This page provides medically supervised information reviewed by specialist physicians at IC Clinic Ueno, a 1-minute walk from JR Ueno Station.
💡 Causes of Underarm Odor (Axillary Osmidrosis) and Treatment Options by Odor Severity
😰 Are you worried that you might have underarm odor (axillary osmidrosis)?
Axillary osmidrosis is not visible to the eye, and it can be difficult to notice the odor yourself. As a result, you may unknowingly be causing discomfort to colleagues or family members without realizing it.
💬 What you will learn from this article
✅ A self-check method to determine whether you have axillary osmidrosis
✅ How to identify your symptom level (mild, moderate, or severe)
✅ How to find the treatment approach that is right for you
✅ Everything from immediate self-care measures to addressing the root cause
⚠️ If left untreated…
❌ You may be causing discomfort to those around you without realizing it
❌ It may begin to affect your personal relationships and work life
❌ Self-managed care alone can only provide temporary relief
✨ Treatment technology has advanced considerably, and there are now treatment methods that can be performed without hospitalization, as well as surgical procedures designed to minimize scarring and disruption to daily life.
📱 Start with a consultation — our specialist physicians will assess your symptoms.
※ Consultations are free of charge. We will never pressure you into booking a treatment.
🔍 If you would first like to check whether you have axillary osmidrosis, please see our Underarm Odor Self-Check.
🔬 What Is Underarm Odor (Axillary Osmidrosis)? | A Condition Causing Strong Underarm Odor Due to Sweat Secreted by the Apocrine Glands
Axillary osmidrosis refers to the condition of unpleasant odor emanating from the underarms.
Formally defined as axillary osmidrosis, it is characterized by a strong odor that can be detected even without raising the arms.
The odor originates from the oxidation of sweat produced by the apocrine sweat glands in the underarms. Because perspiration intensifies the odor, symptoms tend to be more noticeable in 🌞 summer, after 💪 exercise, or in other situations where sweating occurs.
📊 The condition often first appears around puberty, and in many cases the symptoms become less noticeable with age.
🇯🇵 Axillary osmidrosis is estimated to affect approximately 10% of the Japanese population — a relatively low proportion globally — yet many people are bothered by the characteristic odor, and a wide range of products aimed at managing it have become available.
✨ Research into axillary osmidrosis treatment has advanced, and in recent years treatment has enabled significant improvement in most cases.
💡 Note that hyperhidrosis presents with similar symptoms to axillary osmidrosis, but involves different sweat glands. For more details, please see the difference between axillary osmidrosis and hyperhidrosis.
The odor associated with axillary osmidrosis is often described in the following ways. For a detailed explanation, please see the characteristics of axillary osmidrosis odor.
🧪 A sulfur-like smell
🌶️ A spicy, pungent smell reminiscent of strong seasonings
🧅 A sharp smell similar to onions
✏️ A smell resembling pencil lead
If you notice an odor with these characteristics, there is a possibility you may have axillary osmidrosis.
In addition, the more of the following physical signs that apply to you, the higher the likelihood of axillary osmidrosis:
✅ Wet or moist earwax
✅ Yellowing of underwear or clothing (the relationship between underarm yellowing and axillary osmidrosis)
✅ One or both parents have axillary osmidrosis
✅ Excessive underarm sweating
🔍 If you are concerned about whether you have axillary osmidrosis, start by checking how many of the above items apply to you using our Underarm Odor Self-Check.
💡 Even if you suspect you may have axillary osmidrosis, in some cases it may be underarm odor that is not axillary osmidrosis. For an accurate diagnosis, please consult a specialist physician.
🧬 Why Does Axillary Osmidrosis Cause Odor?
Sweat secreted by the apocrine glands contains components such as iron, fatty acids, and ammonia, giving it a slightly viscous quality and making it the primary source of the distinctive odor associated with axillary osmidrosis.
Sweat glands are divided into apocrine glands and eccrine glands, and the composition of the sweat they produce differs between the two.
💧 Sweat from the eccrine glands is approximately 98% water and produces little to no odor.
Apocrine glands, on the other hand, secrete sweat that contains fatty acids. These fatty acids are broken down by bacteria on the skin into shorter-chain fatty acids, eventually converting into 3-methyl-2-hexenoic acid.
