If Hayat goes out to eat, she\u2019ll choose a table far away from other diners, ideally by a door or open window. She likewise tries to avoid people at the cinema or on planes, even if it means paying extra \u2013 whatever it takes to avoid being too close to others.<\/p>\n
She chalks it up to a persistent past insecurity. \u201cI still have that paranoia \u2026 It\u2019s just in my head, because of everything I went through.\u201d<\/p>\n
For more than a decade, 66-year-old Hayat lived with bromhidrosis: chronic body odour. Though the term applies to BO from any cause, including poor hygiene, it is more typically driven by a bacterial imbalance or other health issue.<\/p>\n
Research shows that \u201815 minutes after a shower, you will already have started smelling\u2019. Photograph: Catherine Falls Commercial\/Getty Images (Posed by a model)<\/p>\n
For those individuals, it\u2019s not a question of bathing more often, or switching to a higher-strength deodorant: their body is working against them, and the impact can be ruinous. \u201cFifteen minutes after a shower, they\u2019ve already started smelling,\u201d says Chris Callewaert, a senior research fellow at Ghent University, Belgium, and one of the few scientists in the world specialising in body odour.<\/p>\n
Callewaert describes bromhidrosis as a natural bodily process gone awry, most typically involving the apocrine glands. These are concentrated around the armpits, breasts and groin, and secrete lipids, steroids and proteins. This sweat itself is odourless; BO is produced by the natural bacteria on the skin and inside the hair follicles as they digest the fatty secretion.<\/p>\n
In people with apocrine bromhidrosis \u2013 that is to say, abnormal or abnormally offensive body odour \u2013 some aspect of that process is out of balance, says Callewaert. They may have overactive apocrine glands, perhaps, or an overabundance of specific \u201csmelly bacteria\u201d.<\/p>\n
Body odour can come on abruptly: with puberty, a change to the microbiome, a disease affecting the metabolism, or even as a side-effect of medication. But once established, it can prove difficult to shift, Callewaert says. \u201cIt\u2019s often multifactorial, and not easy to perceive the deeper origin or to fix it. Sometimes people have been stuck with this for many, many years.\u201d<\/p>\n
Body odour can come on abruptly with puberty, a change to the microbiome, or even as a side-effect of medication Photograph: bymuratdeniz\/Getty Images (Posed by a model)<\/p>\n
In Hayat\u2019s case, she developed bromhidrosis along with hyperhidrosis \u2013 excessive and uncontrollable sweating, a distinct but often coexistent condition \u2013 during menopause. In 2007, when she was 48, she had an ovary removed, which disrupted her oestrogen production. \u201cAfter that, life started to change. It was absolutely disruptive,\u201d she says.<\/p>\n
She was constantly overheated, \u201cburning inside\u201d even during New York\u2019s freezing winters. On the subway, she would be wearing a sleeveless top and sandals, her hair dripping wet from sweat, while other commuters were in heavy coats, boots and scarves. \u201cPeople were looking at me like I was crazy,\u201d she says.<\/p>\n
That was only half of it. She also smelled \u2013 from her armpits, under her breasts, her groin. Her fellow New Yorkers did not hold back from letting her know. Some covered their noses as she passed, or moved away from her. \u201cThose were the polite ones,\u201d Hayat says. Others verbally abused her; more than once, she was harassed off the train. \u201cIt was awful, a total nightmare.\u201d<\/p>\n
Hayat understood the strong reactions: \u201cIt\u2019s normal \u2013 you don\u2019t want to be next to anybody who smells bad.\u201d But over-the-counter and prescription remedies made no difference. Hayat estimates that she spent thousands of dollars searching fruitlessly for relief. \u201cAt one point I was seeing endocrinologists, gynaecologists, general cardiologists \u2026 I had a whole team, trying to find out what was going on in my body.\u201d<\/p>\n
There is no set diagnostic threshold at which bad BO becomes bromhidrosis, which makes it difficult to estimate how common it is. A 2024 review<\/a> described it as prevalent, at least in the west, and taking a \u201csignificant\u201d toll on patients\u2019 social and psychological wellbeing. Yet there is very little focused attention on the condition or specialised support.<\/p>\n \u201cIt is underserved,\u201d says Angela Ballard, a registered nurse and communications director for the International Hyperhidrosis Society (IHS). The US-based organisation was founded in 2003 to advocate for the estimated 4.8% of people who live with uncontrollable sweating, but has expanded its focus to include bromhidrosis and body odour, given the frequent overlap and lack of other resources.<\/p>\n \u201cThere is not a lot of information, and I think that\u2019s sort of indicative. People are ashamed,\u201d Ballard says. \u201cThey don\u2019t talk about it with their healthcare providers, even their friends.\u201d<\/p>\n The stigma over BO persists despite it being a natural part of life, from puberty to pregnancy and beyond. According to the IHS, an estimated 50% of the 1.6m women entering menopause annually in the US alone experience increased underarm sweat and odour.