March 29, 2007
Excessive Body Odor
Dear Dr. Dela Cruz,
I need your advice very badly. I am 25 years old. My problem is about body odor. I use many kinds of deodorants but after three to four hours, the odor comes back. I want to know:
1) Can body odor be eradicated?
2) Can permanent prevention of underarm perspiration help cure it?
3) How much will it cost?
4) Do I need hospitalization?
5) How long is the recovery time?
Thank you very much. I hope you will answer this email of mine very soon. I don’t know what to do with my life. I want to die.
I know you’re the only person who can help me with my problem. Please help me.
Name Withheld
Dr. Perry replies:
Body odor or malodorous sweating is medically known as bromhidrosis, and is chiefly encountered in the axillae or armpit. It is considered to be due to bacterial decomposition of apocrine sweat, producing fatty acids with distinctive offensive odors.
Various substances such as arsenic and garlic may also affect the odor of perspiration.
In order to control body odor formation, we should first control excessive perspiration especially in the armpit area.
Antibacterial soaps and many commercial deodorants are quite effective in controlling the malodor. Frequent bathing, changing of underclothes, shaving of the axillae, and applying aluminum chloride topically are all helpful measures. Surgical removal of the glands, as in axillary hyperhidrosis (excessive sweating) is possible.
The apocrine sweat glands which are mainly responsible for odor formation are surgically removed, and this is accomplished in a variety of ways. One is by the elliptical excision of the most actively sweating portion of the avillary skin, followed by undercutting and subcutaneous resection of the sweat glands. Some surgeons would avoid skin excision by doing multiple incisions to expose the sweat glands. The glands are then removed by scraping, direct excision, or with the use of a suction machine.
The removal of these glands will minimize the amount of excretion into the skin surface in the form of perspiration. Once this is controlled, the action of bacteria on apocrine secretion will in turn be diminished. This last effect is the most crucial since body odor formation is determined by the amount of the mixture between apocrine excretion and bacteria.
This procedure can be done on an out-patient basis, so hospitalization is not really necessary. You must come back to the clinic for follow-up. First follow-up will be one to two days after surgery for removal of the drains. Stitches are removed seven to 10 days later.
Recovery period is from 10 to 14 days after which you are allowed to resume your usual household chores. Strenuous physical exertion may be resumed four to six weeks post operatively.
With the advent of botulinum toxin type A, which is produced by the bacteria clostridium botulinum, hyperhidrosis and bromhidrosis can be controlled without resorting to surgery. This particular substance comes in different trade names like Botox, BTx, Dysport, ECBT, and Refinex, to name a few.
It works by blocking neuronal acetylcholine release at the neuromuscular junction when injected intradermally (inside the skin), and this action prevents the excretion of sweat. However, the relief is good only for three to six months.
DR. PERRY DE LA CRUZ obtained his medical degree from the University of Sto. Tomas. He is a diplomate of the Philippine Board of Cosmetic Surgey; a fellow of the Philippine Society for Cosmetic Surgery, and the American Academy of Cosmetic Surgery; and a member of the Asian Pacific Academy of Cosmetic Surgery. He pioneered research on "Serial Revision of Leg Scars" in 1988.
Clinic:
Asian Hospital and Medical Center
Unit 517 Medical Office Building
205 Civic Drive, Alabang, Muntinlupa City
Telephone no. 771-9299
Visit his web site at www.geocities.com/docperryster or e-mail him at docperryster@gmail.com.
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