Daughter, 8, has underarm odour

The odour is more apparent on some days than others, especially after she participates in physical activities or if she is stressed.

Q A year ago, my eight-year-old daughter started having underarm odour.

The odour is more apparent on some days than others, especially after she participates in physical activities or if she is stressed.

Is the condition hereditary and is it normal to have underarm odour at such a young age? And what can I do about it apart from using adult deodorant on her?

A Body odour is also known as bromhidrosis. It can occur in people of any age group.

It arises mainly from the interaction between secretions from the sweat glands and bacteria on the surface of the skin.

There are two main types of human sweat glands - the eccrine and apocrine glands.

Eccrine glands are distributed over the entire skin surface and they play an important role in regulating body temperature by sweat production.

When eccrine sweat softens keratin - a component of the outer layer of skin - bacterial degradation of the keratin yields a foul smell.

Excessive sweating that occurs during physical activity may contribute further to bromhidrosis by creating a moist environment that encourages overgrowth of bacteria on the surface of the skin.

This may explain why you feel your daughter's underarm odour is more apparent after she has participated in physical activity.

Eating certain drugs and some types of food, such as garlic, onion and curry, may also cause eccrine bromhidrosis.

Underlying medical conditions, such as kidney failure and metabolic disorders, can also cause eccrine bromhidrosis.

Skin infections also contribute to the condition.

Apocrine glands are distributed over a limited number of areas in the body - the axilla (armpit), breasts and skin in the genital area.

These glands do not help to regulate body temperature but are responsible for secreting pheromones.

Pheromones are chemicals that are released into the air to influence other people's behaviour or physiology - for instance, to attract them - when their noses detect the chemicals.

The apocrine glands secrete a small amount of oily fluid, which is odourless when it reaches the surface of the skin.

But bacterial decomposition of the apocrine secretion on the surface of the skin yields ammonia and short-chain fatty acids, which give off characteristic strong odours.

Apocrine bromhidrosis is the most prevalent form of bromhidrosis, but it usually occurs after puberty and will be relevant to your daughter only if she has features of early puberty.

Puberty normally starts in girls between the ages of 10 and 14.

The body produces female sexual hormones, leading to the development of breasts, which is usually the first sign. This is followed by the growth of pubic hair and the appearance of armpit hair.

In general, the management of bromhidrosis is aimed at reducing the bacteria load on the surface of the skin and moistness.

Regular showers are essential. If the weather is hot, your daughter may need to shower more than once daily, especially if she perspires a lot.

She should wash her armpits thoroughly using an antiseptic wash.

As her underarm odour is more obvious after physical activity, she should consider taking a shower immediately after the activity if possible. Otherwise, wiping dry after the activity should suffice.

Also, she should change out of the damp clothes as soon as she can.

She should wear clean clothes and ensure that the clothes are washed regularly.

She should also wear clothes made of cotton, which allow the skin to breathe. This facilitates quicker evaporation of sweat.

She should continue to use the deodorant.

Do note there is a difference between deodorant, which works by using perfume to mask the smell, and antiperspirant, which contains aluminium chloride to reduce sweat production.

If excessive sweating contributes to her odour, do consider having her use an antiperspirant instead.

Also consider limiting her intake of spicy foods, onions and garlic, which can make her sweat smell.

It is also important to treat any skin infection that is present.

Other types of treatment have also been employed to combat body odour. However, I tend to use them for patients who are older.

One of the methods is the use of botulinum toxin, which blocks the signals from the brain to the sweat glands and thus helps to decrease sweat production.

Alternatively, patients can undergo surgery such as sympathectomy, a procedure to cut the nerves that control sweating.

Another viable surgical option involves removing a small area of skin from the armpit and the tissue just below it. This will help get rid of the most troublesome sweat glands.

Do take your daughter to see a dermatologist to determine the cause of her body odour and explore the most appropriate management for her condition.

Dr Raymond Kwah

consultant dermatologist at Raffles Aesthetics and Skin Centre at Raffles Hospital

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