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.

Life cycle of hair

The life cycle of hair and its subsequent growth occur at a speed of 1-1.5 cm per month. Hair is a living element that follows a follicle cycle with an average duration of 2-6 years. In humans, unlike other mammals that are subject to a periodic change, this cyclic evolution is not synchronous (therefore each hair is independent from the others).

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Hair loss (telogen defluvium)

With the term Telogen Defluvium we mean a modest, not excessive, loss of hair in the telogen phase, but which tends to often be irreversible, with the precise characteristics of hair in decay or involution. The hair that falls out is usually short and fine, with bulbs that are undeveloped and reduced in size.

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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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Female hair loss

Female hair loss is a common form of non-scarring hair loss, characterized by the progressive loss of hair in the forehead and crown regions, resulting in visible thinning. Unlike male hair loss, female hair loss in the affected areas is usually incomplete and the occipital area is generally spared.

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Grey hair

In the trichological field, with the passing of age hair whitening is seen to follow the greying process of the hair on the scalp (called grey hair). Hair becomes grey (white) following a natural biological aging process of the melanocytes, which are the cells tasked with coloring hair.
In the majority of people, the first grey hairs appear around 35/40 years of age in women and around 30/35 in men.

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Scalp pain

Scalp pain and irritation (or trichodynia) are pathological conditions that affect both women (in a greater percentage) and men (in a lower percentage). The pain felt on the scalp, spontaneous or caused by treatment, and in particular around the roots of the hair, may be more or less intense, alternating at times between periods of disappearance, associated with burning, tingling or itching.

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