⚠️ The substance known as “3-methyl-2-hexenoic acid” is considered to be responsible for the odor characteristic of axillary osmidrosis. For more details, please see the causes of axillary osmidrosis.
Moist earwax is considered an indicator of a higher likelihood of axillary osmidrosis.
The ear canal also contains apocrine glands — the same glands associated with axillary osmidrosis — and the number of these glands influences the consistency of earwax.
A greater number of apocrine glands leads to more secretion, which is why moist earwax may be associated with a higher likelihood of axillary osmidrosis.
🍯 If the earwax has a sticky, caramel-like texture, the possibility of axillary osmidrosis may be even higher.
However, even among people with moist earwax, the rate of axillary osmidrosis is estimated at around 80%, meaning moist earwax does not necessarily indicate the condition.
👩 In particular, for women, the correlation between earwax type and odor severity is not as strong as it is for men.
📝 Rather than relying on earwax alone, consider multiple factors when assessing whether you may have axillary osmidrosis.
❓ If you have wondered “Can axillary osmidrosis be contagious?”, please see whether axillary osmidrosis is contagious.
🍴 What Causes Axillary Osmidrosis? Diet and Lifestyle Habits Also Play a Role
The causes of axillary osmidrosis involve both genetic factors and lifestyle habits. For more details, please see the causes of axillary osmidrosis.
The main causes can be grouped into the following three categories:
🧬 Inheriting a larger number of apocrine glands through genetics
⚡ Increased apocrine gland secretion due to the influence of sex hormones
🏃 Disrupted lifestyle habits, which can act as a trigger for the onset of axillary osmidrosis
Let’s look at each one in turn.
Inheriting a larger number of apocrine glands from one’s parents is one contributing factor.
It is well established that axillary osmidrosis can be inherited. If one parent has the condition, there is approximately a 50% chance it will be passed on to their child.
If both parents have axillary osmidrosis, the likelihood of inheritance rises to around 80%, indicating a significant genetic influence.
The greater the number of apocrine glands and the larger their size, the stronger the associated odor tends to be.
While inheritance is not guaranteed, if one or both parents have axillary osmidrosis, the probability that their child will also develop the condition is higher.
👶 If you are concerned about axillary osmidrosis in your child, please also see our page on axillary osmidrosis in children.
The amount of secretion from the apocrine glands is determined by their size and number, which in turn affects the intensity of odor.
Axillary osmidrosis most commonly develops around puberty, when shifts in sex hormone balance cause the apocrine glands to enlarge and become more active.
While the size and number of apocrine glands are determined by genetics, axillary osmidrosis does not typically manifest immediately after birth.
The age of onset varies from person to person; however, onset during puberty — when sex hormone levels are more likely to fluctuate — is particularly common.
Irregular lifestyle habits can also contribute to the onset of axillary osmidrosis.
When the body is under stress, the apocrine glands may be stimulated, leading to increased sweat secretion.
😓 Sweating when nervous — such as when speaking in front of others — is a familiar example of stress-induced perspiration that many people have experienced.
Furthermore, a lack of physical activity can make it harder for the body to sweat regularly, which may intensify underarm odor.
Without regular exercise, the body sweats less, allowing waste products to accumulate.
When sweating does eventually occur, these accumulated waste products are released all at once, which can result in a stronger odor.
📊 Axillary Osmidrosis Severity Levels: Three Main Categories
Axillary osmidrosis can be broadly classified into three severity levels, ranging from mild to severe.
The characteristics of each level are as follows:
🟢 Mild: Odor is only noticeable when the nose is brought close to the affected area
🟡 Moderate: Odor is detectable when in close proximity or in an enclosed space
🔴 Severe: Odor is strong enough for anyone entering the room to notice
🔍 If you are concerned about whether you may have axillary osmidrosis, use these descriptions to get a sense of where your symptoms might fall.
In mild cases, the odor is barely noticeable unless one gets close, and many individuals are unaware of it themselves.
For example, this level might describe someone who has never been told about the odor by others but notices a faint smell from their underarm when changing clothes and bringing their nose close to the area.
🧴 Over-the-counter antiperspirants can be helpful for managing mild symptoms, though those who are concerned may wish to consult a clinic sooner rather than later.
At this level, others are unlikely to find the odor unpleasant, and in most cases, only the person themselves is aware of it.
