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How to Tell If You Smell -- And What to Do About It
William P. Coleman III, MD
Tulane University School of Medicine

Special from Bottom Line/Women's Health
September 1, 2009

R aise your arm and take a whiff... smell the shirt you wore today... ask a friend if your odor offends. Everyone has some body odor -- but if these tests make you cringe, you need more than one daily shower.

Basics: Body odor occurs when bacteria interact with sweat. For people with hyperhidrosis -- excessive perspiring, generally due to genes -- odor can be extreme. Helpful...

Bathe twice daily. Use a deodorant soap, and pay extra attention to areas where sweat glands are plentiful -- underarms, nipples, genitals, feet.

Use a combination antiperspirant/deodorant. Apply to underarms twice daily after bathing and toweling off. Antiperspirants prevent sweating by blocking pores... deodorants mask smells and kill bacteria.

Safety: Despite rumors, there is no convincing evidence linking aluminum (the active ingredient) in antiperspirants to cancer or neurological problems. But if you prefer natural deodorants, try witch hazel or baking soda... Tom’s of Maine... or Crystal Body Deodorant (www.thecrystal.com), made of mineral salts.

If body odor persists: See your dermatologist. If you are diagnosed with hyperhidrosis, medical insurance may cover one or more of these treatments...

Prescription antiperspirant. Drysol and Xerac have higher aluminum concentrations. Apply one at bedtime to dry underarms -- it works overnight, typically reducing perspiration within seven days.

Cost: About $30 to $50.

Botox injections. These block chemical signals from nerves that stimulate sweat glands. Underarm treatment requires multiple injections... effects last eight months on average.

Cost: $1,000 to $2,000.

Liposuction. With a suction device, a dermatologist removes fat from the armpits -- which also removes sweat glands. Bruising and swelling subside in a few days... occasionally, scarring or numbness occurs. Effectiveness varies -- some patients get permanent relief.

Cost: About $2,500 to $3,500.


Bottom Line/Women’s Health interviewed William P. Coleman III, MD, clinical professor of dermatology and adjunct professor of surgery, Tulane University School of Medicine, New Orleans, and editor-in-chief of Dermatologic Surgery.

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