Traditional Chinese Medicine Definition

Axillary osmidrosis, known as "body odor" in Traditional Chinese Medicine (TCM), falls under the category of surgical diseases. According to the records of *Internal Medicine of Traditional Chinese Medicine*, axillary osmidrosis results from impaired circulation of qi and blood, combined with abnormal secretion of local sweat glands, leading to acidification of axillary sweat and the production of a peculiar odor. This condition is often associated with dysfunction of the liver, spleen, kidneys, and other viscera, manifesting as severe axillary odor, excessive sweating, and sometimes accompanied by symptoms such as skin itching.

In TCM clinical practice, the core pathogenesis of axillary osmidrosis involves impaired circulation of qi and blood and abnormal sweat secretion. Common triggers include emotional disturbances, improper diet, and prolonged exposure to damp environments. In syndrome differentiation, the following key points must be distinguished:

1. Cold, heat, deficiency, and excess: The syndrome of damp-heat accumulation is characterized by severe axillary odor, excessive sweating, bitter taste in the mouth, scrotal dampness, red tongue with yellow greasy coating; the syndrome of yin deficiency with internal heat features odor accompanied by vexing heat in the five centers, night sweats, dry mouth, red tongue with scant coating; the syndrome of hereditary predisposition presents as onset in childhood, familial tendency, and constitutional bias.

2. Key points of syndrome differentiation: A comprehensive analysis of the patient's constitution, medical history, and symptoms is required to determine the specific syndrome type.

General treatment direction: In TCM clinical practice, treatment of axillary osmidrosis often starts with regulating the functions of the liver, spleen, and kidneys, employing methods such as clearing heat and draining dampness, nourishing yin and clearing heat, strengthening the spleen and removing dampness, and using aromatic herbs to resolve turbidity, so as to harmonize qi and blood and restore normal sweat secretion.

Common Syndrome Types and Key Points of Differentiation

Damp-Heat Accumulation Syndrome

Main Manifestations: Strong underarm odor, excessive sweating, bitter taste in mouth, damp scrotum, red tongue with yellow greasy coating

Management Approach: Clear heat, resolve dampness, and dispel turbidity with aromatics.

Yin deficiency with internal heat pattern

Main Manifestations: Offensive odor accompanied by five-center heat, night sweats, dry mouth, red tongue with scant coating.

Management Approach: Nourish yin, clear heat, restrain sweating, and eliminate odor.

Hereditary Constitution Syndrome

Main Manifestations: Childhood onset, family genetic predisposition, and constitution bias.

Management Approach: Fortify the spleen and eliminate dampness, use aromatics to transform turbidity.

The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.

Physician's Clinical Insights

In outpatient settings, patients with axillary osmidrosis often present with increased sweating. Treatment focuses on regulating the spleen and stomach to improve the problem of excessive sweat secretion.

— Zhu Yongbing Traditional Chinese Medicine Practitioner

Reviewed by: Zhu Yongbing (Traditional Chinese Medicine Practitioner) | 2026-07-30 | Version 2

Body odor