Author: Vanessa Ngan, staff writer, 2005.

Bromhidrosis is also known as osmidrosis and bromidrosis. The common name for this condition is body odour or BO.

What is bromhidrosis?

Bromhidrosis is a condition of abnormal or offensive body odour, to a large extent determined by apocrine gland secretion, although other sources may play a role. Sudoriferous (sweat) glands are divided into two types: apocrine and eccrine. There is some cross-over.

Eccrine glands

Apocrine glands

Apocrine bromhidrosis is the most common type of bromhidrosis and results from the bacterial breakdown of apocrine sweat, essentially all within the armpit area. Fatty acids and ammonia are the major products of bacterial breakdown and the odour has been described as pungent, rancid, musty or “sour and sweet”.

Who gets bromhidrosis and what is the cause?

Although both types of bromhidrosis may occur in people of all races, sex and age, some differences do exist between the two types.

Apocrine bromhidrosis

Eccrine bromhidrosis

How is the diagnosis made?

The clinician's perception of smell is the only tool needed to diagnose bromhidrosis. Taking a medical history may reveal diseases or conditions that contribute to the occurrence of bromhidrosis e.g. obesity, diabetes mellitus, and intertrigo.

One distinction the clinician must be aware of is the difference between the true bromhidrosis patient and the bromhidrosiphobic individual. Bromhidrosiphobic patients have a morbid dread of bodily odours and their sensory delusions can be an early warning sign of schizophrenia.

What is the treatment for bromhidrosis?

The two main factors to consider when treating bromhidrosis are to:

Improved hygiene and topical therapy are the main treatment options for mild cases of bromhidrosis and may include the following.

If hyperhidrosis is a contributing factor, this needs to be treated first, usually with the use of antiperspirants.

The treatments described above do not offer a cure for bromhidrosis and results can often be short lived and incomplete. A visit to a specialist physician may provide more permanent treatment options, and include:

If hyperhidrosis is a contributing factor, this needs to be treated first, usually with the use of antiperspirants. If this fails and the hyperhidrosis is a problem in its own right, then the following options may be considered:

These treatments may not help the bromhidrosis, however, as this condition is often independent of hyperhidrosis and, as mentioned above, may in some cases be lessened by associated hyperhidrosis.

For further details on these options see hyperhidrosis: treatment available from a specialist.

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