FAQ: Bromhidrosis

No. It is a common and cruel misconception to think so. Patients with bromhidrosis usually take multiple showers a day. The problem lies in the bacterial flora and the composition of the sweat, which require medical treatment, not just regular soap.

Because the apocrine glands (responsible for the fat-rich secretion that bacteria consume) only become active under the stimulation of sex hormones during puberty.

Absolutely. Foods like garlic, onion, curry, strong spices, and alcohol contain volatile compounds that are partially excreted through sweat, altering body odor.

It is the bad smell on the feet. It occurs when bacteria digest the dead keratin of the skin on moist feet trapped in closed shoes.

Yes, the use of topical antibiotic lotions (directly on the skin) helps to eliminate the bacteria causing the odor. It must be prescribed by a dermatologist to avoid bacterial resistance.

Indirectly, yes. By paralyzing excessive sweating with Botox, we remove the moisture and the "food" for the bacteria, drastically improving the odor situation.

They might disguise it in the short term, but they usually alter the skin's pH aggressively, causing dermatitis and dark spots (such as phytophotodermatitis, if exposed to the sun).

Yes, Trimethylaminuria, for example, is a metabolic disorder that prevents the body from breaking down a compound, generating a "fishy" odor.

Yes! Hair accumulates secretions and serves as "nests" for bacteria. Removing the hair significantly reduces the area for bacterial attachment.

Bacteria and sweat lipids lodge in the weaves of synthetic fabrics (like polyester). Often, regular washing does not remove the biofilm from the clothing.

Yes, natural fiber fabrics allow sweat to evaporate, keeping the skin drier and making it harder for bacteria to thrive.

In true bromhidrosis, no. We need soaps with clinical formulations or compounded with specific active ingredients recommended by the doctor.

It is a psychiatric disorder where the patient has the delusional belief that they emit a foul odor, when, in fact, there is no odor. The dermatological exam helps to diagnose and refer the patient appropriately.

The antiperspirant reduces eccrine sweat, and common deodorant masks the odor. For severe bromhidrosis, they are insufficient alone and require a medical protocol.

No. You cannot catch bromhidrosis from other people, pools, or towels. It is a relationship between a person's own flora and their glands.

Yes. Sweat produced during moments of stress (mediated by adrenaline) strongly stimulates the apocrine glands, which release the milky fluid responsible for the bad odor.

Yes. In extreme and refractory cases, surgical removal (curettage or excision) of the axillary apocrine glands can be performed.

Excessive washing can destroy the skin's natural protective barrier, causing a rebound effect and the proliferation of even more resistant bacteria.

The anogenital region also has apocrine glands and can develop the condition. However, it is crucial to rule out fungal and gynecological infections.

Generally, by adjusting soaps and using topical antibiotics, the patient notices an improvement in a few days, but control requires long-term maintenance.

Yes. In old age, the activity of the apocrine glands tends to regress, and underarm odor decreases. (Note: do not confuse with "old age odor," which is related to fatty acids on the skin in general).

It is crucial. Fungi and bacteria love moisture. After a shower, drying the folds and the spaces between the toes very well is the number one step in treatment.

Mixing perfume substances with bacterial odor usually creates an even more pungent and noticeable smell. Treat the base before perfuming.

The incidence is similar, but the psychosocial impact and embarrassment tend to be greater in women due to cultural pressures.

Dr. Caroline will listen empathetically, without judgment, map out the worsening factors, and prescribe the appropriate protocol, whether topical, injectable, or routine-based.