Bromhidrosis

What is it bromhidrosis?

Bromhidrosis is an abnormal or offensive body odor condition, largely determined by apocrine gland secretion, although other sources may play a role. The sweat glands (sweat) are divided into two types: apocrine and eccrine. There are some crosses. Bromhidrosis is also known as osmidrosis and bromidrosis. The common name for this condition is body odor or BO.

Eccrine glands

• It is found throughout the body and produces a diluted salt solution in response to increased body temperature.
• Eccrine sweat is normally odorless, but you can start to smell if bacteria get a chance to break up stale sweat. It may also take on an offensive odor after ingestion from various substances, including food (for example, garlic, curry), alcohol, or certain medications.

Apocrine glands

• It is found in limited areas, especially the armpits, breasts, and groin region, and produces a thick discharge containing pheromones ("personal scent").
• Apocrine sweat is odorless when it first appears on the skin, but within an hour bacteria that normally live on the skin break down the sweat to produce an offensive body odor.
• Body odor is worse if more bacteria are present or if the level of apocrine sweat production is high.

Apocrine bromhidrosis is the most common type of bromhidrosis and results from bacterial breakdown of apocrine sweat, essentially everything within the armpit area. Fatty acids and ammonia are the main products of bacterial breakdown, and the odor has been described as pungent, rancid, musty, or "sour and sweet."

Who gets bromhidrosis and what is the cause?

Although both types of bromhidrosis can occur in people of all races, sex and age, there are some differences between the two types.

Apocrine bromhidrosis

• Possibly associated with a positive family history.
• It only occurs after puberty, as the apocrine glands are not active until puberty is reached.
• More common in men than women, which may be a reflection of increased apocrine gland activity in men than women.
• The skin generally appears normal, except when bromhidrosis is associated with concomitant skin condition such as erythrasma
• Corynebacterium species are the most common bacteria found in the armpit and have been shown to produce foul-smelling fatty acids.

Eccrine bromhidrosis

• It occurs in all races.
• Bromhidrosis can rarely be caused by metabolic disorders: amino acids alterations (trimethylaminuria [olorapescado [fishodoursyndrome]), sweaty feet syndrome, smell of cat syndrome.
• Possibly caused by ingesting certain foods or medications.
• Bromhidrosis caused by bacterial breakdown of skin protein. curb may be associated with maceration and a thick mat of moist keratin present on the skin.
• The role of excessive eccrine secretion (hyperhidrosis) in causing bromhidrosis is unclear. It can promote the spread of apocrine sweat and cause further bacterial growth and breakdown, or it can improve bromhidrosis symptoms by eliminating the most smelly apocrine sweat.
• One study found an increase in body odor in regular users of underarm antiperspirant due to a change in underarm bacterial flora.

How was the diagnosis made?

The clinician's perception of smell is the only tool necessary to diagnose bromhidrosis. Taking a medical history can reveal diseases or conditions that contribute to bromhidrosis, e.g. obesity, diabetes mellitus and intertrigo.

One distinction that the clinician must take into account is the difference between the true bromhidrosis patient and the hydrobromhidrosiphobic individual. Hydrobromidephobic patients have a morbid fear of body odors, and their sensory delusions can be an early warning. sign schizophrenia

What is the treatment for bromhidrosis?

The two main factors to consider when treating bromhidrosis are:

• Keep the number of naturally occurring bacteria on your skin to a minimum.
• Keep the skin in the area, that is, the armpit in apocrine bromhidrosis, as dry as possible.

Improved hygiene and current Therapy are the main treatment options for mild cases of bromhidrosis and may include the following.

• Wash the armpit at least twice a day with germicidal soap
• Regular shaving of the armpits hair to prevent the accumulation of bacteria and sweat on the hair shafts
• Immediate removal of sweaty clothing.
• Try antimicrobial socks and other garments impregnated with silver or copper.
• Use of topical deodorants.
• Treatment of coexisting skin conditions such as intertrigo, erythrasma, and axillary trichomycosis.

• Electrolysis to remove the hair shaft and follicle

If hyperhidrosis is a contributing factor, this should be treated first, usually with the use of antiperspirants.

The treatments described above do not offer a cure for bromhidrosis and the results can often be short-lived and incomplete. A visit to a specialist physician can provide more permanent treatment options and include:

• Elimination of apocrine sweat glands by superficial liposuction.
• Removal of apocrine sweat glands by surgery. excision.

If hyperhidrosis is a contributing factor, this should be treated first, usually with the use of antiperspirants. If this fails and hyperhidrosis is a problem in itself, then the following options can be considered:

• Anticholinergic drugs or beta-blockers.
• Iontophoresis
• Botulinum toxin injection
• Chemical or surgical sympathectomy
• Microwave treatment of the axillary eccrine glands.

However, these treatments may not help bromhidrosis, as this condition is often independent of hyperhidrosis and, as mentioned above, in some cases it can be reduced by associated hyperhidrosis.

For more details on these options, see Hyperhidrosis: Treatment Available from a Specialist.