Body odor may be sign of a medical disorder


September 22, 2009|By Tribune Media Services

Dear Mayo Clinic: I am a young, healthy woman with a slightly embarrassing problem. I have unusually strong body odor. It is most noticeable under my arms, but I also notice it in my feet. I do not sweat excessively. I shower daily, keep my underarms hair-free and use deodorant. Is there something I can do to reduce this odor?

Answer: For some people, strong body odor (bromidrosis) is part of their natural makeup. But for others, it may be a sign of an underlying medical disorder.

The cause of sweating and body odor stems from the body's temperature regulation system, specifically the sweat glands. The skin has two types of sweat glands: eccrine and apocrine. Eccrine glands occur over most of the body and open directly onto the surface of the skin. Apocrine glands develop in areas abundant in hair follicles, such as on the scalp, armpits and groin.

When the body temperature rises, the autonomic nervous system stimulates the eccrine glands to secrete fluid onto the skin's surface, where it cools the body as it evaporates. This fluid (perspiration or sweat) is composed mainly of water and salt and contains small amounts of other electrolytes, as well as substances such as urea, a chemical waste product.

Apocrine glands, on the other hand, secrete a fatty sweat into the tubule of the gland. When someone is under emotional stress, the wall of the tubule contracts and the sweat is pushed to the skin's surface, where bacteria begin to break the fat and other chemicals in the sweat. The perspiration itself is practically odorless. But the smell can become unpleasant when perspiration comes into contact with bacteria on the skin.

The way sweat smells can be influenced by a variety of factors, including a person's mood, diet, some drugs and medical conditions, and even hormone levels. For example, foods with strong odors -- such as onions, garlic and cumin -- can contain oils that may cause odor as they are excreted through the skin. Caffeinated drinks can increase sweating.

Unusual body odor, and particularly a change in the amount or type of odor, could be a sign of a medical problem, such as diabetic ketoacidosis or kidney failure. Body odor that has a fishy smell may be a sign of trimethylaminuria, a rare genetic disorder.

More often, however, strong body odor isn't a sign of a medical problem. In these cases, using an antibacterial soap, along with deodorant and an over-the-counter benzoyl peroxide wash, can be helpful measures for underarm odor. Drying powders, such as baby powder, in combination with antibacterial soap, may reduce foot odor. Frequent bathing and clothing changes can also sometimes help control the odor.

If these steps aren't enough to control body odor sufficiently, your doctor may recommend a prescription-strength antiperspirant made of aluminum chloride. In extreme cases of bromidrosis, the measures already mentioned do not help control underarm odor, and the odor remains severely distressing. In this situation, surgical removal of the sweat glands may be an option. Surgery, however, should only very rarely be considered.

To determine the treatment that's best for your situation, make an appointment with your doctor or a dermatologist to discuss your concerns.

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