Bromhidrosis is defined by excessive or abnormal body odor. Unlike hyperhidrosis, which involves an excess of sweat from the eccrine sweat glands, bromhidrosis is the result of sweat from the apocrine sweat glands.

The apocrine sweat glands produce a thick, milky fluid that interacts with bacteria on the skin to produce body odor.

There are no diagnostic laboratory tests for bromhidrosis. Diagnosis is based on a subjective observation of odor.

Underlying causes like poor hygiene or infection should be ruled out before starting treatment.

Most cases of bromhidrosis are "secondary" meaning that they are caused by something else. That "something else" varies from person to person, and can also change over time.

The most common causes are:

• microbial overgrowth: some patients have an over-colonization of odor-producing bacteria on their skin;
• hormonal changes: puberty, menstruation, menopause, and endocrine disorders can all increase the output of the apocrine sweat glands; and
• obesity: skin folds and friction may lead to bacterial buildup.

Over-the-counter deodorants should be tried before trying a prescription product. The first OTC option is a topical deodorant applied directly to the area where odor is observed. We developed MagDeo® deodorant, which is a simple two-ingredient deodorant ideal for the management of body odor. Free from unnecessary fragrances and dyes, the magnesium chloride works to balance skin pH to naturally control bacteria.

Controlling odor often takes more than a topical deodorant. We developed DeoCaps oral deodorant to help manage odor from the inside-out. This 4-ingredient formula provides odor-fighting Chlorophyllin, Zinc, and Magnesium together with Sage, which has been shown to promote normal sweat gland activity.

For some people, topical and oral deodorants are not enough. In these cases, a topical antibacterial is the best add-on. We recommend Clindamycin Phosphate 1% Pledgets for their ease of use.

For those who notice excessive sweating as well, consider adding a prescription-strength antiperspirant or methenamine cream to help manage the sweating. If an oral medication is preferred, glycopyrrolate tablets are an effective choice. Iontophoresis, an FDA-cleared medical device, is also effective at managing sweating and is being explored for the treatment of body odor as well.