⚠️ Some individuals may worry more than necessary; in such cases, it is worth considering whether the concern might relate to a separate condition called “olfactory reference syndrome” — a tendency to believe others perceive an odor when they do not.
Counseling can help ease these concerns, so consulting a healthcare provider is worth considering.
Of course, medical treatment for axillary osmidrosis is also available, so if you are concerned, we recommend speaking with a physician.
When odor is noticeable when getting close to someone or in an enclosed space, this falls into the moderate category.
🚃 For example, this level might describe a situation where a faint odor is perceptible when in a confined space such as a train carriage and in close proximity to others.
In moderate cases, some people nearby may notice the odor, but it is generally not clear who the source is.
As long as you are not in very close contact with others or frequently in enclosed spaces, others are unlikely to notice.
However, on a 🌞 hot summer day when wearing light clothing, others nearby may find the odor uncomfortable.
Since moderate axillary osmidrosis can cause discomfort to those around you, it is worth considering treatment as appropriate.
✨ For mild to moderate cases, miraDry treatment is an option with relatively low physical burden.
In severe cases, the odor is strong enough for anyone entering the room to notice.
For example, if a strong odor is detectable even when wearing a jacket and without being in a crowded space, this is indicative of severe axillary osmidrosis.
The odor can permeate a room, causing discomfort to many, and in enclosed spaces particularly, a significant number of people are likely to notice it.
Over-the-counter products are generally insufficient to manage this level of odor, and prompt medical treatment is advisable.
Removing or destroying the apocrine glands responsible for the odor can help reduce it significantly.
✂️ For severe cases, insurance-covered axillary osmidrosis surgery (excision method) is the first treatment to consider.
💡 For concerns about underarm odor, please consult IC Clinic.
Living with the worry of axillary osmidrosis and constantly managing it can be exhausting.
IC Clinic offers consultations for underarm odor treatment.
✅ “I want to minimize scarring” → Axillary osmidrosis treatment with minimal scarring
✅ “I want to see results as soon as possible”
✅ “I don’t want surgery” → Axillary osmidrosis treatment without surgery
We propose treatment approaches suited to a range of individual needs.
To find the treatment approach that is right for you and move toward relief from axillary osmidrosis concerns, we encourage you to take advantage of our consultation.
📍 Axillary Osmidrosis in Other Areas (By Body Part)
Axillary osmidrosis can develop not only in the underarms but also in other areas of the body where apocrine glands are concentrated.
🔹 Genital Area Osmidrosis (Intimate Zone)
An osmidrosis-like odor originating from around the genital area. While a sensitive concern, improvement is possible through treatment.
🔹 Areola Osmidrosis (Around the Nipple)
An odor arising from the apocrine glands around the areola. This can be a particular concern for those who are breastfeeding.
Axillary osmidrosis in these areas can also be improved with appropriate treatment from a specialist physician.
👶 Axillary Osmidrosis in Children
Many parents are concerned about axillary osmidrosis in their children.
As axillary osmidrosis often develops around puberty, it can sometimes lead to bullying at school or a loss of confidence, making early intervention important.
📖 We provide a detailed explanation on axillary osmidrosis in children.
💰 Insurance coverage may be available for axillary osmidrosis treatment in children. Please also see our page on axillary osmidrosis in children and insurance coverage.
💊 Three Types of Underarm Odor Treatment | Features and Approximate Costs
When focusing specifically on the underarm area, the appropriate treatment depends on whether you wish to address odor, excessive sweating, or both.
Each option has its own advantages and disadvantages, and costs can range widely from tens of thousands to several hundred thousand yen. It is therefore important to receive a consultation from an experienced physician and select the treatment approach that is right for you.
💰 For a detailed breakdown of costs by treatment, please see a cost comparison of axillary osmidrosis treatments.
Here we explain three of the most common underarm odor treatment methods:
💉 Botox (botulinum toxin) injections
✂️ Surgical treatment (insurance-covered)
🌟 miraDry
Botox treatment requires relatively little treatment time and is comparatively affordable, making it a convenient treatment option.
A medication is injected directly into the affected area to suppress nerve activity and reduce the amount of sweat produced.
⏰ This treatment is well suited to those who want a straightforward option they can access when needed.
📖 For details on the differences between miraDry and Botox, please see the difference between miraDry and Botox.