<\/p>\n Ballard says a diagnosis of bromhidrosis is tied to \u201cthe level of distress it\u2019s causing a person\u201d, and its effect on their wellbeing and day-to-day function: \u201cHow much is this impacting your self-esteem, your confidence, your social life?\u201d<\/p>\n Botox injections can reduce sweat production. Photograph: Steklo_KRD\/Alamy (Posed by a model)<\/p>\n There are strategies that can help with alleviating the odour, she says \u2013 from the straightforward (using antibacterial soap, avoiding certain fabrics, improving laundry practices) to the unexpected (laser hair removal or waxing, which limit sites for bacteria, and Botox, which reduces sweat production) and, increasingly, hi-tech.<\/p>\n The miraDry, for instance, is an FDA-approved handheld microwave device that destroys the sweat glands, odour glands and hair follicles in the armpits, and has proved to be effective at managing hyperhidrosis, and sometimes bromhidrosis too.<\/p>\n But, often, even a combination of strategies can only do so much to improve the smell. Meanwhile, managing the social anxiety, second-guessing and paranoia is a separate concern. \u201cYou feel like people are judging you, that they think it\u2019s your fault, when you\u2019ve perhaps tried everything,\u201d Ballard says. \u201cIt can really spiral.\u201d<\/p>\n The toll can be far-reaching. \u201cPeople will choose jobs where they can work from home, or skip certain social occasions where their odour could be more apparent \u2026 You may hesitate to hug someone or get too close to other people.\u201d<\/p>\n Having been diagnosed with hyperhidrosis as a child, Ellie, 30, began struggling with body odour as she got older. She had wanted to pursue teaching, \u201cbut I just couldn\u2019t imagine standing in front of a room full of students all sweaty, fearing smelling bad,\u201d she says.<\/p>\n She now works as an accounting assistant. \u201cThere were several career paths I wanted to pursue but didn\u2019t.\u201d She considers herself fortunate to not have been so affected in her intimate relationships.<\/p>\n Many people with bromhidrosis report it negatively affecting their confidence and success in dating, but Ellie says her husband, who has known her since she was a teenager, has always been \u201ccompletely unfazed\u201d. She was, however, very nearly dissuaded from having children, for fear of passing on her conditions.<\/p>\n But Ellie now has a young daughter: \u201cWhile excessive sweating and body odour is extremely unfortunate, it is not a reason to not want to live. Even if I do end up passing this down, I will be the best advocate possible for my daughter.\u201d<\/p>\n With doctors having been, generally, \u201cpretty dismissive\u201d, Ellie has developed her own coping strategies, such as wearing only cotton socks and never leaving the house without a full change of clothes on hand. \u201cI swear I\u2019ve tried every deodorant on the market.\u201d<\/p>\n Added to the frustrations and challenges of managing her bromhidrosis are other people\u2019s assumptions \u2013 that she is either oblivious to how she smells, or wilfully not doing anything about it. \u201cDon\u2019t think we don\u2019t realise. Odds are, we\u2019re trying everything we can to mask it, and get rid of it, but sometimes there is no way.\u201d<\/p>\n Callewaert\u2019s research has found that people who know or fear that they have BO are actually more attentive to personal hygiene than others. But, he says, the anxious striving to get on top of bromhidrosis can worsen the problem by further imbalancing the microbiome and stoking the production of sweat. \u201cThey have stress and, as such, they have odour, and because they have odour, they have more stress: it\u2019s self-enforcing.\u201d<\/p>\n \u2018People might develop anxiety or depression \u2013 on average, their quality of life is lower.\u2019 Photograph: Tara Moore\/Getty Images (Posed by a model)<\/p>\n Over time, bromhidrosis can become as much a psychological issue as a physiological one. People with the condition often self-isolate, exacerbating the negative effect on wellbeing, and they might develop anxiety or depression, says Callewaert: \u201cOn average, their quality of life is lower.\u201d<\/p>\n Faced with \u201cembarrassing situations and mistreatment\u201d, Hayat organised her life around managing others\u2019 discomfort. Aged 50, she learned to drive and got a car so that she might bypass public transport \u2013 no mean feat in New York \u2013 and began flying business class for the extra space. \u201cEconomically, it was a sacrifice, but for my wellbeing, it was perfect to be as far away as I could from people,\u201d Hayat says.<\/p>\n Her family thought she was behaving irrationally and told her she didn\u2019t even smell: \u201cThey used to say: \u2018It\u2019s all in your head.\u201d But Hayat didn\u2019t feel that she could trust them over the feedback she was getting in public, \u201cbecause they love me\u201d.<\/p>\n The experience went so far as to test Hayat\u2019s faith: she says she often turned to the Bible in search of solace and answers. \u201cIt was really frustrating: \u2018Why me? Why do I have to go through this? What did I do?\u2019\u201d<\/p>\n Her world shrank. \u201cBefore menopause, I used to go to the theatre, the movies, to clubs to dance, to restaurants \u2026 I stopped all of that.\u201d For more than a decade, she did not go anywhere other than work.