Bromhidrosis: Causes, Treatments and Prevention of Excessive Body Odor

Bromhidrosis is a chronic medical condition characterized by extreme body odor.

Excessive body odor can have a negative impact on your confidence and your life. In this article, we explain more about bromhidrosis, why you might have it and how you can treat it.

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WHAT IS BROMHIDROSIS?

Bromhidrosis is a disease that occurs when the bacteria on your skin breaks down sweat and produces an abnormally offensive smell similar to onions or sulfur. Bromhidrosis body odor is more pungent and persistent than ordinary B.O.

There are two types of bromhidrosis: apocrine and eccrine. These forms of bromhidrosis differ significantly from regular body odor.

APOCRINE VS. ECCRINE BROMHIDROSIS

Bromhidrosis is typically associated with apocrine gland sweat, but can also stem from eccrine gland sweat (more on this below).

Body odor occurs when the proteins in sweat mix with bacteria on your skin. The difference between the two conditions depends on how these variables interact.

Apocrine Bromhidrosis

Apocrine bromhidrosis is the most common type of bromhidrosis. Apocrine sweat glands are located in the armpits or genital area.

When you have apocrine bromhidrosis, body odor is the byproduct of lipid-rich apocrine gland sweat mixing with skin bacteria. When these two ingredients come together, they produce thioalcohols — compounds that smell like sulfur, onions or raw meat. So if your  armpit sweat smells like onions, it may be a sign of apocrine bromhidrosis.

Eccrine Bromhidrosis

Eccrine bromhidrosis is the rarer form of bromhidrosis. Eccrine sweat glands are found in the palms and soles as well as the head or torso.

Eccrine bromhidrosis happens when sweat from your eccrine glands softens the keratin on your skin. The softer the keratin is, the easier it is for bacteria to break down. This break-down process produces a stenchy odor.

But what’s the difference between bromhidrosis and regular B.O.? How do you know if you have bromhidrosis?

REGULAR BODY ODOR VS. BROMHIDROSIS

It’s easy to keep natural  body odor under control with good hygiene habits and over-the-counter treatments like antiperspirant and deodorant. But when you have bromhidrosis, these simple solutions don’t work. You might find it hard to keep body odor at bay, even if you shower more than once a day or reapply deodorant often.

Here are a few more examples of what it’s like to have normal body odor versus bromhidrosis.

Anti-Stink Tactic Normal Body Odor Result Bromhidrosis Result
Shower Eliminates B.O. completely Does not reduce B.O. significantly
Apply deoderant once per day Keeps B.O. away most of the day Keeps B.O. away for a few hours
Apply extra-strength antipersperant deoderant Eliminates B.O. for extended periods Reduces B.O. for very short periods

If you’re wondering why your body odor and sweat smell like onions or cheese, there’s a good chance you have bromhidrosis.

Most of the time, you can detect bromhidrosis from its distinct scent. Common symptoms of this condition include:

  • Constant (but not overpowering) body odor
  • Body odor within 30 minutes of showering or bathing
  • A cheese or meat-like smell coming from your underarms or groin
  • A garlic or onion-like smell coming from your breasts, underarms or groin
  • Social anxiety due to body odor

Doctors can diagnose bromhidrosis by swabbing and testing the bacteria on your skin. Excessive amounts of Corynebacterium, Propionibacterium, Staphylococcus and Micrococcus usually indicate chronic body odor. Staphylococcus is typically the strongest-smelling bacteria.

Being able to spot the signs of bromhidrosis is a helpful first step in overcoming chronic body odor. But to solve the problem, you also need to understand the underlying cause of your condition.

CAUSES OF BROMHIDROSIS

Certain factors that can cause or exacerbate bromhidrosis include genetics, the consumption of certain foods and other medical conditions.

GENETICS

Chronic body odor can run in the family. Studies show that there is a strong correlation between the ABCC11 gene and bromhidrosis. This same gene is present in individuals with wet ear wax. So believe it or not, if you have wet ear wax, you’re more likely to have bromhidrosis.

OBESITY

Having large amounts of excess fat on your body makes you more susceptible to bromhidrosis.

Excess fat creates skin folds. These warm, dark crevices are the perfect environment for sweat and bacteria to mix and produce an odor. Because these areas can be challenging to clean, you may neglect them when you bathe or shower. Failing to cleanse and exfoliate these areas allows bacteria and sweat to fester and create a pervasive odor.

DIABETES

Sometimes bromhidrosis can be mistaken for a condition called diabetic ketoacidosis, which can occur if you have untreated diabetes. When you have diabetes, your body doesn’t produce enough insulin to regulate your metabolism. As a result, you start to break down fat which causes acids to build up in your bloodstream. This process can result in body odor and bad breath.

INTERTRIGO

Intertrigo is a rash caused by trapped moisture and sweat. Although the most common form of intertrigo is infant diaper rash, adults can also get it from lack of air circulation to their skin.

When intertrigo goes untreated, bacteria thrives in moist, friction-prone areas which can lead to chronic body odor.