For patients with severe axillary osmidrosis, surgery is generally the first treatment to consider.
Surgical treatment can provide substantial improvement and has been performed for many years.
Several surgical techniques exist; at our clinic, we use the standard procedure known as the “excision method (skin-flap technique).”
After administering anesthesia, the affected area is surgically opened and the apocrine glands are directly removed.
💰 For more details on insurance-covered axillary osmidrosis surgery, please see this page.
📖 Other surgical options: Sweat gland removal surgery, Underarm sweat reduction surgery, Roller clamp method
⚠️ Surgery may not be suitable for everyone. Please also check our page on who is not a good candidate for axillary osmidrosis surgery.
miraDry involves minimal discomfort and is a treatment option that has been attracting attention for its potential to provide long-lasting results.
Microwave energy is applied to the underarm area to target and destroy the apocrine glands.
📖 For more information about miraDry, please see:
・miraDry efficacy
・miraDry disadvantages
・miraDry and insurance coverage
💊 Temporary Management of Underarm Odor with Topical and Oral Medications
Topical and oral medications are also available as options for managing axillary osmidrosis.
However, these medications offer only temporary relief and do not address the underlying cause of axillary osmidrosis.
💊 Medications may be prescribed by a physician or, in some cases, purchased at a pharmacy.
There are two main types of topical medications:
💧 Those that help reduce sweating
👃 Those that help suppress odor
Both types work by being applied directly to the affected area where sweating is most pronounced.
Topical antiperspirants typically contain aluminum chloride; as they may cause itching upon application, it is advisable to apply them using a tissue or similar material to limit contact to the target area.
Topical antibiotics are also effective. Applying them for 2 to 3 days to suppress odor can provide relief for approximately 1 to 2 weeks before reapplication is needed.
By reapplying the medication whenever symptoms return, axillary osmidrosis can be kept under control.
If topical medications alone are insufficient to manage odor, using oral medication in combination or wearing antibacterial clothing may also be helpful.
Oral medications containing anticholinergic agents work by inhibiting acetylcholine, thereby reducing the amount of sweat the body produces.
The dosing schedule will be determined in consultation with your physician, but typically requires taking the medication 3 to 4 times per day. Effects generally appear within about one hour of taking the medication, so timing your doses accordingly is helpful.
One potential side effect of reducing sweating is a sensation of warmth in the body.
Long-term use may place a burden on the body, so for those seeking a more fundamental solution, treatments such as miraDry or surgery may be worth considering.
✨ Self-Care Measures for Managing Underarm Odor
For those who want to address the root cause of axillary osmidrosis, medical treatment is recommended. However, if you are not yet in a position to pursue treatment — whether due to cost or a preference to try accessible measures first — the following approaches may help:
🚿 Shower frequently / wipe away sweat regularly
✂️ Remove or reduce underarm hair
🧴 Use antiperspirants or deodorant products with antibacterial properties
🧼 Wipe with alcohol-soaked cotton
Let’s look at each one in turn.
Keep your body clean by showering regularly and wiping away sweat promptly.
Removing excreted waste products from the skin is an effective way to help reduce odor.
Showering is ideal where possible, but when you are out, thoroughly wiping the underarms — where sweat tends to accumulate — can also be sufficient.
Use clean handkerchiefs or wipes, and make sure to dry the area thoroughly — this is key.
💧 Make a habit of wiping down whenever you notice perspiration.
Moisture and heat trapped by hair can contribute to odor. Removing or reducing hair in the underarm and intimate areas helps prevent sweat from becoming trapped and causing that issue, so it is particularly advisable to address areas with dense hair growth.
Hair removal also makes it easier to wipe away sweat, helping you maintain cleanliness more consistently.
⚠️ Hair removal creams suitable for intimate areas are rarely available over the counter, so undergoing hair removal at a clinic is recommended for safety.
Antiperspirants can be helpful for managing mild odor.
Antiperspirants are products that can temporarily help reduce sweating. Their appeal lies in how they can be used in targeted situations — such as during summer when sweating is more likely, or before exercise.
Deodorants help reduce unpleasant odor by inhibiting the growth of odor-causing bacteria.
Furthermore, products that also contain antiperspirant ingredients can help reduce the amount of sweat at the same time.
🏪 Both types are readily available at pharmacies.
