Body Odor: Why You Have It and How to Get Rid of It (original) (raw)

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Summer is over, but dozens of U.S. cities are still reporting record-high temperatures into the fall season. As you can imagine, excessive sweating has been a major complaint in my office. But one of the most distressing parts of sweating can be the accompanying odor.

Sweating is normal. It allows us to regulate our body temperature and prevent overheating. We sweat continuously throughout the day. On average, we produce 16 to 64 ounces or sweat per hour, and this amount can vary with activity.

Excessive sweating, or hyperhidrosis, is a well-recognized condition. It is a result of overstimulation of your eccrine sweat glands. Hyperhidrosis can affect certain areas, such as your underarms or palms, or all over your body.

Hyperhidrosis is separated into two categories, primary and secondary. Primary hyperhidrosis is caused by overactive nerves stimulating receptors on the eccrine glands. It affects younger people and is usually worse during the day but reduces or resolves itself at night. While the cause of this process is unclear, there is likely a genetic component, as 62% of people with hyperhidrosis report a family history.

Secondary hyperhidrosis develops as a response to certain medical conditions or medications. Diabetes mellitus can directly affect the endocrine system, which can trigger increased sweating. Both generalized anxiety disorder and the medications used to treat this condition can also increase sweating.

You have an average of 3 million sweat glands covering your body. Sweat glands are found everywhere on your body, except your lips and nail beds. There are two major categories of sweat glands, apocrine and eccrine glands. The apocrine glands are in the underarms, groin, and breasts. These sweat glands are directly attached to your hair follicles and become active during puberty. They typically produce sweat intermittently and during stressful events. Eccrine glands are found everywhere else. They open directly onto the skin and are key in regulating body temperature.

All sweat is initially odorless. But when skin bacteria interacts with sweat, the production of fatty acids creates a distinct and often offensive odor. This process is called bromhidrosis. Body odor is a direct result of the production of thioalcohols. This process happens from enzymes within certain skin-loving bacteria. The most recognized odor-causing bacteria is Staphylococcus hominis. It is the second most common non-harmful bacteria found on healthy human skin, mostly in your underarms.

Bromhidrosis can occur for several reasons, including your diet, medications you take, medical conditions you may have, and your lifestyle habits.

Diet

Medications

Medications that increase your heart rate, like amphetamines and adrenaline, increase sweating. For example, selective serotonin reuptake inhibitors, a popular class of medication for anxiety/depression or ADHD medications, can increase your heart rate, which increases sweating and the ability of sweat to interact with certain bacteria.

Medical conditions

Lifestyle

How to Treat Your Body Odor

Addressing the root issue of body odor is essential in controlling the symptoms. There are treatment options available to either reduce the bacteria on your skin surface or decrease sweat production.

For every patient I see diagnosed with body odor, I recommend eating odor-causing foods in moderation. Additionally, I tell them to avoid nonessential medications linked to body odor. Simultaneously, I begin over-the-counter (OTC) treatment to reduce the amount of sweat on the surface of the skin. OTC antiperspirants are a great option, as they contain fragrance to mask body odor. Many antiperspirants contain aluminum salts, which temporarily clog the sweat glands to prevent or reduce sweating. The products that market as “clinical strength” contain a higher percentage of active ingredient. If OTC treatments are ineffective, there are prescription-strength antiperspirants like Drysol. However, you could have some possible side effects, including irritation and itching.

In 2023, TikTok influencers discovered using OTC acid-based products, like salicylic and lactic acids, helped control body odor. There is some science to back this up. Staphylococcus hominis bacteria secrete proteins that allow the bacteria to create a microfilm on the skin. Using pH-lowering products helps reduce the expression of these proteins and reduces the formation of biofilm on the skin.

Medical options for body odor include:

Medical options for sweating include:

Treating body odor is a process influenced by several factors, and it can involve adjustments to both your diet and medications. Initial treatment starts more conservatively but can escalate, depending on the response and severity of your symptoms.

For this reason, I recommend starting with over-the-counter treatments, giving them at least 4 weeks of use. If there’s no improvement, I recommend consulting a board-certified dermatologist to discuss specific treatment options.

Photo Credit: Getty Images

Lauren Henderson, MD

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