Bromhidrosis, a condition characterised by chronic body odour, is often misunderstood and can be devastating for those affected. While the term can apply to body odour from any cause, it is more commonly linked to a bacterial imbalance or other health issues, according to Chris Callewaert, a senior research fellow at Ghent University.
Callewaert, a specialist in body odour research, explains that in individuals with bromhidrosis, a natural bodily process, typically involving the apocrine glands, is out of balance. These glands secrete lipids, steroids, and proteins, which are then digested by skin bacteria, producing odour. This imbalance may involve overactive glands or an excess of specific bacteria.
The onset of body odour can be abrupt, triggered by factors such as puberty, changes to the microbiome, metabolic diseases, or medication side-effects. However, once established, it can be challenging to resolve, often being multifactorial in origin.
There is no defined diagnostic threshold for bromhidrosis, making it difficult to estimate its prevalence. A 2024 review described it as prevalent, particularly in the west, and noted its significant impact on patients' social and psychological wellbeing. Despite this, there is limited focused attention or specialised support for the condition.
Angela Ballard, a registered nurse and communications director for the International Hyperhidrosis Society (IHS), states that a bromhidrosis diagnosis is tied to the level of distress it causes an individual and its effect on their wellbeing and daily function. The IHS, originally focused on hyperhidrosis, has expanded its scope to include bromhidrosis due to frequent overlap and a lack of other resources.
Strategies to help alleviate odour include using antibacterial soap, avoiding certain fabrics, and improving laundry practices. More advanced options include laser hair removal, waxing to limit bacterial sites, and Botox to reduce sweat. The miraDry device, which destroys sweat and odour glands, has also shown effectiveness in managing hyperhidrosis and sometimes bromhidrosis.