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Pain and nerve irritation of the scalp (TRICODINIA) are skin manifestations that affect people of both sexes, although the majority of cases see women suffer from them frequently.

Pain canò be spontaneous or caused by chemical treatments unsuitable for the skin type. È felt on the scalp at the root of the hair.

Può be moreù or less intense, alternating with periods of disappearance, associated with burning, tingling or itching.

Difficult to determine the cause, it very often increases when touching the hair or combing, and trichodynia is often associated with hair loss.

In the long term, there are unequivocal correlations between skin pain and both acute and chronic hair loss, between telogen effluvium and trichodynia, and between seborrhoeic alopecia and the constant sensation of pain or irritation on the scalp.

There is a great correlation between the emotional component and trichodynia: nervousness, stress and anxiety are often found associated with the appearance of pain and itching of the scalp with subsequent possible hair loss.

Other pain triggers are hyperseborrhoea, which leads to seborrhoeic dermatitis, inflammation and skin irritation, and oily dandruff, which irritates the scalp by deteriorating follicular activity.

Scalp pain canò occur in conjunction with scalp folliculitis: a form of acne that affects the skin of the hair, resulting in erythematous reactions, pain, itchy skin, with the appearance of furuncles and pustules.

During the inflammatory process, the erector muscles of the hair forced into abnormal positions for a long time can cause pain. The erector muscles and hair follicles can thusì inflammation leading to a deep skin inflammatory process.

Another cause of trichodynia canò be the neuro-muscular inflammation of the skin hypersensitive to the tendency to grind one's teeth especially at night (bruxism), resulting in the contraction of the temporomandibular musculature, which over time involves the cranial nerves causing headaches and painful skin sensitivity.

Trichodynia should be treated with trichological paths that aim to soothe and calm the overexcitation of the surface nerve endings. Attenuating the surface tension results in a cascade relaxation of the deep neuro-muscular tensions with a beneficial psycho-physical rebalancing.

Lotions and shampoos must be used to cleanse the skin of any impurities or bacteria that cause inflammation, to soothe and calm any irritation and overexcitation of the nerve endings, and consequently calm the pain.

Once the sensation of pain has subsided è It is advisable to use remedies against hair loss to stimulate bulb activity and regenerate the dermal structures supporting the bulb itself.

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Dandruff is a scalp problem that can occur between the ages of 10 and 25. It may improve between the ages of 45 and 55 or may persist throughout old age.

It is caused by an accelerated turnover of epidermal cells that, due to the increased rate of production, fail to reach complete maturation before detaching. White-greyish scales (clusters of horny cells) are formed, localised in patches or more often distributed diffusely over the scalp. They accumulate in abundance and as they detach they are visible along the hair shafts and on clothing, creating considerable aesthetic discomfort.

The size of the scales varies from subject to subject and they usually occur at the temples, forehead and ears. The disorder is almost always subject to seasonality and manifests itself with greater intensity in the cold seasons, then subsides during the summer.

The causes of dandruff are still not entirely clear.

Some studies hypothesise a hormonal influence, in particular male hormones (androgens), which are also present to a lesser extent in women, and others believe that the digestive system, in particular the liver, is responsible. Factors related to nutrition, fat metabolism and psychological or pharmacological problems.

All people can suffer from dandruff at some particular time in their lives.

Scientifically proven is the presence in massive quantities on the skin and in the hair of dandruff sufferers of Pityrosporum ovale, Malassezia Furfur and Streptococcus, i.e. fungi and bacteria.

It is not yet known whether it is fungi and bacteria that are responsible for dandruff or whether a scalp rich in dandruff provides a favourable breeding ground for these microorganisms.

Dandruff may be associated with other scalp problems, such as seborrhoea, giving rise to a variety of nuances of the problem: the most frequently encountered is seborrhoeic dermatitis.

Two different types of dandruff can be distinguished:

1. Dry or simple dandruffoften caused by a mild dermatitis in which the scalp is covered with very fine, easily detachable, small scales that dust clothes, sometimes with the presence of itching.

