Parent series: Why is my kid so obsessed with their smell?

Is your teen overly concerned about their smell? Is tis Olfactory Reference Syndrome (OFS)?

Is your teen is overly concerned about is body odor ? Does he asks you often to check whether his body is smelling or not? Does he asks you to not forget to buy cologne otherwise he wouldn’t be able to go out? Does he asks you to open the window so nobody can smell his body odor?

Olfactory Reference Syndrome (OFS) often develops in late adolescence, and often goes untreated. Dealing with OFS is a precursor for developing other serious issues such as social phobia or agoraphobia, substance use, and increased suicide risk.

How can you distinguish normal concern about body odors from OFS?

OFS is under the umbrella of OCD, and it has a similar presentation. As your teen gets more distressed by his thought about having an odor that is perceived by others, he will develop compulsions or avoidance behaviors to alleviate the distressing thought/belie/sensations. Your teen may indicate that his body odor comes from the mouth, genitals, armpits, to name a few body areas; or he may describe other types of odors such as detergent, garbage, etc.

What to look for?
Compulsive behaviors to look for are excessive showering or washing, constant checking of the source of the smell, excessive use of perfumes/deodorants or mouthwash/gum, constant reassurance seeking about his smell, and requests for multiple doctor visits related to the offending odor. Your teen may also ask to go to the doctor and request different medical test to prove that his body smells bad, even though the doctors and others around him don’t smell the body odor he’s referring to.

Avoidance behaviors to look for are avoidance of school, sports, gatherings with others, and any situation or location that their feared body odor could be detected.

If your teen becomes too distressed by the perceived odor or the compulsive or avoidance behaviors interfere with his daily life at school, friendships, and at home, and this struggle last for over a month,, it is necessary to seek professional help from a qualified therapist. While many CBT therapies have shown good effectiveness at treating OFS, the most effective treatment is Exposure and Response Prevention.

What does ERP look like?

Exposure and Response Prevention (ERP) is a behavioral treatment with two main components. First, triggering the offending or distressing condition, in this case a feared odor. Second, not engaging in compulsions or safety behaviors to lessen the discomfort of the feared condition. In the case of OFS this could look like having your child sit in a crowded place while not wearing any deodorant or fragrances.

What else can you do?
It is important to try not to reinforce the belief by allowing excessive cleaning or checking behaviors. If they constantly seek reassurance, put a limit on the number of times you will respond to this question. Make a specific plan for hygiene that includes how long they can spend washing and the number of products they can use. You may consider making pre-portioned bath kits to help stick with this plan. Most importantly, don’t let them avoid their normal activities out of fear that people will find them stinky.

To sum up, here are the basic Do’s and Don’ts

● Do let your child know you will tell them if they actually are stinky!
● Don’t reassure them multiple times about their scents.
● Do help them make an appropriate hygiene plan.
● Don’t accommodate excessive washing and use of products.
● Do encourage them to continue going places even if they feel they might become stinky, rather than allow them to avoid.
● Do seek professional help if the problems become too persistent.