of your sweat are to the skin’s bacteria the more they will thrive.
  
  When should one be concerned about sweating?

• A marked change in the volume of sweat that your body produces.
• When sweating impacts daily life.
• Sweating at night for no apparent reason.
• There is a sustained change in the odour of your sweat.
• If cold sweating.

Remedies for controlling body odour:

•  Washing at least twice a day the entire body with soap and water, paying particularly close attention to areas that are most likely to generate odours, as outlined above. Dry yourself thoroughly afterward.
• Shaving the armpits regularly has been shown to reduce the odour generated from this area. With less hair, there is reduced bacterial build-up.
• Change and wash your clothes regularly.
• A good antiperspirant reduces the volume of sweat produced and the build-up of odour-generating bacteria in the armpit.
• Wear light-coloured cotton clothing.
• Once there are no medical contra-indications, consider washing and or applying any of the following to your underarms – baking soda, dissolved rock salt, green tea, tomato juice, lemon, apple cider vinegar, and or witch hazel.
• Ensure that you have an adequate intake of water
• Antiseptic scrubs, and or antibiotic ointments can be used in the areas of greatest concern regarding odour generation. These should not be initial go-to options, for this approach can facilitate the emergence of resistant strains of bacteria.

Controlling body odour in extreme circumstances:

•  A prescription-strength antiperspirant containing up to 30% aluminium chloride can be prescribed to reduce the volume of sweat produced by the armpits significantly.
• Botox injected directly into the armpit can significantly reduce the volume of sweat this area produces.
• Endoscopic thoracic sympathectomy (ETS) is a type of surgery that is directed at severing the nerves controlling armpit sweating.
• Liposuction may be done on your armpits to remove the apocrine sweat glands.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.