1. An oily dandruff in which the scalp is covered with large, thick, greasy, yellowish scales that adhere to an often irritated, reddened and oozing scalp, with the presence of itching, a peculiar rancid smell and hair loss. It is very unsightly. This type of dandruff is also present in people suffering from contact eczema or seborrhoeic dermatitis.

Today, fortunately, there are many treatments to help the dandruff problem: mud baths, peelings, shampoos and/or lotions. They may contain germicidal substances to combat microorganisms, in combination with keratolytic substances to eliminate dead cells and limit subsequent desquamation, slowing down the hyperproduction of scales.

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Psoriasis is defined as a growth abnormality of the epidermis caused by a disorder of keratinocyte activity.

Counted among the Auto-Immune problems, it presents with inflamed-reddened areas covered with white-greyish scales

Psoriasis is a scalp problem that does not usually lead to hair loss because it does not involve the follicles

Tends to be often confused with seborrhoeic dermatitis due to a number of common manifestations including irritation, skin reddening and flaking with horny scales (superficial layer of the skin), but is characterised by little or no sebum and intense dehydration of the skin due to inflammation.

The causes of psoriasis are not yet well known. It has been pointed out that members of the same family can often manifest it at particular times in their lives, thus denoting a hereditary component.

It has a chronic relapsing course: it alternates between periods of acute manifestation and periods of remission or even disappearance.

Triggers can be:

• Trauma: accidents, fractures, surgery, shock
• Corticosteroids: the use of cortisone drugs canШ trigger the psorisic manifestation
• Intense and prolonged stress
• Medications: beta blockers, lithium, antimalarials

It is counted among the psycho-somatic dermatological diseases, i.e. those that translate psychological discomforts onto the body.

Itching of the scalp is not always present.

When it occurs, it is mild, except in severe cases when it can turn into an intense sensation of pain in the hair.

It can occur at any age and has the same incidence in both men and women.

The horny plaques or dandruff-like scales can be very varied in both thickness and extent and come off easily.

Underneath, the skin is inflamed and bright red.

Psoriasis manifests itself in a more acute form during the winter period, probably due to the cold weather attacking the skin.

During the summer period, it tends to recede due to both sun exposure, which favours the metabolic transformation of vitamin D, and the climate-related improvement in mood and an increase in serotonin (happiness hormone) levels.

The typical signs of scalp psoriasis are reddish patches covered by compact accumulations of silvery-white scales. In the more severe forms, these manifestations extend to the entire scalp ('cap' or 'helmet' psoriasis) and only rarely reach and go beyond the insertion margin of the hair.

Psoriasis rarely causes hair loss and hair loss, as the hair bulb and hair matrix are located deeper in the skin and are not affected by the problem, which affects the superficial layer of the scalp.

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Seborrhoeic dermatitis (or Seborrhoeic Eczema) is a fairly common scalp problem, characterised by the presence of yellowish, greasy scales on the skin. It is associated with erythema, small crusty formations, intense itching and sometimes a burning sensation and pain in the affected areas.

The causes are not yet clear, but triggering factors may be:

• Environmental (sweat, climate, clothing)
• Genetics
• Vitamin and zinc deficiency
• Psychological (stress, anxiety)
• Use of drugs (corticosteroids)
• Hormonal
• Infectious (yeasts)

Seborrhoeic dermatitis occurs when the chemical composition of sebum and sweat, also due to the influence of bacteria that like to reside on this type of substrate, produces an inflammation of the epidermis and dermis.

It is a real skin disease that affects men more than women and can occur between the ages of 18 and 40.

In seborrhoeic dermatitis, oily scales (dandruff) are shed not only from the scalp, but also from other areas rich in sebaceous glands such as the eyebrows, the skin areas on the sides of the nose, the skin areas behind the ears, the axillary area and finally also the groin area.

Many men and women since puberty present oily, greasy, shiny and thickened skin with the follicular orifices more evident especially at the level of the grooves of the nose, forehead, chest, scalp (where we find the so-called oily dandruff).

