Excessive sweating and body odour is an unpleasant problem that can affect a person's confidence and self-esteem.

A body odour problem can usually be managed by getting rid of excess skin bacteria – which are responsible for the smell – and keeping the skin in the affected area (usually the armpits) clean and dry.

Read on to learn about the different treatments you may be offered. You can also see a summary of the pros and cons of these treatments, which allows you to easily compare your options.

Self care advice

Your armpits contain a large number of apocrine glands, which are responsible for producing body odour.

Keeping your armpits clean and free of bacteria will help keep odour under control. Following the below advice will help you achieve this:

• Take a warm bath or shower every day to kill the bacteria on your skin. On hot days, you may need to have a bath or shower twice a day.
• Wash your armpits thoroughly using an antibacterial soap.
• Use a deodorant or an antiperspirant after bathing or showering.
• Regularly shaving your armpits will allow sweat to evaporate quicker, giving bacteria less time to break it down.
• Wear natural fibres, such as wool, silk or cotton. They allow your skin to breathe, which means your sweat will evaporate quicker.
• Wear clean clothes, and make sure you wash your clothes regularly. 
• Limit the amount of spicy foods you eat, such as curry or garlic, because they can make your sweat smell. Evidence also suggests that eating a lot of red meat tends to make body odour worse.

Deodorant and antiperspirant

The active ingredients used in antiperspirants and deodorants differ, so you may find some more effective than others.

Deodorants work by using perfume to mask the smell of sweat. Antiperspirants contain aluminium chloride (see below), which reduces the amount of sweat produced by your body.

Use roll-on antiperspirants if you sweat heavily, as they tend to be more effective.

Aluminium chloride

Aluminium chloride is the active ingredient in most antiperspirants. It helps prevent the production of sweat.

If the above self care advice doesn't improve your body odour, you may need a stronger antiperspirant that contains more aluminium chloride.

Your GP or pharmacist can recommend a suitable product and advise about how often you should use it. 

Aluminium chloride solutions are usually applied every night before bed, and washed off in the morning. This is because you stop sweating in your sleep, so the solution can seep into your sweat glands and block them. This reduces how much you sweat the next day.

As the aluminium chloride solution begins to take effect, you can use it less often (every other night, or once or twice a week).

Surgery

Surgery may be recommended for severe body odour that can't be treated by self care measures and over-the-counter products.

One type of surgery involves removing a small area of skin from your armpit and the tissue just below it. This will get rid of the most troublesome sweat glands.

It may also be possible for the sweat glands to be drawn out from the deeper skin layers using liposuction – a technique that's often used to remove unwanted body fat.

Another option is a type of surgery called endoscopic thoracic sympathectomy (ETS), which uses keyhole surgery to destroy the nerves that control sweating.

During ETS, the surgeon will make two or three small incisions under each arm. A tiny camera (endoscope) will be inserted through one of the incisions so the surgeon can see the inside of your armpit on a monitor.

The surgeon will insert small surgical tools through the other incisions, allowing them to cut the nerves. Alternatively, a thin electrode that emits an electrical current will be used to destroy the nerves.

Risks associated with ETS include damage to nearby arteries or nerves, and compensatory sweating (increased sweating from other areas of the body). You should fully discuss the risks of the procedure with your surgeon beforehand. 

Read more about how excessive sweating is treated.

Botulinum toxin

Botulinum toxin, often referred to as Botox, is another possible treatment for people with excessive underarm sweating.

Botulinum toxin is a powerful poison that can be used safely in minute doses. Between 12 and 20 injections of botulinum toxin are made in the affected area of the body, such as the armpits, hands, feet or face.

The toxin works by blocking signals from your brain to the sweat glands, reducing the amount of sweat produced. The procedure takes 30-45 minutes, and the effects of botulinum toxin usually last for between two and eight months. After this time, further treatment will be needed.

The availability of treatment with botulinum toxin on the NHS can vary widely, and it may not be available in your area. You may need to visit a private cosmetic clinic for treatment. Prices can vary, depending on the area of the body being treated (treating both armpits costs around £400). Make sure you find out the cost before starting treatment.