Bromhidrosis refers to foul-smelling sweat, which can be categorized into generalized bromhidrosis and localized bromhidrosis, with the latter commonly including axillary odor and foot odor.

bubble_chart Etiology

The sweat in bromhidrosis can originate from either eccrine sweat glands or apocrine sweat glands (formerly known as profuse sweating glands). The sweat secreted by eccrine glands is over 99% water, normally colorless and odorless. When sweat is excessively secreted and not promptly washed away, it soaks the stratum corneum, making proteins and lipids more susceptible to breakdown by Chinese Taxillus Herb bacteria on the skin's surface, producing foul odors. Additionally, certain dietary factors such as garlic and onions can be excreted through eccrine glands, leading to unpleasant smells. The sweat secreted by apocrine glands contains not only water but also lipids and proteins. Due to the locations of apocrine glands—such as the armpits and genital areas—being hairy and folded, they harbor more Chinese Taxillus Herb bacteria, which break down the organic substances in apocrine secretions, producing short-chain fatty acids and ammonia that emit foul odors. The occurrence of axillary odor is also influenced by racial and genetic factors.

bubble_chart Clinical Manifestations

Axillary odor (bromhidrosis axillae), commonly known as armpit odor, refers to the distinctive smell emitted from the armpits, which becomes more noticeable in hot weather or when sweating excessively. The development of apocrine sweat glands is influenced by sex hormones, so the condition often begins during puberty. Secretion is most active during young adulthood, and the odor is most intense during this period, gradually diminishing or disappearing in old age. Besides the armpits, areas with a high concentration of apocrine sweat glands, such as the genital and anal regions, may also produce a similar odor.

bubble_chart Treatment Measures

1. Pay attention to cleanliness and hygiene, frequently wash the affected area, change clothes often, and keep the skin dry. For patients with axillary odor, shaving the underarm hair can reduce the number of local Chinese Taxillus Herb bacteria.
2. Local bromhidrosis can be treated with topical medications that have astringent, antiperspirant, disinfectant, and bactericidal effects. Commonly used solutions include 0.1% benzalkonium bromide (new germicide) solution, 20% aluminum chloride anhydrous ethanol solution, and 2–4% formaldehyde solution. For foot odor, soaking in a 1:5000 potassium permanganate solution for half an hour daily for several weeks can be effective. Axillary odor can be treated with Chinese medicinal litharge powder, dried alum powder, or underarm odor powder (30g dried alum, 15g clam shell powder, 15g camphor, ground into fine powder).
3. For axillary odor, surgical removal of the hairy skin in the armpit can be performed. Alternatively, high-frequency electrotherapy instruments can be used to insert electrodes along the hair roots, or lasers can be used to destroy the hair roots and apocrine sweat glands, thereby reducing apocrine sweat secretion.