💧 Roll-on type
💨 Spray type
📄 Sheet type
🧴 Cream type
These products come in various forms, but the roll-on type is generally recommended for close contact with the underarm. Oronine, which has antibacterial properties, is also a popular choice.
Many products contain fragrance, so choose one that suits your preferences.
Wiping the affected area with alcohol-soaked cotton can help inhibit bacterial growth and keep the area consistently clean.
If cotton is not available, tissues or antibacterial body wipes can also be effective.
Do not reuse the same cloth or wipe; always use a fresh one each time.
After wiping, put on clean clothing and try to prevent sweat from transferring back to the fabric.
🏥 Choosing a Clinic for Underarm Odor Treatment
Choosing a trustworthy clinic is important when seeking treatment for axillary osmidrosis.
📖 How to choose a clinic for axillary osmidrosis treatment explains the key points to consider when selecting a clinic.
🏥 Please also refer to which medical specialty to consult for axillary osmidrosis.
🔍 For those who would like to be tested for axillary osmidrosis, please see hospitals that offer axillary osmidrosis testing.
📍 Area information: Axillary osmidrosis treatment in Akihabara
🏥 For Underarm Odor Treatment in Tokyo, Please Consult IC Clinic
If you are considering treatment for axillary osmidrosis, please feel free to consult IC Clinic.
IC Clinic offers a range of treatments — including sweat-reducing injections, miraDry, and the skin-flap surgical technique (insurance-covered) — with options tailored to the severity of your condition.
✅ “I want to see results quickly”
✅ “I want surgery but would prefer to minimize scarring” → Treatment with minimal scarring
✅ “I want treatment that won’t interfere with my daily routine”
We can suggest flexible treatment approaches to match a variety of individual needs.
To find the treatment approach that suits you best, we encourage you to make use of our consultation.
💡 If you are concerned about the amount you sweat, you may also have hyperhidrosis. Please also see the difference between axillary osmidrosis and hyperhidrosis.
※ Consultations are free of charge. Please feel free to reach out.
📚 Related Articles on Axillary Osmidrosis
🔍 Self-Check & Symptoms
・Underarm Odor Self-Check
・Characteristics of Axillary Osmidrosis Odor
・The Relationship Between Underarm Yellowing and Axillary Osmidrosis
・Underarm Odor That Is Not Axillary Osmidrosis
🧬 Causes & Mechanisms
・Causes of Axillary Osmidrosis
・Is Axillary Osmidrosis Contagious?
・The Difference Between Axillary Osmidrosis and Hyperhidrosis
📍 Axillary Osmidrosis by Body Part
・Genital Area Osmidrosis
・Areola Osmidrosis
👶 Axillary Osmidrosis in Children
・Axillary Osmidrosis in Children
・Axillary Osmidrosis in Children and Insurance Coverage
💊 Treatments
・Insurance-Covered Axillary Osmidrosis Surgery
・miraDry
・Excision Method
・Axillary Osmidrosis Treatment Without Surgery
・Axillary Osmidrosis Treatment with Minimal Scarring
・Cost Comparison of Axillary Osmidrosis Treatments
🏥 Choosing a Clinic
・How to Choose a Clinic for Axillary Osmidrosis Treatment
・Which Medical Specialty to Consult for Axillary Osmidrosis
・Hospitals That Offer Axillary Osmidrosis Testing
📸 Case Studies at Our Clinic
🔬 [Case Study] Male Patient in His 20s — Surgical Treatment (Excision Method) for Axillary Osmidrosis and Hyperhidrosis (Updated August 3, 2025)
This patient is a male in his 20s who had long been troubled by underarm odor and sweat stains, which were affecting his daily life and personal relationships, and came to IC Clinic Ueno for a consultation. Following examination and consultation, he opted for the excision method (subcutaneous sweat gland removal surgery) as a fundamental treatment for his axillary osmidrosis and hyperhidrosis. The photograph shows his progress during the post-operative recovery period, during which bruising and swelling were present; these gradually subsided over time, and his odor and sweating symptoms have since improved, allowing him to enjoy a more comfortable daily life.
![[Case Study] Male Patient in His 20s — Surgical Treatment (Excision Method) for Axillary Osmidrosis and Hyperhidrosis (Updated August 3, 2025)](https://ic-clinic-ueno.com/wp-content/uploads/2025/08/IMG_2493.png)
