What is the most effective way to eliminate persistent axillary (armpit) body odor, specifically bromhidrosis, in a patient with normal showering habits, using benzoyl peroxide (Benzac 5 gel) and glycolic acid (The Ordinary 7% glycolic acid)?

Immediate Action Plan for Tonight (5pm Shower)

Apply benzoyl peroxide 5% gel to your clean, dry armpits tonight after showering, leave it on for 5-10 minutes, then rinse off—this is the most effective antimicrobial agent you have available to kill odor-causing bacteria. 1, 2

Tonight's Protocol

Step 1: Shower Preparation

• Wash your armpits thoroughly with regular soap and water to physically remove bacteria and organic debris 3
• Pat the area completely dry rather than rubbing 4, 5

Step 2: Benzoyl Peroxide Application

• Apply a thin layer of Benzac 5% gel to both armpits 1
• Leave on for 5-10 minutes as a "contact therapy" 1
• Rinse thoroughly with water
• Pat dry gently 4, 5

Step 3: Post-Treatment

• Do not apply any moisturizer or deodorant immediately after—let your skin breathe for at least 30 minutes 5
• If you experience dryness or irritation, apply a simple, non-greasy moisturizer later 5, 6

Why This Works

Benzoyl peroxide has potent antimicrobial activity against the bacteria that cause body odor, and unlike antibiotics, bacteria cannot develop resistance to it. 1 The compound works by releasing oxygen that kills odor-producing bacteria like Corynebacterium species that metabolize sweat into malodorous compounds 7, 1.

• Concentrations from 2.5% to 10% show similar efficacy, so your 5% gel is appropriate 2
• The antimicrobial effect occurs rapidly upon contact 1, 8
• Lower concentrations (like your 5%) minimize irritation while maintaining effectiveness 1, 2

Ongoing Treatment Plan

Daily Maintenance (Starting Tomorrow)

Continue the benzoyl peroxide contact therapy every evening for 5-7 consecutive days to establish bacterial reduction. 1

After the initial week:

• Reduce to 2-3 times per week for maintenance 1
• Monitor for dryness, redness, or irritation 6
• If irritation develops, reduce frequency or apply moisturizer 30 minutes after treatment 5, 6

Alternative: Glycolic Acid Option

The Ordinary 7% glycolic acid can be used as an alternative or adjunct, but benzoyl peroxide is superior for antimicrobial action. 4

If you want to incorporate glycolic acid:

• Use it on alternate days from benzoyl peroxide (not the same day initially) 4
• Apply to clean, dry skin and leave on 4
• Glycolic acid helps with hyperkeratosis and dead skin buildup that can trap bacteria 4

Important Caveats

Watch for Irritation

• Benzoyl peroxide causes dose-dependent dryness and irritation in many users 1, 6
• Up to 55% of users report dry skin and 44% report irritated skin 6
• If you develop significant redness, burning, or peeling, reduce frequency immediately 5, 6

Avoid These Mistakes

• Do not use both products on the same day initially—this increases irritation risk 5
• Do not apply to broken or excoriated skin 5
• Do not use alcohol-containing deodorants immediately after treatment—they will worsen dryness 5
• Do not expect instant results—bacterial reduction takes 3-5 days of consistent use 1

When to Escalate

If odor persists after 2 weeks of consistent benzoyl peroxide use:

• Consider underlying medical conditions like bromhidrosis, hyperhidrosis, or metabolic disorders 7
• Bacterial culture may be warranted to identify resistant organisms 3
• Prescription-strength chlorhexidine 4% solution is more potent but requires medical supervision due to higher irritation risk 9

Expected Timeline

• Days 1-3: Bacterial load begins decreasing, minimal odor improvement 1
• Days 4-7: Noticeable reduction in odor as bacterial populations decline 1, 2
• Week 2+: Maintenance phase with 2-3 applications weekly 1