Body odour is the unpleasant smell produced by bacteria on the skin that break down the acids in your sweat.The medical term is bromhidrosis.

Anyone who has reached puberty can produce body odour, as this is when the apocrine sweat glands develop, which produce the sweat that bacteria can quickly break down.

Men are more likely to have body odour, because they tend to sweat more than women.

Things that can make body odour worse include:

• being overweight
• consuming rich or spicy food and drink – such as garlic, spices and alcohol
• some types of medication – such as antidepressants
• certain medical conditions – a fruity smell can sometimes be a sign of diabetes, while a bleach-like smell may indicate liver or kidney disease

Excessive sweating

Hyperhidrosis is a condition where a person sweats excessively and much more than the body needs to regulate temperature.

If you have hyperhidrosis, you may also have smelly feet (bromodosis). Smelly feet are caused by wearing shoes and socks that prevent sweat evaporating or being absorbed, which attracts bacteria.

When to see your GP

See your GP if:

• your sweating or body odour is causing you distress
• you notice a change in your body odour
• you suddenly begin to sweat much more than usual

Managing body odour

Excessive sweating and body odour is an unpleasant problem that can affect a person’s confidence and self-esteem.

A body odour problem can usually be managed by getting rid of excess skin bacteria – which are responsible for the smell – and keeping the skin in the affected area (usually the armpits) clean and dry.

Self-care advice

Your armpits contain a large number of apocrine glands, which are responsible for producing body odour.

Keeping your armpits clean and free of bacteria will help keep odour under control. Following the below advice can help you achieve this:

• take a warm bath or shower every day – to kill the bacteria on your skin; on hot days, you may need to have a bath or shower twice a day
• wash your armpits thoroughly – using an antibacterial soap
• use a deodorant or an antiperspirant – after bathing or showering
• regularly shave your armpits – this allows sweat to evaporate quicker, giving bacteria less time to break it down
• wear natural fibres, such as wool, silk or cotton – they allow your skin to breathe, which means your sweat will evaporate quicker
• wear clean clothes – make sure you wash your clothes regularly
• limit the amount of spicy foods you eat – such as curry or garlic, because they can make your sweat smell; evidence also suggests that eating a lot of red meat tends to make body odour worse

Deodorant and antiperspirant

The active ingredients used in antiperspirants and deodorants differ, so you may find some more effective than others.

Deodorants work by using perfume to mask the smell of sweat. Antiperspirants contain aluminium chloride (see below), which reduces the amount of sweat produced by your body.

Use roll-on antiperspirants if you sweat heavily, as they tend to be more effective.

Aluminium chloride

Aluminium chloride is the active ingredient in most antiperspirants. It helps prevent the production of sweat.

If the above self-care advice doesn’t improve your body odour, you may need a stronger antiperspirant that contains more aluminium chloride.

Your GP or pharmacist can recommend a suitable product and advise about how often you should use it.

Aluminium chloride solutions are usually applied every night before bed, and washed off in the morning. This is because you stop sweating in your sleep, so the solution can seep into your sweat glands and block them. This reduces how much you sweat the next day.

As the aluminium chloride solution begins to take effect, you can use it less often (every other night, or once or twice a week).

Surgery

Surgery may be recommended for severe body odour that can’t be treated by self-care measures and over-the-counter products.

One type of surgery involves removing a small area of skin from your armpit and the tissue just below it. This gets rid of the most troublesome sweat glands.

It may also be possible for the sweat glands to be drawn out from the deeper skin layers using liposuction – a technique that’s often used to remove unwanted body fat.

Another option is a type of surgery called endoscopic thoracic sympathectomy (ETS), which uses keyhole surgery to destroy the nerves that control sweating.

During ETS, the surgeon makes two or three small incisions under each arm. A tiny camera (endoscope) is inserted through one of the incisions so the surgeon can see the inside of your armpit on a monitor.

The surgeon will insert small surgical tools through the other incisions, allowing them to cut the nerves. Alternatively, a thin electrode that emits an electrical current will be used to destroy the nerves.

Risks associated with ETS include damage to nearby arteries or nerves, and compensatory sweating (increased sweating from other areas of the body). You should fully discuss the risks of the procedure with your surgeon beforehand.

Botulinum toxin

Botulinum toxin, often referred to as Botox, is another possible treatment for people with excessive underarm sweating.

Botulinum toxin is a powerful poison that can be used safely in minute doses. Between 12 and 20 injections of botulinum toxin are made in the affected area of the body, such as the armpits, hands, feet or face.

The toxin works by blocking signals from your brain to the sweat glands, reducing the amount of sweat produced.

The procedure takes 30-45 minutes, and the effects of botulinum toxin usually last for between two and eight months. After this time, further treatment will be needed.