Bromhidrosis, a condition characterized by persistent and often offensive body odour, results from a biological malfunction rather than inadequate hygiene, according to researchers studying the phenomenon. Chris Callewaert, a senior research fellow at Ghent University in Belgium and one of the few scientists specializing in body odour, explains that the condition typically involves an imbalance in the apocrine glands, which are located around the armpits, breasts and groin. These glands secrete lipids, steroids and proteins that are themselves odourless; the unpleasant smell develops when naturally occurring bacteria on the skin and in hair follicles break down these fatty secretions. In some cases, individuals may have overactive apocrine glands or an excess of particular odour-producing bacteria.
The condition can develop suddenly following puberty, microbiome changes, metabolic diseases or medication side effects. Once established, bromhidrosis often proves resistant to treatment because multiple factors typically contribute to its development. For Hayat, a 66-year-old living in New York, the condition emerged during menopause following ovary removal at age 48, which disrupted her oestrogen production. She simultaneously developed hyperhidrosis, or excessive sweating, and experienced significant social distress as a result of both conditions, including verbal harassment and physical avoidance from others. Despite spending thousands of dollars on over-the-counter and prescription solutions, she found no relief.
The prevalence of bromhidrosis remains difficult to quantify because no standardized diagnostic threshold exists. A 2024 review characterized it as prevalent in western populations and associated with significant impacts on patients’ social and psychological wellbeing. The International Hyperhidrosis Society, founded in 2003 to support an estimated 4.8% of people living with uncontrollable sweating, has expanded its mission to address bromhidrosis as well. According to the organization, an estimated 50% of the 1.6 million women entering menopause annually in the United States experience increased underarm sweat and odour.
Treatment approaches vary considerably in complexity and effectiveness. Practical strategies include antibacterial soap, fabric choices and improved laundry practices, while more advanced options encompass laser hair removal, waxing and Botox injections. The FDA-approved miraDry device uses microwave technology to destroy sweat glands, odour glands and hair follicles in the armpits. However, even combined interventions frequently provide only partial relief. The psychological toll extends beyond odour management, as individuals often experience social anxiety and isolation, potentially affecting employment choices and social participation. Healthcare providers report that patients frequently avoid discussing the condition due to shame and stigma surrounding body odour, despite its classification as a natural biological process.
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