Dear Doctor, My teenage daughter sweats so much and her sweat smells bad no matter what. She takes regular baths, uses deodorant but after a brief walk, it gets worse. Why can’t it go away permanently? Liz Dear Liz, How long has your teenage daughter had this problem? Has it been a long time or it developed recently? Sweat is produced from sweat glands in the body in a bid to maintain the body’s temperature and keep it cool. These are more in soft, moist, areas of the body — like armpits, private parts, areas around and below the breast, over the hands and soles. Sweat is high in protein and is broken down by bacteria present in the body. This imparts a bad odour to it. Some people have more sweat glands naturally and sweat a lot. This is primary hyperhidrosis (excess sweating). Excess sweating can be due to wearing warm clothes, wearing clothes of material like nylon, polyester, being inside stuffy rooms with no ventilation, over-heated rooms, moving on a hot day, inadequate intake of fluids, dehydration, and et cetera. Excess sweating can be due to stress and anxiety as well. Obesity is also one of the causes for hyperhidrosis. It is a manifestation of infections like T.B., heart problems, low blood glucose, some cancers, to mention a few, and is associated with fever. Sweat produced may smell bad if it is in excess, as there will be more bacteria breaking it down. Around puberty, a person may have bad smelling sweat, as apocrine glands become active at that age. Eating spices like garlic, ginger, raw onions can impart a bad odour to the sweat. It may be due to presence of fungal infections in the soft moist areas of the body. Poor personal hygiene is a major preventable cause of bad smelling sweat. Hence, improving personal hygiene is very useful in this regard. Particularly soft, moist areas like armpits, genitals, areas around breasts, should always be kept clean and dry. Always wear clean clothes regularly, particularly under garments. Clothes worn should be lose, comfortable and made of natural fibre like cotton. Similarly, avoid wearing closed shoes and socks all the time, if necessary, use clean, fresh socks every day, made of cotton. Deodorants help to reduce bad smell of sweat and antiperspirants reduce excess sweating, by acting directly on the sweat glands. They can be used two to three times each day. Rooms should be well ventilated with no extra heating. While moving out in the hot sun, adequate protective measures like sun caps, sun glasses and goggles, should be used. The above mentioned measures should be helpful. Surgical interventions like surgical ablation of sweat glands, or their removal by electrolysis or laser, are also options available to reduce troublesome extra sweating. It would also be desirable to get investigations done to exclude any treatable, underlying medical disorder. Dr. Rachna Pande is a specialist in internal medicine.
