The Problem with Bromhidrosis
Individuals who experience really problematic “body odour” suffer from a condition known as Bromhidrosis (or Osmidrosis) and no matter how much deodorant, antiperspirant or perfume is used, the odour remains most of the time, despite almost constant washing. The syndrome affects every aspect of the sufferer's life; school, work, friendships, romance, sporting activities, even shopping. Treatments are now available to alleviate this distressing condition, but in order to gain the maximum benefits, it is important to fully understand the background of this complaint and how the various treatments work.
Why do I have Bromhidrosis?
The skin contains two types of sudoriferous glands, the eccrine and apocrine, whose secretions can cause problematic body odour. The eccrine glands, found in large numbers all over the body, secrete a watery liquid known as perspiration which helps control body temperature, this liquid is normally odourless unless it is contaminated with other secretions or skin debris, that can lead to the production of unpleasant odours.
The apocrine glands are far fewer in number, mostly found underarms (axilla) and in the ano-genital area, these glands produce small amounts of a waxy substance into nearby hair follicles, however, the amount of wax produced by Bromhydrosis sufferers is far greater than normal. It is the action of the normally occurring bacterial skin flora in breaking down the excessive amounts of this “waxy food” that causes the problematic odours. Successful treatment therefore depends on reducing the skin bacteria and apocrine gland activity.
The background to Bromhidrosis
The Aprocine glands have no known physiologic importance as we live today, their role of "scent glands" being lost long ago in our evolutionary past, unfortunately there are several distinctive dermatological disorders involving these glands. Control of the pervasive odour of apocrine sweat is regarded by most of modern society as a daily necessity. North Americans alone spend over 800 million dollars annually on the purchase of axillary (underarm) deodorants and antiperspirants.
Apocrine sweat / wax is the only natural product of the body which, when decomposed with bacteria, gives rise to the classic apocrine odour. Nothing in the world can be substituted for apocrine sweat and result in the same odour: not sebum, hair, ordinary sweat (eccrine), keratin scales, or any combination of these. In fact, this odour can be so pervasive and prominent, that despite its origination from the axilla only, it has been given the common designation of "body odour".
Apocrine bromhidrosis never occurs before puberty, because the particular glands involved are not active in the pre-pubescent individual. It is also less likely in the elderly. Apocrine sweat is sterile and odourless when it first appears on the skin surface. However, within an hour bacteria degrades the sweat to the point where the classic acrid odour is detectable. Fatty acids and ammonia are the major odoriferous products of this bacterial decomposition. Thus, a variety of odours - musty, rancid, faecal, sour and sweet' may be detected: reflecting, of course differences in chemical makeup of each individual's axillary sweat. Hair and clothing also provide additional lodgings for the retention of the odorous sweat and this contributes greatly to the odour-producing problem.
Bromhidrosis occurs in all races, but there are some variations in racial incidence. The apocrine glands from individuals of African ancestry are the largest and most active. Asian's have the smallest and least active glands. Beyond that, variations in the occurrence of bromhidrosis are unexplained, there are individual differences in the composition of apocrine sweat but no studies have yet been made to determine causal factors. The hygienic routine (or lack of) probably explains why there is a greater frequency of the problem in males.
The diagnosis of Bromhidrosis
The diagnosis of apocrine bromhidrosis can be easily made if the examiner has normal nasal function. There is, however, one very important distinction that must be made between the true bromhidrosis patient and the bromhidrosiphobic individual: the latter being people who have a morbid dread of bodily odours and unreal images about what they smell, or in this case, what they think they smell. This sensory delusion can be an early warning sign of schizophrenia. Olfactory hallucinations may also be a sign of neurological disease. By and large, people with apocrine bromhidrosis are not careless in their personal hygiene. They regularly cleanse their underarms (sometimes several times a day), usually with a germicidal soap. This accomplishes two things: the removal of the apocrine sweat, and temporary inhibition of the underarm bacteria.
Odaban as part of a full regime
In short the main factors to consider in successfully treating Bromhidrosis are to keep the number of naturally occurring skin bacteria as low as possible, remove as much of the skin "food" that these bacteria thrive on (cleanse several times daily with alcohol swabs and showers twice daily with germicidal soap) and also foster an environment under the arms unfavourable to bacterial growth, that means dry skin. Those individuals also suffering from Hyperhidrosis must first seriously address this problem before attempting to solve their bromhidrosis.
Shaving the underarm hair (men and women) is an absolute necessity for all patients with apocrine bromhidrosis, in order to prevent the accumulation of sweat and bacteria on the hair shafts. As well as shaving, patients should carry alcohol pads (pre-injection swabs obtained from pharmacies) for regular clean-ups between-showers.
As suggested above, antibiotic creams, antioxidant creams (Vitamin E), Farnesol / Tea Tree Oil products, germicidal soaps and lotions and alcoholic swabs can all be used to good effect. Shaving under arms is important and the use of an effective antiperspirant against hyperhidrosis to keep the skin dry is vital.
Odaban is obviously efficient in keeping the skin very dry and this means an unfavourable environment for the skin flora to reproduce in, this is another major plus for Odaban in controlling this unpleasant condition. Less bacteria mean less odours.
The big break through in treating Bromhidrosis in recent years has been the use of Electrolysis, your doctor can recommend a practitioner. This process not only removes all the unwanted underarm hair but also stops the unwanted secretions from the aprocrine glands. Treatment by a trained electrologist takes several weeks or more but really is life changing.
Regular use of an underarm deodorant, several times daily, will help to suppress underarm bacteria. Contrary to what we might expect, the metallic aluminium, zirconium, or zinc salts in most over the counter antiperspirants have no antiperspirant action on the apocrine glands, but they do work well on eccrine glands, and the antibacterial agents in the deodorants are effective on both glands.
Another obvious means of suppressing axillary odour involves the use of perfumes to cover up or mask the offensive odour. But it must be remembered that perfumes carry the risk of allergic sensitisation. Most axillary deodorants contain perfumes, too, and for those patients who find this a problem, there are now a few perfume-free preparations on the market. Topical antibiotics such as neomycin or gentamicin creams are effective axillary deodorants, but they also carry the risk of allergic contact sensitisation, especially with neomycin. Topical antioxidants, especially vitamin E cream, may offer some help and Farnesol / Tea Tree Oil products (see Internet) have also proved useful without causing the skin sensitisation of other non-organic products.