<\/p>\n The office was difficult enough. Hayat\u2019s colleagues knew she had a medical condition, but were far from sympathetic, she says. A younger co-worker made a show of using a room spray in Hayat\u2019s presence; she overheard another pair of colleagues talking about her, waving their hands in front of their noses.<\/p>\n Hayat says that her working environment became so hostile that she considered suicide. But eventually, she sought help from her employer\u2019s human resources department, which moved swiftly to find her a spot far from those colleagues and gave her the option of taking action against them for bullying. She declined, but \u201cthey made me feel really supported\u201d.<\/p>\n \u2018Maybe someone is going through menopause \u2026\u2019 Photograph: Highwaystarz-Photography\/Getty Images (Posed by a model)<\/p>\n Later in her career, Hayat took advantage of advances in remote working, such as telephone meetings and Zoom calls. She also became more adept at managing her sweating and stress, and with it the smell: \u201cI found ways to survive.\u201d<\/p>\n The strict social penalty against having body odour is worsened by the casualness and flippancy with which the topic is often treated. Even doctors can be dismissive, instructing patients to simply apply more deodorant. \u201cPeople are being brushed off very easily [because] \u2018it\u2019s not life-threatening\u2019,\u201d says Callewaert.<\/p>\n That doesn\u2019t just discount the real suffering of living with bromhidrosis: a subtle change in body odour has been associated with diabetes, Parkinson\u2019s disease and cancer, he says. \u201cKnowing that body odour can be a symptom for underlying diseases, it\u2019s a real sign that needs to be picked up.\u201d<\/p>\n In most cases, however, strong BO stems from the microbiome and poor gut health. A stronger and more offensive body odour is linked to diets high in meat and fast food, and low in vegetables. \u201cLeading a healthy lifestyle will help in smelling better,\u201d Callewaert says. High stress is also a factor.<\/p>\n With the microbiome makeup often stubborn to shift, progress can be slow. Even using antiperspirants and deodorant can exacerbate odour, he says, killing beneficial bacteria while encouraging the more stress-resistant, \u201csmelly\u201d kind to bounce back stronger and more numerous.<\/p>\n At best, these \u201cunderarm cosmetics\u201d \u2013 widespread only since the mid-20th century \u2013 are a short-term solution, Callewaert says. He argues that their use has led to worse BO at the population level, together with the trends, at least in the west, for poor nutrition, high stress and unhealthy guts. So Callewaert \u2013 who publicly styles himself as \u201cDr Armpit\u201d \u2013 has been developing what he hopes might prove a silver bullet to BO: his own range of patented probiotic deodorants.<\/p>\n In the meantime, Ballard calls for greater understanding of body odour as a natural product of bacteria on our skin, and compassion for people who might be struggling to keep it in check. Instead of leaping to the assumption that someone who smells must be skipping showers, we might consider their experience, she says.<\/p>\n \u201cMaybe they have bromhidrosis, and it took a lot for them to get out the door to go to work and live their lives. Maybe they have another medical condition, and they have to take medication that has changed their body odour. Or maybe they\u2019re going through menopause \u2026 You can notice that you smell something, and stop before the judgment.\u201d<\/p>\n For Hayat, recently retired, the bullying she experienced over her bromhidrosis affected her wellbeing as much as the condition itself. After a decade of the menopause wreaking havoc, her symptoms began to ease. \u201cIt got better, thank God,\u201d she says fervently. \u201cIt\u2019s still not 100% managed \u2013 it\u2019s just that I learned to get by.\u201d<\/p>\n She, too, urges compassion \u2013 after all, no one is above body odour. \u201cYou can be smelling like roses now, but eventually, for whatever reason, your body\u2019s gonna change.\u201d<\/p>\n All case studies\u2019 names have been changed<\/p>\n In the UK and Ireland, Samaritans<\/a> can be contacted on freephone 116 123. In the US, you can call or text the 988 Suicide & Crisis Lifeline<\/a> at 988 or chat at 988lifeline.org<\/a>. In Australia, the crisis support service Lifeline<\/a> is 13 11 14. Other international helplines can be found at befrienders.org<\/a><\/p>\n Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters<\/a> section, please click here<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"If Hayat goes out to eat, she\u2019ll choose a table far away from other diners, ideally by a…\n","protected":false},"author":2,"featured_media":777583,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[59,102,56,54,55],"class_list":["post-777582","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-gb","tag-health","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/777582","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=777582"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/777582\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/777583"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=777582"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=777582"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=777582"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}