Causes and risk factors
There are two types of sweat glands. Eccrine glands and apocrine glands. Eccrine glands are located all over the body, but are more commonly seen on palms and soles. As the body temperature increases, the eccrine gland produces more watery and dilute sweat. This sweat is devoid of odor, however, it can start smelling if bacteria start breaking the sweat. Apocrine glands are more commonly seen in axilla, in breast and groin region. This gland produces thick secretions. However, the sweat produced is also odorless. Odor can be caused due to bacterial infection. Bacterial infection is one of the most important causes leading to offensive odor. Corynebacterium species is one of the major causative agents. Bromhidrosis is often associated with certain skin conditions like erythrasma. In some cases it seen as hereditary. Ingestion of certain strong foods, alcohol, or medications can also lead to offensive odor from body.
Clinical presentation:
A person suffering from bromhidrosis often suffers from offensive odor from the body. It is more commonly seen in axilla. However, it can also occur on rest of the parts of the body. The sweating can either be increased or normal. Staining of clothes can also occur.
Investigations:
No special investigations are needed for diagnosing this condition. Clinical examinations are usually sufficient for the diagnosis. Certain investigations like routine blood test, cultures, or other tests can be done if any underlying infection is suspected. Other investigations which can be done are chromatography or spectrometry. Along with this, starch iodine test is also done. Rarely, skin biopsy can be needed.
Treatment:
Maintenance of good hygiene is the major step which should be implemented. Daily bathing, wearing of clean clothes and shaving must be done. Use of topical deodorants is advised. If there is any underlying skin condition, it must be treated first. If hyperhidrosis is also associated with it, it needs to be treated with antiperspirants. Certain other techniques which can be adopted are administration of medications like beta blockers or anticholinergic drugs. Botulinum injections can be given. Removal of the apocrine sweat glands by superficial liposuction or sympathectomy can also be done.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.