Madrid, Sep. (Edizions) -
The 'bromhydrosis', 'osmidrosis', or bad body smell is a condition in which there is an excessive body smell that is usually unpleasant.This can significantly alter a person's quality of life, as well as those around him.This bad smell is observed above all in the armpits, but it can also originate in the soles of the feet or in the genital area.
"It has been described as a smell, sour, rancid, wet or bitter. It is fundamentally due to the secretion of the apocrine glands, so it is frequent after puberty," explains in an interview with Infosalus Mercedes Sigüenza Sanz, responsible for theHYPERHIDROSIS UNIT OF THE DERMATOLOGY SERVICE OF THE UNIVERSITY HOSPITAL PUERTA DE HIERRO MAJADAHONDA (MADRID).
As indicated, the secretory glands of the human being are mainly divided into 'Ecrinas' and 'Apocrine' glands.Ecrine glands are distributed throughout the body surface and are responsible for thermoregulation through sweat production, which typically lacks smell.However, the apocrine glands are found only in certain locations such as the armpits, the genital zone, the periocular and preauricular regions.They have no thermoregulator function.They produce fatty secretions, and are lacking smell.
"Apocrine bromhydrosis is more frequent than Ecrine bromhidrosis. By decomposing apocrine secretions, due to the bacteria of the skin surface, ammonia and short -chain fatty acids are generated that produce a" strong, penetrating, and very characteristic smell.Some studies have shown that people with bromhydrosis have larger apocrine glands and more numerous than normal, "adds the specialist.
The bad smell of food intake
Sometimes, it can also produce ecrine bromhydrosis.When sweat softens the keratin of the skin, it decomposes through bacteria, producing bad smell.Other causes of ecrine bromhydrosis are the intake of certain foods (onion, garlic, curri, alcohol), drugs, toxins and certain metabolic diseases (especially alterations in the metabolism of amino acids) or endogenous.
Likewise, the specialist of the Puerta de Hierro de Iron Hospital Majadahonda (Madrid) adds that the lack of hygiene and disorders associated with hyperhidrosis or bacteria overgrowth can contribute to their development, such as diabetes, obesity or skin infections(Interchange, erythrasma, axillary tricycosis).
"Excess ecrine or sweating secretion, also called hyperhidrosis, can worsen bromhydrosis, since moisture favors the growth of bacteria. The incidence of bromhydrosis is not well established. Although it is considered rare, it is possibly infradiagnosed.All races, being more frequent apocrine bromhydrosis in people with dark skin. It is more frequent in men. It manifests itself after puberty and is rare in the elderly population.
On the contrary, Ecrine bromhidrosis is more frequent during childhood, but may appear at any age, "says Dr. Mercedes Sigüenza. Moreover, it emphasizes that most patients with bromhydrosis have relatives who suffer from this disorder.Diagnosis, he says that it is done through the olfactory perception of the examiner.
"In the exploration of the axillary skin it is possible that no alteration is found, unless associated with bacterial infections such as erythrasma (well -defined red plate) or axillary tricycosis (brown or yellowish concretions attached to hair). In patientsWith Ecrine bromhidrosis it is possible to observe maceration and a thick cape of wet keratin, especially in plants and folds, "he adds.
Treatment for this condition
For the treatment of this condition, dermatologist advocates maintaining adequate personal hygiene and using antiseptic soaps."You have to wash your clothes and let it dry completely. You should not reuse clothes that have previously sweat. Axillary hair removal prevents sweat retention and bacterial growth, so it is recommended," adds the specialist.
In turn, it emphasizes that the identification and elimination of foods involved in bad smell, such as garlic, onion, alcohol, curri, can also be useful."If there are other associated skin diseases, it is important to treat them properly. For mild cases, deodorants can be used that mask the smell and decrease the number of bacteria. Topical antibiotics (clindamycin, erythromycin) are beneficial as bacterial growth decreases, but they mustUse only if there has been no response to antiseptics, to avoid the development of resistance, "he says.
On antitranspirants, such as 20%aluminum chloride, he points out that they inhibit sweat production.In fact, he defends that they are useful in apocrine and ecrine bromhydrosis, especially if there is hyperhidrosis, since they decrease moisture and maceration.
In cases of ecrine bromhydrosis, in which excessive ecrine sweating plays a paper, treatment with ionthophoresis can be considered (treatment that interrupts the production of sweat from the treated area when passing a small electric current through the skin submerged in waterof tap).
"These treatments are not definitive and in some cases they are not enough. When the response is inappropriate, in the most severe cases and when patients seek longer treatments there are other alternatives such as anticholinergic drugs, botulinum toxin, lasers and lasersDifferent surgical techniques. Bromhydrosis affected patients are recommended, especially if they do not improve with the use of deodorants or antitranspirants, consult with a dermatology specialist to assess and recommend the most appropriate treatment, "he says.