What you need to know about bad breath

The article was professionally consulted with Doctor Tran Quoc Tuan - Emergency Medicine Doctor - Emergency Resuscitation Department - Vinmec Phu Quoc International General Hospital.

Although armpit odor does not affect health, it causes discomfort, embarrassment, and loss of confidence when communicating. Understanding about armpit odor will help patients find a treatment for armpit odor that is right for them.

Underarm sweating, also known as underarm sweating, is a very common disease. This is a genetic disease, if a parent has bad breath, their children will have a high risk of developing the disease. Although it does not affect health, underarm odor makes sufferers feel very uncomfortable and lose confidence when living and communicating. People who live and work next to people with bad breath are also affected.
Underarm odor can be easily recognized by the following features:
Onset at the age of 25 or younger, often with a family history. The underarm odor is very unpleasant, like a skunk. When exercising a lot or when it is hot, the smell is more obvious, the armpits sweat a lot, sometimes the shirt is wet. Does not appear at night. In cases of severe underarm odor, even if you don't exercise, your armpits still smell. Deodorizing after bathing only works for a short time, then the underarms smell again. The underarms are often discolored. Especially the white shirt, the underarm shirt area will turn yellow, harden due to sweat and combined underarm rolling products. Wet armpit skin folds are easy to breed fungi, infections, and irritant dermatitis. If the armpit hair is long, you can see a discharge due to the bacteria breaking down sweat, forming deposits in the armpit.

Sweating is a normal physiological activity that plays an important role in the elimination of substances and helps maintain a stable body temperature. The human body consists of 2 to 4 million sweat glands with two main types: Eccrine glands are found throughout the surface of the skin, sweat secretes mainly water and mineral salts, without odor. This is the type of sweat secreted in the forehead, hands, feet, ... when hot, exercising a lot. This type of sweat does not cause odors in underarms, they only occasionally have a slightly unpleasant odor when we eat strong-smelling foods such as onions, garlic, curry, etc. Apocrine glands: only work when puberty. This gland is concentrated in places such as armpits, groin, genitals, around the ears, eye area, areola, ... Sweat secreted by apocrine glands contains a number of substances such as fatty acids, cholesterol, hydrocarbons. These substances are born with no odor, but due to the action of certain bacteria on the skin, the breakdown of these substances causes an unpleasant odor. Two common sweat-degrading bacteria are Propionibacterium acnes and Staphylococcus epidermidis. Sweat is broken down into products such as isovaleric acid, propionic acid, and propanoic acid. Isovaleric acid smells like cheese while propionic acid smells like vinegar.

Underarm sweating occurs mainly in people with both apocrine glands and increased sweating. Hyperhidrosis is an abnormal disorder, when the amount of sweat produced exceeds the required level of body temperature regulation.
Increased sweating may be due to increased sympathetic nervous system activity. Due to using a lot of tobacco, coffee, hot spicy foods or participating in a lot of physical activities. Increased sweating can also occur in people with certain medical conditions such as trimethylaminuria, diabetes, hyperthyroidism, cardiovascular disease, respiratory failure, Parkinson's disease, menopause, etc. or due to the use of certain drugs.

To treat armpit odor, patients need to improve their living conditions, depending on each specific case, the doctor may prescribe the use of therapeutic drugs, local interventions or surgery.
3.1. Improve living conditions Patients with underarm odor should wear cool clothes, use fabrics that absorb sweat well, and limit wearing tight clothes. Shower with soap-free body washes, use deodorant talcum powder after bathing or use topical deodorants. Use insoles and change them often. Limit the use of caffeinated beverages, drugs that increase sweating. Use aluminum salt Aluminum chloride 10-25% for local antiperspirant. 3.2. Ion Therapy Helps reduce underarm sweating. palms, soles of feet. Using electricity through the hydrolysis system to deliver ions through the skin. Do 10-20 minutes/day, do it for several days. This method may cause irritation, discomfort or contact dermatitis.

3.3. Drug treatment Anticholinergic drugs, beta-blockers, calcium blockers, anxiolytics, non-steroidal anti-inflammatory drugs,... can be effective in some cases. Note that each of the above drugs has its own contraindications, which must be considered before using for patients.
3.4. Local interventional therapies The commonly used methods are:
Injection botulinum toxin: Botulinum toxin is a toxin extracted from Clostridium botulinum, this toxin helps inhibit nerve impulses from the brain to the sweat glands. , reduce sweating. The treatment efficiency of this method is over 90%, leaving no scars, effective duration of 2-8 months. YAG laser: low efficiency, now rarely used. Axillary sweat gland removal surgery: the patient will be given local anesthesia, then the doctor will perform surgery to remove as much of the skin as possible. The surgery took about 1 hour. Method for high efficiency, underarm odor can be reduced by up to 90%. During the initial period after surgery, physical activities involving arm movement should be limited.