Do you really need deodorant? Experts weigh in | CNN



CNN
 — 

Like brushing your teeth or washing your face, putting deodorant on every day might seem like one of those rituals crucial for basic hygiene.

But your decision is most likely based more on personal and cultural preferences than any potential medical necessity, dermatology experts say.

“People have strong preferences and sensitivities to smell. People, from the beginning of time, have used perfumes (or) colognes to mask odor,” said Dr. Nina Botto, an associate professor of dermatology at the University of California, San Francisco. “But it’s not like flossing your teeth, where there’s data that you’re actually going to live longer if you floss your teeth regularly.”

“We live in a society where body odor is not universally accepted, making deodorant a part of your daily hygiene routine,” said Dr. Joshua Zeichner, an associate professor of dermatology at Mount Sinai Hospital in New York City, via email. “There’s also a stigma surrounding wetness of the clothes because of sweat, which has pushed antiperspirants into daily skincare routines.”

Deodorants neutralize body odor, while antiperspirants reduce wetness on the skin, Zeichner added. Both are often offered in one product.

Despite the commonly accepted reasons why people wear deodorant, natural body odor isn’t necessarily considered unpleasant by everyone.

Ahead of his return from a military campaign, Napoleon is said to have written to his wife, Joséphine Bonaparte, that he would be home in three days and that she shouldn’t wash herself before then, said Tristram Wyatt, a senior research fellow in the department of biology at the University of Oxford, in “Smelling Your Way to Love,” an episode of the CNN podcast “Chasing Life With Dr. Sanjay Gupta.”

Like many people today, Wyatt added, Napoleon was an “enthusiast” of smells — both colognes and natural scents, or at least his wife’s.

One reason why someone might find a certain person’s natural scent more attractive than those of others is due to differing immune systems, Wyatt said, since we tend to be more attracted to people who are immunologically different.

There’s no right or wrong answer when it comes to your personal preferences, and what — if any — products you might use to mask body odor. With those preferences and other personal factors in mind, CNN asked dermatologists to address common reasons behind people’s choices and how to manage in either scenario.

Sweat has a purpose.

“We sweat to help control our body temperature,” Zeichner said. “However, in some cases we sweat beyond what is necessary. This is known as pathologic sweating, or hyperhidrosis. Sweat itself is odorless. However, bacteria on the skin break down the sweat, creating a foul smell.”

If you choose to use antiperspirant products for this reason, apply them in the evening, Zeichner said. “Since we make less sweat at night, they can more effectively form a plug within the sweat gland if you apply them before bed.”

But if you don’t sweat excessively, blocking sweat production with antiperspirant “is probably not a good idea,” said Dr. Julie Russak, a board-certified dermatologist and founder of Russak Dermatology Clinic in New York City. “(By) blocking it completely, you are risking paradoxical increase of sweat production in other areas.”

Some people prefer wearing deodorant to have a more pleasant smell or if they deal with certain skin issues, such as irritation under breasts or between abdominal skin folds, Russak said via email.

The odor of your sweat can be influenced by diet, too, Zeichner said. The sweat of people who eat large amounts of cruciferous vegetables — broccoli, kale and cauliflower, for example — can have a distinct, sulfurous smell.

“Gut health, health of the skin and health of the microbiome of the skin can all influence our body odor,” said Russak via email. “Some metabolic disorders produce a very particular odor in general (for example, ketoacidosis or uremia from diabetes). Healthy skin and a healthy body should not have malodor.”

If you’re considering forgoing deodorants or antiperspirants because of concerns about potentially harmful ingredients or rumors that wearing such products causes cancer, know that those claims haven’t been scientifically proven, these experts told CNN. Research on whether there’s a causal relationship between cancer and use of talcum powder products that don’t contain asbestos has also been inconclusive.

