What to know about chromhidrosis

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Chromhidrosis is a chronic condition that causes a person to have colorful sweat.

There are three types:

• Apocrine chromhidrosis: This affects areas that contain apocrine sweat glands, such as the torso, eyelids, scalp, ears, and areola — the darker area of skin around the nipple.
• Eccrine chromhidrosis: Because eccrine sweat glands are widely distributed, this can affect sweat in almost every area of the body.
• Pseudochromhidrosis: This results when dyes, chemicals, or pigment-producing bacteria mix with colorless eccrine sweat to form colored sweat.

Chromhidrosis can occur at nearly any age, but it usually becomes noticeable after puberty, when the apocrine glands begin secreting fluid.

The International Hyperhidrosis Society (IHS) note that information about this condition is scarce because it is so rare. There seems to be no association between chromhidrosis and sex, geographic location, season, or weather, though it may be more likely to develop in people of African descent.

Although the condition is chronic, the discoloration of sweat may decrease over time as the body produces less lipofuscin, a pigment that is likely responsible for the color changes.

People with chromhidrosis may have more lipofuscin, or lipofuscin that is more oxidized, than others.

Chromhidrosis is a harmless condition. However, stress or embarrassment about the coloration can lead to depression and anxiety.

The defining symptom of chromhidrosis is the production of colored sweat. The color may only affect sweat in certain areas or sweat all over the body. The color and the vividness of the shade can vary from person to person.

Some people experience a warm or prickly feeling caused by stress or physical activity before colored sweat appears.

Chromhidrosis can cause sweat to turn:

• black
• green
• blue
• yellow
• brown

Anyone who has chromhidrosis should speak with a healthcare provider if they start to experience symptoms of emotional distress, depression, or anxiety. These symptoms can include:

• a general feeling of hopelessness, worthlessness, helplessness, guilt or pessimism
• a persistent anxious, sad, or “empty” mood
• a decrease in energy or increase in fatigue
• weight loss
• a lack of interest in once enjoyable activities
• physical symptoms, such as a headache, that does not respond to treatment
• insomnia
• trouble concentrating, making decisions, or remembering
• a lack of appetite or overeating
• irritability
• thoughts of suicide or death

There are a few possible causes of chromhidrosis, depending on the type.

In a person with apocrine chromhidrosis, lipofuscin causes discoloration as part of the natural process of creating sweat.

Certain situations stimulate the apocrine glands and make this discoloration more likely to occur:

• friction against the skin
• hot showers or baths
• stimuli such as anxiety, sexual arousal, or pain

In people with eccrine chromhidrosis, the discoloration usually happens because the person has ingested:

• water-soluble dyes
• heavy metals, such as copper
• certain food colorings or flavorings
• certain medications, such as bisacodyl, a laxative, when it is coated in tartrazine, a yellow dye

Pseudochromhidrosis is more common, and it occurs when the skin comes into contact with:

• chemicals
• dyes
• pigment-producing bacteria

The IHS also point to other health issues that can cause sweat to change color:

• infection
• blood in the sweat
• extra bilirubin from the liver
• poisoning

It is a good idea to see a doctor about colored sweat. They can rule out more serious causes and recommend any necessary treatment.

The best treatment depends on the type of chromhidrosis:

Apocrine chromhidrosis

Treatment for this type of chromhidrosis either aims to reduce the amount of sweat or to induce the sweat and empty the glands. The latter approach can stop the sweat from happening for up to 3 days at a time.

Treatments may involve:

• applying a capsaicin cream once or twice a day, though this can cause a burning sensation
• applying topical aluminum chloride
• receiving Botox injections

However, authors of a review point out that current treatment options are limited and may not be very effective They emphasize the need for more research.

Eccrine chromhidrosis

Treatment for eccrine chromhidrosis tends to involve reducing or eliminating contact with the dye, chemical, or heavy metal responsible for the discoloration.

Pseudochromhidrosis

Pseudochromhidrosis treatment may involve using antimicrobial medications or stopping other medications and thus allowing the skin’s natural population of bacteria to rebalance.

To diagnose this issue, a doctor performs a physical examination and asks about when and where the colored sweat appears.

They may then run or request tests to rule out other causes of the discoloration.

Regular sweat is clear or slightly cloudy in color. If a person notices any coloration, they should consult a doctor.

If a person with chromhidrosis experiences any symptoms of emotional or psychological distress, they should let a healthcare provider know. Some people may benefit from therapy, counseling, medication for anxiety or depression, or a combination of these approaches.

Chromhidrosis is a rare chronic condition that causes sweat to turn black, blue, green, yellow, or brown.

The coloration may be barely noticeable and restricted to a few locations or more widespread.

Chromhidrosis is harmless, but it can cause embarrassment or distress that may lead to depression or anxiety.

If sweat changes color, contact a doctor, who may rule out other causes before diagnosing chromhidrosis. Anyone who has chromhidrosis and experiences any emotional distress should let a healthcare provider know.