What a correct hygiene routine looks like - everyone needs to start here!
What A Correct Hygiene Routine Looks Like:
The first thing for EVERYONE who thinks they have TMAU to do is to confirm that there are no problems with their hygiene routine that they may not be aware of. Because TMAU is usually a devastating, lifelong situation, it is essential to definitively rule out all the reasonable alternatives before accepting that you really do have a TMAU like disorder. The main alternatives to TMAU are a mistaken belief that you have a malodor condition (‘Olfactory Reference Syndrome’, which I cover elsewhere) or a possible hygiene issue that you are not aware of. I am including a possible dental problem that you are not aware of in with the hygiene topic - and that must be ruled out as well. Even if it looks like you probably have TMAU, you MUST definitively rule out the alternatives rather than saying that ‘probably’ is good enough.
The younger someone is, the more likely it is that a hygiene issue is the real explanation for the malodor situation, rather than TMAU. Hygiene requirements DRAMATICALLY increase at puberty – and this is when someone with hygiene problems will stop being able to get away with it.
Let me go through what a normal, correct hygiene routine looks like: First, you need a shower every single day, or at least on every single day that you are going to be around other people. If you shower at night rather than in the morning the benefit of the shower will be reduced, and you now add in the complication of having to ensure that your bedding is being cleaned often enough. Anyone with this kind of condition needs to shower in the morning, rather than at the end of the night. The shower will be more beneficial this way, and the issue of the bedding (sheets, pillowcases, blankets, ect.) possibly contributing to the problem is removed.
For the shower itself, it should last a minimum of 10 minutes. I think a 15 minute shower should be fine. Taking 40+ minute showers is not going to help things and is not necessary. It does not take that long to remove sweat and bacteria from the skin. If a 15 minute shower is not enough, its unlikely that taking longer, or much longer showers is going to improve things. It is key that you have a handheld showerhead (with a hose) and not just a fixed showerhead. You need a handheld showerhead so that you can reach any area and direct a strong jet of water at it. A fixed showerhead above your head will NOT allow you to get the same kind of cleaning done.
It is key to understand that not all areas of the body are equally responsible for creating odors. The underarms are the primary odor creating area of the body, and they absolutely have to be cleaned with soap and water in the shower, every time you take a shower. The genital area is a source of odors and must be cleaned every time with soap and water as well. The scalp and feet are also possible sources of odor issues. The rest of the body needs to be cleaned with soap and water as well, but the rest of the body is less responsible for odor issues than the areas I just mentioned. If someone is not aware that the underarm area is the major area responsible for odors, then they may not be taking the time to clean it properly, or at all.
It is now common for people to not wash & shampoo their hair everyday – but the scalp can be a source of odor. If you think you have some kind of TMAU like malodor condition, you should wash and shampoo your hair/scalp everyday because this is a possible source of at least some part of the odor issue. I have a whole post on improving hygiene in the anal area as a possible source of odor issues, and that is mostly based on using the showerhead to clean that area out. See the blog post for the details on that.
It is also important to clean the feet in the shower. Spread your toes and use a jet of water to clean the top and bottom of the feet, and between the toes as well. It is essential to clean the genital area well, including with soap, because this is a significant potential source of odors. If you are male and uncircumcised then you have special hygiene obligations in this area. If you are not aware of this fact, then do a quick google search to get educated about this. One possible explanation for an odor issue would be having some kind of inhibition about having any contact with this area, and not cleaning it properly. If you are female, the area under the breasts needs to be kept clean and dry to prevent odor issues – so called ‘underboob’ sweat resulting from sweat occurring between smooth skin with no breathability.
The temperature of the water is important. You need some heat, since hot water always cleans much better than cold water. However, you must be careful to avoid having so much heat that you irritate the skin, which will create a breeding ground for bacteria and make the problem worse, in addition to damaging the skin and making it itch. So, you need to experiment a little to create some heat, WITHOUT making the water hot enough to irritate the skin, which again will create a breeding ground for bacteria, making the problem worse. Do not make the water painfully hot!
You need to realize that the skin in the underarm area is VERY delicate and so you need to make sure the water you use to clean it is not hot enough to irritate it. It is not fun to have itchy underarms because you irritated the skin, and again, this will create a breeding ground for bacteria and make the problem worse. You need to carefully adjust the water temperature for cleaning the underarms. What I do is to spray water on my underarms for just a few seconds at a time to avoid irritating them. So the water might be hot enough to irritate that area, but I only spray it for a few seconds and then take a break for a couple seconds before spraying it again, and I will do that several times.
Some people with this condition use things like loofahs to scrub themselves for a deeper clean. Personally, I think that hot (but not too hot) water and soap that is sprayed on your skin with a jet of water from a shower head will be enough to remove anything from your skin. If you still have problems after that, it probably means that hygiene measures are not going to fix it, not that you need to take 40+ minute showers and rub your skin raw. The things that are causing the malodor condition are being produced internally, and the bacteria you wash off the skin will quickly start multiplying again after your shower is finished.
If you want to try something like a loofah to scrub your skin clean you can, but be sure not to rub your skin raw. Just like with using water that is too hot in the shower, this will irritate the skin and create a breeding ground for bacteria, making the problem worse. You will also damage your skin and itch all day if you do this. While I personally prefer bar soap, many people report that a body wash gives a superior clean, so that is something to investigate. Since perfume/cologne always makes this condition worse, an unscented soap might be a good idea.