“Usage of inorganic ingredients like aluminum salts in cosmetics and personal care products has been a concern for producers and consumers,” said Dr. Amanda Doyle, a board-certified dermatologist who works with Russak at the Russak Dermatology Clinic. “Although aluminum is used to treat hyperhidrosis some worries have been raised about aluminum’s role in breast cancer, breast cysts and Alzheimer’s disease. The absorption of aluminum by the skin is not fully understood yet, but the carcinogenicity of aluminum has not been proved.”

Not wearing deodorant or antiperspirant products can have pros and cons depending on how you and others feel about your natural body odor.

“If you stop wearing deodorant or antiperspirant, you can develop a stronger odor over time,” Doyle said. “When you stop using (such products) and sweat more, this creates a breeding ground for bacterial and fungal overgrowth, which can cause odor to become stronger.”

Thoroughly bathing every day, however, is the most important way to avoid bad body odor, experts said. You should focus on bathing the face, under arm and genital areas — these tend to have more sweat than other parts of the body, which can facilitate overgrowth of microorganisms such as yeast and bacteria, Zeichner noted.

Having unusually bad body odor could indicate that you’re not cleansing your skin as you should, he added.

Other ways to reduce odor risk by preventing sweat and bacterial overgrowth include wearing loose-fitting, breathable, cotton clothing and using topical antibacterial washes such as benzoyl peroxide or prescription topical antibiotics such as clindamycin, Doyle said.

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How confusion about textured hairstyles can prevent some patients from getting necessary medical imaging | CNN



KFF Health News
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Sadé Lewis of Queens, New York, has suffered migraines since she was a kid, and as she started college, they got worse. A recent change in her insurance left the 27-year-old looking for a new neurologist. That’s when she found West 14 Street MedicalArts in New York.

MedicalArts recommended that she get an electroencephalogram (EEG) and an MRI to make sure her brain was functioning properly.

An EEG is a test to measure the electrical activity of the brain. It can find changes in brain activity that can help in diagnosing conditions including epilepsy, sleep disorders, and brain tumors. During the procedure, electrodes consisting of small metal discs with attached wires are pasted onto the scalp using adhesive, or attached to an electrode cap that you wear on your head.

A little over a week before her EEG, Lewis was given instructions that she didn’t remember getting before a previous EEG appointment.

To Lewis’ surprise, patients were told to remove all hair extensions, braids, cornrows, wigs, etc. Also, she was to wash her hair with a mild shampoo the night before the appointment and not use any conditioners, hair creams, sprays, oils, or styling gels.

“The first thing I literally did was text it to my best friend, and I was, like, this is kind of anti-Black,” Lewis said. “I just feel like it creates a bunch of confusion, and it alienates patients who obviously need these procedures done.”

The restrictions could discourage people with thick, curly, and textured hair from going forward with their care. People with more permanent styles like locs — a hairstyle in which hair strands are coiled, braided, twisted, or palm-rolled to create a rope-like appearance — might be barred from getting the test done.

Kinky or curly hair textures are typically more delicate and susceptible to damage. As a result, people with curlier hair textures often wear protective hairstyles, such as weaves, braids, and twists, which help maintain hair length and health by keeping the ends of the hair tucked away and minimizing manipulation.

After receiving the instructions, Lewis scoured the internet and social media channels to see if she could find more information on best practices. But she noticed that for people with thick and textured hair, there were few tips on best hairstyles for an EEG.

Lewis has thick, curly hair and believed that explicitly following the instructions on the preparation worksheet would make it harder, not easier, for the technician to reach her scalp. Lewis decided that her mini-twists — a protective style in which the hair is parted into small sections and twisted — would be the best way for her to show up to the appointment with clean and product-free hair that still allowed for easy access to her scalp.

Lewis felt comfortable with her plan and did not think about it again until she received a reminder email the day before her EEG and MRI appointment that restated the restrictive instructions and added a warning: Failure to comply would result in the appointment being rescheduled and a $50 same-day cancellation fee.

To avoid the penalty, Lewis emailed the facility with her concerns and attached photos.

