Management of Bromhidrosis -- Excessive Odor Due to Sweating

Craig Kraffert, MD

As we discussed in last week’s post, hyperhidrosis is a medical condition caused by excessive sweating that can impair a person’s quality of life. To make matters worse, hyperhidrosis can be associated with problematic bromhidrosis, the unpleasant odor that tends to develop under the arms.

Bromhidrosis is caused by bacterial breakdown of heavier sweat substances produced by apocrine glands. In patients with hyperhidrosis, these glands are often stimulated in concert with the eccrine sweat glands that produce a thinner more watery secretion.

Botox® Treatment for Bromhidrosis

The best overall treatment for bromhidrosis may be Botox. Botox seems to block sweat release by both eccrine and apocrine glands and thus blocks both odor and wetness. In extreme bromhidrosis cases, the apocrine glands can be removed via surgical excision or liposuction.

Aside from Botox, the best treatment for bromhidrosis may consist of thorough cleansing with an antibacterial soap such as sulfur soap or, more commonly, triclosan-containing bath soaps such as Dial. This cleansing should be combined with an effective deodorant/antiperspirant such as Mitchum Clear Gel Unscented or CertainDri®. CertainDri is not alcohol based but is otherwise similar to DrySol, a topical prescription medication that is often the method of first choice in treating hyperhidrosis. CertainDri has a host of hyperhidrosis products at its website,

Minimizing Bromhidrosis

Bromhidrosis can be decreased by promptly removing moist or sweaty clothes; this minimizes ongoing bacterial activity and resultant odor creation. Clothing should be washed in hot water and rinsed twice. Adequate quantities of laundry detergent should be used. Repeat wash cycle should be selected when available.

Some hyperhidrosis/bromhidrosis interventions are perhaps best avoided. Body wipes are inconvenient, ineffective and can cause irritation. Because sweat and odor tend to collect and remain on clothing material, odor sprays are simply a cover and have little value.

Management of hyperhidrosis and bromhidrosis has come a long way in recent years. By following the suggestions above, it will be easier than ever to ‘take it easy’ and ‘not sweat it.’