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Scientific Area

Hyperhidrosis

CATEGORIES SCIENTIFIC AREA

Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome.

Excess sweat production on the entire surface of the body or just in some areas (especially the scalp, palms of the hands, soles of the feet) is called hyperhidrosis.

Some of the causes that may lead to temporary hyperhidrosis are physical hyperactivity, fevers, saunas, vomiting and dysentery. Causes that may instead lead to a repeated state of hyperhidrosis are hyperthyroidism, hypoglycemia and alcoholism.
Psycho-affective causes may lead to constant hyperhidrosis, particularly in young people.

Hyperhidrosis of the scalp is often confused with seborrhea but certain elements exist that differentiate the two different scalp conditions: those who suffer from hyperhidrosis have off-white, only slightly red, wet, dull skin with dry hair tips and the skin of their face is neither greasy nor oily.

Eccrine sweat glands cause hyperhidrosis. These are located over the entire body, especially on the scalp, face, palms of the hands, soles of the feet, bikini area and armpits. Sweat glands have a tube-like structure, with the base located in the deeper dermis, coiled upon its own structure. These glands exit onto the skin in correspondence with an epidermic crest. These vascularized, innervated glands are regulated by the autonomic nervous system (cholinergic fibers of the sympathetic nervous system). The eccrine sweat glands produce sweat (through merocrine secretions), composed 98-99% of water, 0.8-1% of minerals and the remainder of organic substances such as urea, lactic acid, uric acid, etc. When sweat mixes on the surface with everything else, it determined the formation of the hydro-lipid-acidic film which makes it necessary to wash one’s hair regularly (3/4 times a week) with a delicate, frequent-use, non-aggressive shampoo, so as to cleanse without irritation.

Hyperhidrosis appears when there is an excessive presence of water on the scalp. This increase in water in the composition of the hydrolipid film, the skin’s first defence from the external environment, leads to an increase in pH towards alkaline values with the loss of bacteriostatic power and scalp sensitivity. Hyperhidrosis nevertheless has internal causes that are difficult to overcome and eliminate. The proper composition of the hydrolipid film must be reset so as to rebalance the pH and consequently the function of the skin as a barrier.

Among the causes of hyperhidrosis we note:

1) hyperemia: excessive blood circulation leads to emotional hyperhidrosis;

2) lymphatic circulation: a slowing of the lymphatic circulation leads to a build-up of lymph at the subcutaneous level with liquid stasis and perspiration;

3) menopause: hormonal imbalances that occur cause cutaneous vasodilation accompanied by excess sweating.

Hyperhidrosis is a complex phenomenon with effects not only at the level of the scalp but also of the hair, which often appears wet.

Sebaceous glands

The sebaceous glands are glands that secrete sebum, an oily, acidic substance with a pH of 3.5. They are connected laterally to the hair follicle. Sebaceous glands are found with a density of approximately 100/cm2 throughout all areas of the skin. In the human body, they are located across the entire surface of the skin, except for the palms of the hands and the soles of the feet.

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Cuneiform hair or dwarf hair

This is very short hair, between 1 cm and a maximum of 2 cm in length, which usually has insufficient pigmentation. This hair has a base structure that is quite large, almost like normal hair. It then tends to get smaller towards the end, thus taking on the form of a very pointed cone.
This hair has a strong tendency to fall out.

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Premature hair loss

Recent studies have demonstrated that around one in five young men tend to lose their hair prematurely over time.
This problem does not affect only young men but also young women.

In the majority of cases, it is androgenetic alopecia (pattern hair loss) and therefore is hereditary/genetic. However, it is important to remember that often factors of psychological origin like performance anxiety, trauma and emotional stress take over, thereby becoming a source and cause of hair loss from stress.

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Thin hair

Genetic factors influence and determine the size of the diameter in hair.
Its volume varies from person to person. This is why some individuals are born with thin hair, while others are born with thick hair.

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Scalp psoriasis

La psoriasi è una frequente dermatosi cronica eritemo-squamosa con squama tipica (psoriasica), circoscritta o diffusa.
La psoriasi è un problema del cuoio capelluto non annoverata tra le cause che comportano la caduta dei capelli.

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