From the Guidelines
For the treatment of bromhidrosis (body odor) using medication, antiperspirants containing aluminum compounds like aluminum chloride are the most effective options, and should be applied to clean, dry skin at night before bed. When considering treatment options for bromhidrosis, it's essential to understand that the condition is primarily caused by the breakdown of sweat by bacteria on the skin surface.
- The most effective treatment approach involves reducing sweat production and minimizing bacterial growth.
- Antiperspirants with aluminum compounds work by forming plugs in sweat ducts, thereby reducing sweat reaching the skin surface and limiting bacterial growth and odor production.
- For severe cases, prescription-strength antiperspirants with higher concentrations of aluminum chloride may be necessary, as they provide more potent sweat reduction.
- Additionally, antibacterial soaps containing triclosan or chlorhexidine can be used daily to help reduce odor-causing bacteria.
- In cases where these treatments are insufficient, oral medications like glycopyrrolate or oxybutynin may be prescribed to reduce sweating, although their use should be carefully considered due to potential side effects. The provided evidence 1 does not directly address the treatment of bromhidrosis using medication, focusing instead on the management of atrophic rhinitis, which involves reducing crusting and alleviating foul odor through nasal hygiene and the use of topical and/or systemic antibiotics when necessary.
- However, in the context of treating body odor, the focus remains on reducing sweat production and bacterial growth, rather than addressing nasal hygiene or infections.
- It's crucial to consult a healthcare provider for personalized advice on treating bromhidrosis, especially if considering prescription medications or experiencing severe symptoms.
From the Research
Treatment Options for Bromhidrosis (Body Odor) Using Medication
- Medications used to treat bromhidrosis include aluminum chloride hexahydrate, botulinum toxin type A, and methanthelinium bromide 2, 3, 4, 5
- Aluminum chloride hexahydrate is considered a first-line therapy for patients with mild-to-moderate hyperhidrosis, and can be used in combination with salicylic acid to reduce irritation 2, 3
- Botulinum toxin type A has been shown to be effective in reducing axillary hyperhidrosis and body odor, and can be used in combination with aluminum chloride hexahydrate for patients who do not respond to monotherapy 2, 4
- Methanthelinium bromide is an oral medication that has been shown to be effective in reducing axillary sweat production in patients with focal hyperhidrosis, particularly in those who are refractory to topical treatment with aluminum chloride hexahydrate solution 5
- Topical anticholinergics may also be used to treat hyperhidrosis, and instruction on proper methods and timing of antiperspirants can enhance their effect 6
Mechanisms of Action
- Aluminum chloride hexahydrate works by forming plugs in the eccrine sweat ducts, reducing sweat production 6
- Botulinum toxin type A works by interfering with skin microbes and denervating apoeccrine sweat glands, reducing sweat production and body odor 4
- Methanthelinium bromide works by reducing sweat production through its anticholinergic activity 5
Efficacy and Safety
- Aluminum chloride hexahydrate has been shown to be effective in reducing sweat production, but can cause irritation in some patients 2, 3
- Botulinum toxin type A has been shown to be effective in reducing axillary hyperhidrosis and body odor, with minimal side effects 4
- Methanthelinium bromide has been shown to be effective in reducing axillary sweat production, with common side effects including dryness of the mouth 5