Why Does Body Odor Persist After Underarm Sweat Gland Surgery? - Dermatology

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Body odor, particularly in the context of hyperhidrosis (excessive sweating) and conditions like axillary osmidrosis (commonly referred to as "body odor" or "fox odor"), can be a complex issue, especially after surgical interventions aimed at reducing sweat production.
When you undergo surgery to remove sweat glands in the underarm area, the expectation is often that the odor will diminish significantly or even disappear. However, several factors can contribute to the persistence or even exacerbation of body odor after such procedures.

1. Compensatory Sweating: One of the most common outcomes after axillary sweat gland surgery is compensatory sweating. This phenomenon occurs when the body compensates for the loss of sweat glands in one area by increasing sweat production in other areas. In your case, it seems that sweating has increased in the chest and thigh regions. This is a well-documented response and can lead to discomfort and embarrassment, especially in warmer weather or when wearing certain fabrics.

2. Residual Sweat Glands: It’s important to note that while surgical procedures can significantly reduce the number of sweat glands, they may not eliminate all of them. If any sweat glands remain, they can still produce sweat, which can mix with bacteria on the skin and lead to body odor.
3. Bacterial Activity: Body odor is primarily caused by the breakdown of sweat by bacteria on the skin. Even if sweat production is reduced, the presence of bacteria can still lead to odor. If the surgical procedure did not adequately address the bacterial flora or if there is an increase in bacterial activity in the remaining areas, this could contribute to the problem.

4. Changes in Skin Microbiome: Surgical interventions can alter the skin's microbiome, which may affect how sweat is processed and can lead to changes in odor.
5. Hormonal Factors: Hormonal changes can also influence sweat production and body odor. Factors such as stress, diet, and hormonal fluctuations can lead to increased sweating and changes in body odor.


Solutions and Recommendations
1. Consultation with a Specialist: It would be beneficial to consult with a dermatologist or a specialist in hyperhidrosis. They can assess your situation and provide tailored recommendations.
2. Antiperspirants: Over-the-counter or prescription-strength antiperspirants can help manage sweating in areas that are now compensating for the underarm surgery. Look for products containing aluminum chloride, which can be effective in reducing sweat production.

3. Botox Injections: For some patients, Botox injections can be an effective way to reduce sweating in areas that have become problematic after surgery. This treatment temporarily blocks the nerves that cause sweating.

4. Lifestyle Adjustments: Wearing breathable fabrics, maintaining good hygiene, and using antibacterial soaps can help manage odor. Additionally, dietary changes may also influence body odor; reducing spicy foods, garlic, and alcohol can sometimes help.

5. Surgical Options: If the problem persists and significantly impacts your quality of life, revisiting surgical options with your healthcare provider may be necessary. There are various techniques available, including more extensive procedures that target other areas of sweat production.

6. Psychological Support: Dealing with body odor can be distressing and may affect self-esteem. Seeking support from a counselor or support group can be beneficial.

In conclusion, while surgery can significantly reduce body odor, it may not be a permanent solution for everyone. Compensatory sweating and other factors can lead to new challenges. A comprehensive approach involving medical consultation, lifestyle changes, and possibly additional treatments can help manage the situation effectively.