What’s that smell Part 3 Should we use Persimmon soap?
Many of my articles start when a patient catches me off guard with a question. As a dermatologist, I learn new things every day. The internet and social media really keep me on my toes because patients are learning new things every day online that may not be a hot topic for dermatologic education. Here’s the question that started off this series of articles.
“I’m worried about old age smell and wonder if I should be using persimmon soap?” Mind you, this question came from a very well educated and well-groomed woman. I encouraged her… you smell fine! But in the back of my head, I wondered, where did she come up with this crazy idea? Turns out she was on to something, and I STILL have A LOT to learn.
So, I spent some time re-educating myself on the mechanism and science of body odor and her question in particular. While I admittedly started out with Google, I did a deep dive into research on body odor, old age smell and persimmon soap.
If you missed the first two articles in this series, they are linked below. You may want to read them first to get some background information.
Turns out scientists have actually analyzed sweat and our secretions and smell. Those studies showed that there are a number of chemicals in our secretions that increase with advancing age.
According to the article, Human Body Malodor and Deodorants: The Present and the Future by Park et al. “Expressions such as “old lady smell,” “old man smell,” or “old person smell are used as idioms to characteristically describe the relationship between odor and age; such idioms suggest that unpleasant body odor increases with increasing age and that the change in odor in the elderly might be related to the decrease in androgen production . Some volatile compounds, such as dimethylsulfone, benzothiazole, nonanal, and nonenal, are strongly associated with odor in the elderly. Aldehyde 2-nonenals, such as cis-2-nonenal and trans-2-nonenal, which are produced via lipid peroxidation, have unpleasant greasy and grassy odors, and volatile compounds, such as dimethylsulfone, benzothiazole, nonanal, and aldehyde 2-nonenal, increase with age, particularly in those aged over 40 years.”
Lots of big words, but the buzz and key word on the internet are the 2-nonenals, trans-2-nonenal to be the most scientifically accurate. This is produced when an Omega-7 fatty acid called 9-hexadecenoic acid in sebum is oxidized through a chemical reaction using lipid peroxides. Studies showed levels of these compounds increase starting in the 40s.
Now, come on, 40 is not old! So why is this a problem of the elderly and not noticed earlier?
Lack of antioxidants. As we age, we have less antioxidants on our skin that can avoid the oxidation process.
Lack of cleansing. In my previous article I discussed the difficulties that elderly patients have with cleansing thoroughly and properly. Although I could not find any scientific study showing this, internet reading suggested that oils may not go away with gently cleansing.
Oils in clothing. Oils may also linger on clothing. Elderly are often unable to change and launder their clothes as much as younger people.
One laboratory study showed trans-2-nonenal may also negatively affect the health of the skin by reducing thickness of the skin and the health of our main skin cells called keratinocytes. Since these studies were in the laboratory only, I am not sure about any human evidence of the true implication on 2-nonenal on skin health and aging.
It is interesting that 2-nonenal tends to be more concentrated in sebum produced from sebaceous glands. This is different than the traditional body odor we discussed in our prior article that comes from our apocrine glands.
Sebaceous or oil glands are much more widespread than our apocrine body odor producing glands. Sebaceous glands and 2-nonenal are more prominent in our oily areas with more abundant sebaceous glands like our face and scalp as well as chest and back.
So, what about the persimmon soap my patient asked me about?
Tannins are a group of plant chemicals called polyphenols that have been shown to bind and neutralize 2-nonenal. Tannins are natural compounds in plants like PERSIMMON, green tea and witch hazel. Interesting. I told you she was smart. Tannins also have natural antibacterial properties. However, the antibacterial activity is mild compared to Hibiclens which I often recommend.
So, that led me do a little more research about what I could recommend patients wipe off with to neutralize 2-nonenal, kill bacteria and not irritate the skin.
TUCKS PADS. Most women know about these pads because they are often recommended post-partum. Their active ingredient? Witch hazel, a tannin. While there are many persimmon soaps and other products containing green tea and witch hazel on the market, Tucks pads have a proven record for use even in sensitive areas. These premedicated pads could be an easy choice for those who find bathing difficult. Tucks pads are small and inexpensive but it may take multiple to cover large areas well.
I also found an article that recommended other tannin containing products and found Thayers witch hazel toner to be a good and affordable option, but I have not tried it myself. Interestingly, they also have a mist that could be misted on hard to reach areas.
Of course, the persimmon soap is a lovely idea as well if one is able to bathe, but in my experience many elderly patients have difficulty with daily bathing. It seems the most popular brand is Mirai after being popularized on Shark Tank. They have both a bar soap and a liquid wash and shampoo. I’m going to order them on Amazon and check them out, but they are quite expensive around $20. Washing with a gentle cleanser like Cetaphil or Cerave is generally fine for most people. I prefer the Cetaphil Bar Soap in the shower myself.
The most important thing for reducing odor is personal care more than a magical product.
Wash face and neck and folds at least once a day.
Wash body every other day minimum.
Wash hair at least twice a week.
Change clothes and undergarments daily.
Wash outer clothes after more than one wearing. Underwear should not be reworn.
Wash towels and bedsheets once a week.
We’d love to know what products you have tried and love. Share with us on social media!
Links for products I mentioned
https://miraiclinical.com/en-int
https://www.thayers.com/shop-all/toner-mists/unscented-facial-toner-mist/3-oz
