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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.

Dandruff or pityriasis

Dandruff is a scalp condition that usually arises between the ages of 10 and 25. It may improve between the ages of 45 and 55 or may continue during old age.
Its cause is a result of an accelerated turnover of epidermal cells, which following an increase in migration speed, are unable to reach complete maturity before detaching. Whitish-yellow flakes (masses of corneum cells) form and detach, gathering in patches or often spreading evenly across the scalp.

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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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Androgenetic alopecia (pattern hair loss) or baldness

Androgenetic alopecia is the most common type of hair loss and affects the majority of white men, with varying degrees of seriousness. It is less frequent in other ethnic groups. Often it can be associated with a family history of baldness, but the absence of other affected family members does not exclude the diagnosis. The condition is characterized by progressive hair loss in the crown area, the front hairline and the temporal area.

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Seborrheic alopecia (seborrheic hair loss)

Seborrheic hair loss is a form of premature hair loss that generally afflicts men in their youth (onset between 20 and 30 years of age), mainly affecting the frontal region and the crown. The cause, as the name of the condition suggests, is related to an excess production of sebum that provokes or accelerates hair loss.

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Hair follicles and bulbs

A hair follicle is a formation of epidermal origin, anchored in the dermis and consisting of a hair and its sheath.
The formation of hair follicles occurs early. They begin to appear as early as the second month of gestation. These follicles will continue to form for the entire duration of the pregnancy. At birth, the baby will indeed have the entire supply of follicles with which it was genetically equipped and from this moment on, no others will form.

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