ERYTHRASMA

Erythrasma is a bacterial infection caused by humid, tropical climates that manifests as a pink skin rash. The bacteria that causes this rash, Corynebacterium, naturally occurs on your skin. It’s also one of the bacteria that exists in excess for those with chronic body odor.

HYPERHIDROSIS

Bacteria and sweat are key components of bromhidrosis. So if you suffer from hyperhidrosis or excessive sweating, you’re more likely to have chronic body odor as well.

If you think sweat or hyperhidrosis is contributing to your bromhidrosis, it’s best to treat hyperhidrosis first to reduce the sweat that’s affecting your body odor issue.

CONSUMING CERTAIN FOODS, LIQUIDS AND DRUGS

Your diet and oral medications can affect the smell of your sweat. When the byproducts of pungent foods like garlic, onion, cruciferous vegetables and red meat blend with sweat and bacteria, it can cause chronic body odor.

Other foods that can aggravate bromhidrosis include:

  • Alcohol
  • Tobacco
  • Fish
  • Asparagus
  • Curry

Bromhidrosis can also be a side effect of these medications:

  • Penicillin
  • Bromides

BROMHIDROSIS TREATMENTS

Thankfully, bromhidrosis is treatable. Here are some ways to mitigate excessive body odor and stop smelling like onions:

TAKE MEASURES TO REDUCE YOUR SKIN BACTERIA

Here are a few ways to keep the bacteria on your skin to a healthy minimum:

  • Use antibacterial or germicidal soap: Choose gentle liquid or cream body wash over solid soap, and avoid scented products that can worsen your B.O.
  • Shave excess body hair: Hair traps bacteria and sweat, which aggravates bromhidrosis.
  • Remove or wash sweaty clothes immediately: This gives bacteria less time to break down sweat.
  • Take regular warm baths or showers: Warm water can help kill the bacteria on your skin. Shower twice a day and pay close attention to extra sweaty areas, especially on a hot day. 
  • Wear anti-odor garments: Most anti-odor clothing features silver or copper, but for a more healthy and natural alternative, look for shirts made with hydrogen peroxide, such as the Thompson Tee Premium Anti-Odor Undershirt.
  • Use extra-strength or prescription deodorant: Over-the-counter products might not cut it. Consult your doctor or dermatologist to explore prescription-strength deodorants and solutions.

CHANGE YOUR DIET

Avoid foods that promote pungent, odiferous sweat secretions to reduce the effects of chronic body odor. Try these odor-fighting foods instead:

  • Lemons, oranges and grapefruits
  • Green leafy vegetables like kale and spinach
  • Fresh herbs
  • Whole grains

Read more: How to Get Rid of Body Odor: 5 Quick, Natural Solutions

KEEP YOUR SKIN DRY

Damp skin is a breeding ground for odor-causing bacteria. If you have a condition like hyperhidrosis, you can manage bromhidrosis by taking the appropriate steps to reduce excessive sweat first.

MEDICAL TREATMENTS FOR BROMHIDROSIS

Bromhidrosis is also treatable with antibiotics, laser hair removal and sweat gland removal surgery. 

Topical antibiotics (or creams and gels containing antibiotics) work by destroying odor-causing bacteria on the skin before they have a chance to break down and release a foul stench. Two common antibiotics for bromhidrosis are clinamycin and erythomycin - talk to your doctor about getting a prescription for these treatments. 

Electric hair removal (electrolysis) is another medical treatment for bromhidrosis. For a temporary solution, consider shaving or waxing your underarms or groin area regularly. 

Sweat gland removal surgery should only be considered as a last resort, as it's highly invasive and could result in very serious long-term side effects. Don't explore this option until you've exhausted all other non-invasive treatment methods. 

WEAR AN ANTI-ODOR UNDERSHIRT

The Thompson Tee Premium Anti-Odor Undershirt is infused with Odor Shield™ technology, a natural non-toxic hydrogen peroxide-based solution that eliminates 99.9% of odor causing bacteria in the fabric. Pair it with the above treatment options for best results to reduce the effects of bromhidrosis.

Try a crewneck or V-neck anti-odor undershirt risk-free today!


Resources:
  1. https://www.healthline.com/health/bromhidrosis
  2. https://www.sweathelp.org/where-do-you-sweat/other-sweating/sweat-and-odor.html
  3. https://en.wikipedia.org/wiki/Eccrine_sweat_gland
  4. https://www.racgp.org.au/afp/2013/may/hyperhidrosis-and-bromhidrosis/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731057/
  6. https://www.healthline.com/health/sudden-change-in-body-odor#causes
  7. https://www.webmd.com/skin-problems-and-treatments/guide/intertrigo-symptoms-causes-treatment-risk_factors_#1
  8. https://emedicine.medscape.com/article/1072342-overview
  9. https://www.medicalnewstoday.com/articles/173478#treatments
  10. https://www.merckmanuals.com/professional/dermatologic-disorders/sweating-disorders/bromhidrosis
  11. https://www.npr.org/sections/health-shots/2015/03/31/396573607/meet-the-bacteria-that-make-a-stink-in-your-pits
  12. https://www.bustle.com/articles/177764-11-weird-causes-of-body-odor-what-to-do-about-it