Bromhidrosis is an unpleasant smell of sweat that usually occurs with excessive sweating due to insufficient compliance with the rules of personal hygiene. On the other hand, bromhidrosis can be caused by the release of various substances with sweat in case of metabolic disorders, the functioning of the urinary system or the gastrointestinal tract. In diagnostics, the main importance is the exclusion of disorders in the work of internal organs in the patient, which may be the cause of odor. Treatment of bromhidrosis involves careful hygiene, adequate correction of existing disorders in the body and therapy of hyperhidrosis.
Dermatology distinguishes the apocrine (axillary) form of bromhidrosis, when an unpleasant odor appears in sweat secreted by the apocrine glands of the armpits, and eccrine bromhidrosis, which occurs with plantar hyperhidrosis and increased sweating in large folds of the skin in overweight people.
The main cause of bromhidrosis is the decomposition of sweat by bacteria that settle on the surface of the skin with insufficiently frequent washing. Sweat itself has no smell, but in the process of the vital activity of bacteria (streptococci and staphylococci) substances are formed that have an unpleasant and even fetid odor.
The appearance of a smell in sweat can also be caused by various disorders of the metabolic processes occurring in the body. Thus, in patients with uremia or chronic pyelonephritis, the excretion of body waste products in the urine is disrupted. As a result, uric acid and urea are excreted with sweat, which gives it the smell of urine. Bromhidrosis can be observed in some endocrine disorders: obesity, diabetes mellitus. According to the conducted studies, this is due to a violation of fat metabolism and increased release of free fatty acids from sweat. Sometimes bromhidrosis occurs in young girls with impaired menstrual function.
Digestive disorders (gastritis, peptic ulcer) and intestinal absorption (colitis, chronic constipation, intestinal obstruction) they can also lead to the release of various substances with sweat, which are normally absent in it. The unpleasant smell of sweat can also be caused by taking certain medications, for example, medications containing sulfur.
Diagnosis and treatment
An important point in the diagnosis of bromhidrosis is to determine its cause. To do this, you may need not only a consultation with a dermatologist, but also a gastroenterologist, endocrinologist, urologist. Young women with the appearance of an unpleasant smell of sweat should be examined by a gynecologist or gynecologist-endocrinologist. Sweat analysis is performed. Additional examinations may be prescribed to the patient: gastroscopy, duodenal probing, irrigoscopy, colonoscopy, ultrasound of the abdominal cavity, Rehberg test, urography, etc.
In most cases, the unpleasant smell of sweat is eliminated by daily thorough washing with soap and regular use of deodorants. To eliminate hyperhidrosis, local remedies that reduce sweating should be used. Treatment of hyperhidrosis of the axillary areas can be carried out by injections of botulinum toxin, ultrasonic destruction or excision of sweat glands. When identifying the cause of bromhidrosis in violation of the work of internal organs, the treatment of the underlying disease is carried out.