Body odour (BO)

Body odour is the unpleasant smell produced by bacteria on the skin that break down the acids in sweat. The medical term is bromhidrosis. Everyone sweats – it’s the body’s way of regulating body temperature, but body odour normally only exists in those who have reached puberty, as this is when the apocrine sweat glands develop, which produce the sweat that bacteria can quickly break down. Men are more likely to have body odour, because they tend to sweat more than women.

Things that can make body odour worse include:

  • being overweight
  • consuming rich or spicy food and drink – such as garlic, spices and alcohol
  • some types of medication – such as antidepressants
  • certain medical conditions – a fruity smell like pear drops can sometimes be a sign of diabetes, while a bleach-like smell may indicate liver or kidney disease

Excessive sweating

Hyperhidrosis is a condition where a person sweats excessively and much more than the body needs to do in order to regulate temperature. If you have hyperhidrosis, you may also have smelly feet (bromodosis) caused by wearing shoes and socks that prevent sweat evaporating or being absorbed, which attracts bacteria.

When to seek help

It’s quite socially difficult to know sometimes if body odour or excessive sweating is a problem as we get used to how our own bodies function and we may be ‘nose-blind’ in not recognising our own problem. We’ve probably all been in social or work situations where someone does smell of BO but it’s awkward knowing what to do or say about it. In some cases – it may be just not washing properly or not laundering clothes properly. It’s equally awkward to be on the receiving end of a complaint, but there are some quick fixes to begin with.

Managing body odour

Excessive sweating and body odour can affect a person’s confidence and self-esteem. It can usually be managed by getting rid of excess skin bacteria – which are responsible for the smell – and keeping the skin in the affected area (usually the armpits) clean and dry. The armpits contain a large number of apocrine glands, which are responsible for producing the body odour.

  • take a warm bath or shower every day to kill the bacteria on the skin. On hot or humid days, it may be necessary to have a bath or shower twice (or more) a day
  • wash armpits thoroughly using an antibacterial soap
  • use a deodorant or an antiperspirant after bathing or showering
  • regularly shave the armpits allowing sweat to evaporate quicker, giving bacteria less time to break it down
  • wear natural fibres, such as wool, silk or cotton as they allow the skin to breathe, which means sweat will evaporate quicker
  • wear clean clothes and make sure they’re washed regularly at a high enough temperature to kill bacteria
  • limit the amount of spicy foods eaten such as curry or garlic, because they can make sweat smell more pungent; evidence also suggests that eating a lot of red meat tends to make body odour worse

Deodorant or antiperspirant?

The terms are used interchangeably but they are actually very different and the active ingredients used in both differ too.  Some are more effective than others with roll-on antiperspirants more effective for those who sweat more. Deodorants work by using perfume to mask the smell of sweat whereas antiperspirants contain aluminium chloride which reduces the amount of sweat the body produces.

Aluminium chloride

Aluminium chloride is the active ingredient in most antiperspirants which helps to prevent the production of sweat. If the self-care advice about washing more and avoiding spicy foods doesn’t improve body odour, a stronger antiperspirant that contains more aluminium chloride might be needed.

A GP or pharmacist can recommend a suitable product and advise about how it should be used.

Aluminium chloride solutions can be applied every night after showering before bed, and washed off in the morning. Which works because there is less sweating during sleep, letting the solution seep into sweat glands and block them which can reduce the amount of sweating the next day.

As the aluminium chloride solution begins to take effect over time, it can be used less often (every other night, or once or twice a week).

Surgery

Surgery may be recommended for severe body odour that can’t be treated by self-care measures and over-the-counter products. One type of surgery involves removing a small area of skin from the armpit and the tissue just below it, getting rid of some of the sweat glands.

It can also be possible for the sweat glands to be drawn out from the deeper skin layers using liposuction – a technique that’s often used to remove unwanted body fat.

Another option is a type of surgery called endoscopic thoracic sympathectomy (ETS), which uses keyhole surgery to destroy the nerves that control sweating. During ETS, the surgeon makes two or three small incisions under each arm. A tiny camera (endoscope) is inserted through one of the incisions so the surgeon can see the inside of the armpit on a monitor. They will then insert small surgical tools through the other incisions, allowing them to cut the nerves. Alternatively, a thin electrode that emits an electrical current can be used to destroy the nerves.

Risks associated with ETS include damage to nearby arteries or nerves, and compensatory sweating (increased sweating from other areas of the body), so the risks of the procedure should be discussed in full with the surgeon beforehand.

Botulinum toxin (Botox)

Botox, is another possible treatment for people with excessive underarm sweating. Botulinum toxin is a powerful poison that can be used safely in very small doses to block the signals from the brain to the sweat glands, reducing the amount of sweat produced. Between 12 and 20 injections of botox are made in the affected area of the body, such as the armpits, hands, feet or face.

The procedure takes about 30-45 minutes, and usually lasts for between two and eight months and after this time, further treatment can be given. The availability of this treatment the NHS can vary widely, so it may need to be done via a private cosmetic clinic. Prices can vary, depending on the area of the body being treated (treating both armpits can cost up to £500) so shop around before starting treatment

Do you suffer from excessive sweating, have you sought medical help because the condition was affecting your quality of life.  Share your experiences.  Start the conversation.