Armpit odor,
armpit smell,
underarm odor,

cased by axillary hyperhidrosis,

brings underarm stains,

Armpit odor,armpit smell,underarm odor,cased by axillary hyperhidrosis, brings underarm stains,

How common is over sweating ,scientifically called axillary hyperhidrosis:

-axillary hyperhidrosis affect 1% of population
-it can be generalized or localized.
.armpit alone,affect 37%,
.hand alone,affect 20%,
.hand and armpit in 43%
.foot,
.body
.facial

Causes of over sweating,armpit smell:

-sweating is centrally controlled process
-sweat gland is connected by
1.noradrenergic sympathetic nerve,affected by emotion
2.cholinergic sympathetic nerve,affected by hot environment

patient having over sweating has ;

1.over functioning sympathetic nerve
2.increased signal of [sympathetic] out flow.

[apocrine] sweat gland in armpit produce vicious fluid rich in odor causing substance

It is interesting to know that people having armpit over sweating do not complaint odor

Lesions /specific nerve blockade cause localized area of absent sweating(called anhidrosis) eg in Horner syndrome. We use this advantageously to our benefit in treatment

Tips on prevention or cure.

1. Antiperspirant,anti-perspirant, given topically, is the 1st line of treatment.
-it contain aluminum chloride ,10-15%.
-initially, given each night,then weekly,or fortnightly , once condition is under control

2. Use anticholinergic.
- work by blocking at nerve-gland junction,the last of nerve pathway,
-this compete for acetlycholine ,reversibly
-can be given topically,transdermally (rarely orally,as it gives lot of side effect,eg glaucoma,dry mouth,urinary retention,constipation)

3.Iontophoresis
-technique is to transport charged particle /molecules into a tissue,
-this is cumbersome,time consuming, costly

4.Botulinium toxin injection
-is derived from anaerobic spore forming Clostridium botulinum bacteria
-it bind rapidly ,irreversibly,to pre-synaptic nerve membrane,at neuro-gland junction
-is the latest treatment modality
-is the treatment of choice,
-has a high level of treatment satisfaction
-rapid onset, and sustained effect,
-given for severe cases,
-however,result is not permanent,as new sprouts grow from nerve terminal,
-definitely improve QoL,quality of life,
-RCT trial confirm the above

Special treatment options:

1. Sympatectomy
-is severing nerve supply to sweat gland
-thoracic 2nd,3rd,4th ganglia are cut, by laser, electrocautery,surgical clippings
-now is done by key-hole surgery,endoscopically
-compensatory hyperhidrosis may return causing dissatisfaction

2.local excision ,removal of sweat gland

3. suction assisted lipolysis

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