Underarm odor makes it uncomfortable for sufferers and the environment. Sufferers of this disorder feel that their clothes get wet quickly and are not, where this condition causes an unpleasant odor in the armpits due to excessive sweat production, unpleasant odor in the armpits appears because bacteria on the skin break down proteins and fats contained in sweat and turn them into acidic substances. In addition to disrupting daily activities, sweat odor can also reduce the quality of life of sufferers.
The cause of the odor is not sweat, but bacteria in the armpits. Its name is staphylococcus hominis. This bacteria is able to produce proteins that then break down sweat molecules into compounds. These compounds are what emit an unpleasant odor from a person's body.
Generally, this condition of underarm odor begins to appear in childhood or adolescence and children who have experienced puberty who experience hormonal changes. Although not dangerous, underarm odor can cause feelings of embarrassment, stress, depression, or anxiety.
Causes of Underarm Odor
Underarm odor itself is not a disease, but rather a condition caused by various factors, such as sweat, bacteria, and hygiene. However, in some cases, strong or unusual underarm odor can be a sign of a more serious health problem. Here are some medical conditions that can be associated with underarm odor:
- Hyperhidrosis: A condition in which the sweat glands produce excessive sweat, which can cause excessive sweating and a stronger odor. Based on the cause, hyperhidrosis is divided into two, namely:
Primary hyperhidrosis
In primary hyperhidrosis, the nervous system is overactive in stimulating the sweat glands. As a result, the sweat glands produce sweat even when not triggered by physical activity or a rise in body temperature. The exact cause of primary hyperhidrosis is unknown. However, it is suspected that this condition runs in families.
Secondary hyperhidrosis
Secondary hyperhidrosis occurs as a result of other medical conditions, such as diabetes, obesity, hyperthyroidism, gout, menopause, and some types of cancer.
- Skin Infections: Bacterial or fungal infections of the skin can cause an unpleasant odor.
- Metabolic Disease: Some conditions, such as diabetes or kidney failure, can cause changes in body odor.
- Glandular Dysfunction: Problems with the glands that regulate sweat and odor can cause unusual odors.
- Hormonal Disorders: Hormonal changes, such as during puberty or menopause, can affect body odor.
- Food: Certain foods, such as garlic, onions, and spices, can affect body odor.
- Hygiene: Lack of personal hygiene can lead to a buildup of sweat and bacteria, which contributes to odor.
If underarm odor is accompanied by other symptoms, such as redness, swelling, or pain, or if it does not improve with proper hygiene care, it is best to consult a doctor for further assessment.
In addition to medical conditions, secondary hyperhidrosis can also occur as a side effect of certain medications, such as antidepressants, propranolol, or pilocarpine. Withdrawal from drug or alcohol dependence can also cause excessive sweating.
Diagnosis of Hyperhidrosis
To diagnose hyperhidrosis, the doctor will ask questions about the symptoms experienced, the age when the symptoms first appeared, and the patient's and family's medical history. After that, the doctor will perform a thorough physical examination.
To determine the cause of hyperhidrosis, the doctor will perform supporting examinations, such as:
- Blood and urine tests
The doctor will take a sample of the patient's blood or urine to be tested in the laboratory. This test is used to determine whether there are medical conditions that can cause hyperhidrosis, such as hyperthyroidism or low blood sugar (hypoglycemia).
- Sweat test
This test is done to find out which parts of the body are experiencing hyperhidrosis and how severe it is.
Hyperhidrosis Treatment
Treatment for hyperhidrosis depends on the cause. If it is caused by a medical condition, the doctor will first treat the cause before treating the hyperhidrosis. However, if the cause of the hyperhidrosis is unknown, the doctor will directly treat the excessive sweating.
The doctor will initially advise the patient to use a deodorant containing an antiperspirant containing aluminum chloride by applying it at night and washing it off in the morning. This deodorant is usually sold over the counter.
In addition to using deodorant, doctors will also advise patients to improve their lifestyle in the following ways:
- Take a shower every day to prevent bacteria from growing on your skin.
- Dry your body after bathing, especially in the armpits and between your fingers.
- Choose clothing materials that are cool on the skin for daily activities and clothes that easily absorb sweat for exercise.
- Practicing relaxation techniques, such as yoga or meditation, to control stress that can trigger hyperhidrosis.
- Limit consumption of foods and drinks that can trigger sweat, for example caffeinated drinks, spicy foods, curry, and alcoholic drinks.
If lifestyle changes cannot control sweating, there are several methods that doctors generally use, namely:
- Administration of medication
To relieve underarm odor, the doctor will prescribe the following medications:
- A cream medication containing glycopyrrolate, to inhibit the action of nerves that trigger sweating.
- Oral medications to improve the performance of nerves that regulate sweat glands, such as glycopyrrolate, oxybutynin, and benztropine
- Oral medications containing beta-blockers, such as propranolol, in low doses to relieve underarm odor due to anxiety disorders
- Iontophoresis ( sweat inhibiting device )
Iontophoresis is performed if hyperhidrosis occurs in the palms of the hands or feet. This therapy is performed by soaking the patient's hands or feet in water. After that, an electric current will be channeled through the water to inhibit the sweat glands.
This therapy is effective in many patients, but the effects are not long-lasting and must be repeated many times.
Initially, patients may need 2–3 therapy sessions per week for 2–5 weeks. After that, patients can reduce the therapy schedule to once a week or once a month when their symptoms have improved.
- Botulinum toxin (botox) injections
Botox injections can temporarily block the nerves that cause excessive sweating. Botox injections are given several times in the sweaty area of the body, preceded by a local anesthetic.
The effects of Botox injections can last up to 12 months and must be repeated. However, it is important to note that this therapy can cause temporary muscle weakness in the injected area.
- Microwave therapy
This therapy uses microwave energy to destroy sweat glands. This therapy is carried out for 20–30 minutes every 3 months, until the patient recovers. However, this therapy can cause side effects in the form of discomfort and changes in skin sensation.
- Sympathectomy operation
Surgery for hyperhidrosis is performed if other treatments are ineffective. This surgery, called sympathectomy, can be performed surgically or laparoscopically (endoscopic thoracic sympathectomy). This surgery is performed by cutting a small portion of the nerve that regulates sweat production.
Complications of Hyperhidrosis
Hyperhidrosis can cause infection if the skin condition is often damp or too wet. In addition, hyperhidrosis can also make sufferers embarrassed because their clothes or armpits look wet. This condition can interfere with sufferers when working or studying.
Prevention of Underarm Odor
Underarm odor due to hereditary factors cannot be prevented. Patients with primary underarm odor can prevent body odor by improving their lifestyle.
In secondary hyperhidrosis, prevention depends on the cause. For example, hyperhidrosis due to side effects of medication can be prevented by changing the medication. While hyperhidrosis due to consumption of caffeinated beverages can be prevented by stopping consuming caffeinated beverages.
It is important to note that secondary hyperhidrosis caused by certain diseases, such as heart disease or cancer, cannot be prevented.
Article written by dr. Achmad Faisal, Sp.BTKV, Subsp. T(K) (Thoracic, Cardiac and Vascular Surgery Specialist, EMC Alam Sutera Hospital).