Colorful Sweat?

Chromhidrosis is a sweating disorder characterized by colorful sweat. Sweat may be yellow, green, blue, brown, or black. Lipofuscin, a pigment produced in the sweat glands, is the culprit for colored sweat. Patients with chromhidrosis may have higher concentrations of lipofuscin and/or they may have lipofuscin that is more oxidized that normal.

Unlike hyperhidrosis, chromhidrosis typically affects the apocrine sweat glands (hyperhidrosis affects the eccrine sweat glands). Eccrine sweat glands and sebaceous glands may be involved in chromhidrosis, but that is much less common. Also unlike hyperhidrosis, there does not appear to be a hereditary/family history component to chromhidrosis.

The face, underarms, and areolas are the most common areas where chromhidrosis is observed. Epidemiological data on chromhidrosis is scant, but we know it is quite rare. There does not appear to be any link between chromhidrosis and gender or geography, but people from African descent are more likely to have it. Many patients with chromhidrosis have a mild discoloration, and it goes unnoticed. Others have a very noticeable discoloration to the sweat, and those patients often report a feeling of warmth or a tingly/prickly sensation before colored sweat appears.

Pseudochromhidrosis is colorful sweat caused when the sweat glands come in contact with dyes, chemicals, or bacteria that can produce pigments. Infections, hyperbilirubinemia (too much bilirubin), and/or poisoning can also cause a change in the color of sweat.

Over-the-counter topical capsaicin cream 0.025% applied twice daily is the standard of care for the management of chromhidrosis. Oral anticholinergics (such as glycopyrrolate) and Botox injections can be considered for patients who are not managed with capsaicin.