“I got kind of worried, and I sent them pictures of my hair thinking that it would go well, and they would be, like, ‘Oh yeah, that’s fine. We see what you see,’” said Lewis.

Soon after, she received a call from the facility and was told she would not be able to get the procedure done with her hair in the twists. After the call, Lewis posted a TikTok video detailing the conversation. She expressed her frustration and felt that the person on the phone was “close-minded.”

“As a Black woman, that is so exclusionary for coarse and thick hair. To literally have no product in your hair and show up with it loose, you’re not even reaching my scalp with that,” Lewis said in her video.

The comments section on Lewis’ TikTok video is full of people sharing in her frustration and confusion or recounting similar experiences with EEG scheduling.

West 14 Street MedicalArts declined to comment for this article.

The New York medical center is not the only facility with similar EEG prep instructions. The Neurology Center, which has several locations in the Washington, D.C., area, provides EEG pretest instructions for patients reading, “Please remove any hair extensions or additions. Do not use hair treatment products such as hair spray, conditioners, or hair dressing, nor should you fix your hair in tight braids or corn rows.”

Marc Hanna, the neurophysiology supervisor at the center’s White Oak location in Silver Spring, Maryland, has more than 30 years of experience performing EEGs. He oversees 10-12 EEG technicians at the facility.

Hanna said the hair rules are meant to help a technician get an accurate reading from the test. “The electrodes need to sit flat on the scalp, and they need to be in precise spots on the scalp that are equally apart from each other,” Hanna said.

For people with thick and curly hair, this can be a challenge.

A 2020 article from Science News detailed a study that measured how much coarse, curly hair could interfere with measuring brain signals. A good EEG signal is considered to have less than 50 kilo-Ohms of impedance, but the researchers found unbraided, curly hair with standard electrodes yielded 615 kilo-Ohms.

Researchers are working to better capture brain waves of people with naturally thick and curly hair. Joy Jackson, a biomedical engineering major at the University of Miami, developed a clip-like device that can help electrodes better adhere to the scalp.

Experimentation with different braiding patterns and flexible electrode clips shaped like dragonfly wings, designed to push under the braids, has had promising results. A study, published by bioRxiv, found this method resulted in a reading well within the range for a reliable EEG measurement.

But more research has to be done before products like these are widely used by medical facilities.

Hanna said the facility where he works does not automatically ask patients to remove their protective styles because sometimes the technician can complete the test without them doing so.

“Each one of those cases are an individual case,” Hanna said. “So, at our facility, we don’t ask the patient to take all their braids out. We just ask them to come in. Sometimes, if one of the technicians are available when the patient is scheduling, they’ll just look at the hair and say, ‘OK, we can do it’ or ‘We don’t think we can do it.’ And we even might say, ‘We don’t think we can do it but come in and we’ll try.’”

In practice, Hanna said, it’s not common for hair to be an issue. But for patients whose hairstyle might make the test inaccurate, he said, it becomes a conversation between the doctor and the patient.

When Lewis arrived the following day for her MRI and EEG appointment, she was told her EEG had been canceled.

“It was just kind of baffling a little bit because, literally, as soon as I walk in, I saw about four different Black women who all had either twists, locs, braids, or something,” she said. “And on the call, the woman was saying if you come in and my hair is not loose, we’re going to charge you. And she did recommend to cancel my appointment. But I never approved that.”

After Lewis explained what happened during the phone call, she said, the receptionist was very apologetic and said the information Lewis was given was not true. Lewis said she spoke with one of the EEG technicians at the facility to confirm that her mini-twists would work for the test — and felt a sigh of relief when she saw the technician was also a Black woman.

“The technician, I think overall, they just made me feel safe,” Lewis said. “Because I felt like they could identify with me just from a cultural standpoint, a racial standpoint. So, it did make me feel a little bit more valid in my feelings.”

Lewis later returned to the facility to get the procedure done while still wearing mini-twists. This time, the process was seamless.

Her advice for other patients? “When you feel something, definitely speak out, ask questions.”

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