Something that most people don’t know is that it is important to use a towel to dry off after the shower, rather than air drying. The mechanical friction of the towel is actually a major part of getting clean. This is just like how using a rag to scrub pots and pans gets a much deeper clean than just using hot water alone, because of the mechanical friction of scrubbing something. Now, don’t use the towel to scrub your skin raw or anything, just use it in a normal fashion to get dry, rather than air drying your skin after a shower. I know from experience that you get cleaner this way, as opposed to if you air dry yourself.
When you are done with your shower and are dry you need a fresh change of clothes. Before putting on your shirt, use some deodorant on your underarms. Deodorant creates a pleasant smell to mask any unpleasant smells. Anti-perspirant uses some aluminum to block the pores in the skin to reduce the amount of sweat released. Deodorant is more important than anti-perspirant, which is only going to reduce sweating to a limited degree. Be aware that there is a chance the deodorant could interact with the odor issue and possibly make it worse, so try and establish if this is the case or not. If you have TMAU, than what you are hoping for with deodorant is some limited improvement, not a cure. A roll-on deodorant stick is probably going to be more powerful than a spray-on deodorant. The amount of time it takes the deodorant scent to fade away is one way of knowing how bad your underarm smell is. Be aware that the scent of a given deodorant will vary based on the temperature, and so can change with the seasons. It might smell differently in summer vs. winter.
There may be a certain percentage of people who think they have TMAU who simply don’t realize that in addition to a daily shower, they can’t wear the same clothes day after day without washing them. You MUST have a fresh t-shirt and underwear and socks every single day that you are going to be around other people. Since you think you have a malodor condition, you need to replace all your clothes with fresh ones every day. This means that pants and sweatshirts and things like that need to be replaced daily. When I refer to a ‘fresh’ piece of clothing, I mean that you have washed it properly after the last time you wore it.
Use a laundry machine with warm or hot water and detergent, and don’t do an extra quick cycle – do a normal length wash cycle to ensure things get clean. Do not leave the clothes in the washing machine beyond 24 hours at most to avoid a mildew smell building up in them. Use a clothes dryer to get the clothes completely dry, if you have access to a dryer. You don’t want to take the clothes out of the dryer in a damp state. If you do not have access to a laundry machine and are doing hand cleaning, ensure you are doing it in a way where there is no doubt that the clothes are getting completely clean. Ensure that the clothes are getting completely dry before putting them away. Do not skip wearing underwear, because this absorbs genital and anal odors.
It is my experience that while the underarms were the main culprit - ALL the areas of the body that could create an odor were creating amplified smells. This is why its so important to have a comprehensive hygiene routine, in addition to the goal of ruling out any kind of hygiene errors/deficiencies.
On the subject of clothes, you want to experiment with different types of clothing to either absorb odors, or to be breathable. Try to stick to natural fabrics like cotton and avoid polyester and other synthetic fabrics. It is widely observed by normal people that this makes a difference in odor control. You will need to experiment to see if wearing a breathable t-shirt is the way to go, or if an absorbent sweatshirt (that might make you sweat) works better.
Occasionally sniff the insides of your shoes to ensure they still smell reasonably fresh. If this is not the case, you can try and place baking soda overnight in the shoes, but if this doesn’t work and the shoes still smell bad, you probably want to replace them. Foot hygiene needs to be treated as its own separate category. Foot odor is a possible and realistic explanation for what manifests as an ‘all-over’ smell. There are many doctors who have some expertise in treating food odor. If there is any possibility that this is the issue, then be sure to rule it out. The way to smell your feet is not to smell the feet directly, but to smell the inside of your shoes – preferably after getting hot and sweaty so any scent will be amplified. Take off a shoe and sniff inside of it. There are options you can try yourself like different things to more deeply clean the feet and activated charcoal insoles to absorb odors. Trying different types of more breathable footwear (try wearing sandals) is something to try if you find some evidence of foot odor.
Dental hygiene has to be included here, because that is a possible source of what might appear to be a general TMAU like malodor situation. You must brush your teeth with toothpaste every morning, preferably with an electric toothbrush and you should floss your teeth as well.
It is vital that anyone who thinks they have TMAU visits a dentist. Tell the dentist you are concerned about an odor issue, so that they do a comprehensive dental examination to look for things like abscesses or cavities or trapped food particles that could explain this. The key point is that it is possible that a dental issue could lead not just to a breath issue, but could potentially manifest as an ‘all-over’ smell and resemble TMAU. Imagine this is the case but you skip the dental visit and instead go through your whole life thinking you have TMAU - that’s why you need to see a dentist!
I want to add that if you are female, you NEED to visit a gynecologist to rule out a possible infection in that area that is causing the odor issue. I talk in another video about trying to briefly wear ‘Depends’, or another brand of incontinence underwear to rule the anal and genital area in or out as a source of the problem, based on whether this causes any change in reactions. As about 80% of the population with TMAU like malodor conditions is female, being female does not mean that this is most likely a gyn issue - but it is a serious possibility that must be ruled out before concluding and accepting you really have TMAU.
Now, I think that anyone who thinks they have TMAU needs to push their hygiene routine to the limit, which is what I mean by a maxed-out hygiene routine. This ensures that at a minimum you are meeting the minimum standards of a decent hygiene routine, and if you have a mild case of TMAU, pushing your hygiene to the limit may significantly improve the problem. If you have a more serious case, this may still make a noticeable improvement. A maxed-out hygiene routine basically means following the above procedures very precisely, and it also means having better anal hygiene than just wiping with dry toilet paper. See the blog post where I discuss that topic in depth.
EDIT: make sure that you are washing and drying the towel you use to dry off after your shower before using it again. And make sure that you brush your teeth in the morning (its good to brush at night as well, but not as a substitute for brushing in the morning). Remember that flossing it important.
