Excessive Body Odor

Q. I am a 35-year-old woman. I have developed severe underarm odor. I have never had this problem before and maintain good hygiene. I buy clinical strength deodorants, but they only work for a while. It's embarrassing and causing a serious disruption in my life. I don't even want to go out anymore. What can I do?

A. "Bromhidrosis" is excessive or offensive body odor. It is common to the armpits but occurs in other areas, too.

Sweat glands called "apocrine sweat glands" are found in the armpits, under the breast, and in the groin. As sweating occurs in these areas, bacteria that like warm, moist areas, break down the sweat to produce body odor. Excessive sweating or an overgrowth of bacteria in such areas can result in bromhidrosis.

Excessive sweating can be controlled by:

• Antiperspirants
• Botulinum toxin injections to inhibit nerves that stimulate sweating
• "Anticholinergic" medications to reduce sweating
• "Iontophoresis" (which uses a machine to electronically reduce sweat gland activity)
• Surgical or chemical destruction of nerves that stimulate sweating

Excessive bacteria can come from skin problems in the underarm area or from the overgrowth of certain bacteria (such as "corynebacteria"). To treat excessive bacteria, you can:

• Carefully clean the area
• Shave underarm hair
• Treat any skin condition that may be present in the underarms

In certain cases, your doctor may prescribe antibiotics you can apply to the area.

Certain food, drugs and medical conditions may also cause body odor.

If you have severe body odor or a change in body odor, see your doctor. Your doctor can look for what's causing it and then talk to you about treatment options.