Seborrhoeic dermatitis often appears in these individuals at some point in their lives. It is characterised by pinkish, pinkish-yellowish, or dark red erythematous patches, covered with small to medium-sized, thick, greasy scales, sometimes forming crusty, serous agglomerations.

Seborrhoeic dermatitis is often localised only to the scalp and its margins. On the scalp, a reddish section called the 'seborrhoeic cord or crown' emerges at forehead level.

Recognised contributory factors are bacterial, fungal (Pityrosporum ovale, Malassezia, Staphylococcus), infectious, mechanical, irritative, psychosomatic and sebaceous dysfunction (hypothetically of hereditary origin).

Seborrhoeic dermatitis, like psoriasis, has a variable course, with phases of exacerbation of the problem and phases of apparent remission. It generally tends to worsen at seasonal changes or during periods of increased stress.

With cosmetic treatment, the aim is to control the evolution of the problem, but never to 'cure' it, or at least to date it seems that no one has ever been definitively cured of these problems.

The correct method of cosmetic treatment for seborrhoeic dermatitis involves mud baths, lotions and peelings in combination with specific sebum-balancing cleansing.

It is very important to keep the skin clean and oxygenated to avoid the inflammatory progression that often causes Effluvium Seborrhoeicum (hair loss) and bacterial proliferation that could trigger complicated infections to be treated.

People with seborrhoeic dermatitis, as well as people with psoriasis, confirm that dermatological treatment with the use of drugs, lotions, creams, medicated shampoos improves the problems for the period of use, but since continuous use is not recommended, as soon as they stop treatment the problem manifests itself again, often in an even more intense form.

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Hyperhidrosis is defined as excessive sweat production over the entire body surface or only in certain areas (scalp, palms of the hands, soles of the feet). The skin is constantly damp and cold. The scalp, due to the presence of hair, may on the contrary be warm

We must distinguish temporary hyperhidrosis due to physical hyperactivity, febrile states, sauna, vomiting or dysentery, from chronic hyperhidrosis due to particular conditions and diseases of internal organs such as:

• hyperthyroidism,
• hypoglycaemia
• alcoholism
• psychological conditions of anxiety, fear, shyness, insecurity.

Other causes of hyperhidrosis include:

• hyperemia: overheating of the body that accelerates blood circulation and increases perspiration. It may depend on climatic, emotional or pharmacological conditions;
• the lymphatic circulation: a slowing of the lymphatic circulation leads to an accumulation of lymph at the subcutaneous level with stagnation and transpiration of liquids;
• the menopause: the hormonal imbalances that occur also cause skin vasodilation accompanied by hypersweating.

This is also evident in particularly psychologically sensitive people who suffer from shyness, fear, uncertainty.

People who feel inadequate in every situation and live their working, social and private lives in a condition of intense discomfort and psycho-emotional tension.

Very often hyperhidrosis of the scalp is confused with seborrhoea but there are elements that differentiate the two scalp anomalies:

• Hyperhidrosis sufferers have skin with a whitish appearance, little or no redness, sweaty, not shiny,
• hair looks dull and limp with dry ends,
• the skin on the face is neither oily nor greasy.

Cause of hyperhidrosis are the eccrine sweat glands, located all over the body, especially on the scalp as well as on the face, palms of the hands, soles of the feet, inguinal region and submaxillary region.

The sweat glands have a tubular structure, with the basal part localised at the level of the deep dermis and hypodermis, gathered like a ball on itself.

These glands flow on the epidermal surface at an epidermal ridge, are highly vascularised and innervated, and are regulated by the autonomic nervous system.

The product of the sweat glands is sweat, 98-99% of which consists of water, 0.8-1% of mineral salts and the rest of organic substances such as urea, lactic acid, uric acid, ammonia, etc. Sweat, combining on the surface with sebum, determines the formation of the ido-acid-lipid film.

The increase of the sudorific component in the composition of the hydrolipidic film leads to an increase of the pH towards alkaline values with loss of bacteriostatic power and sensitisation of the scalp, which is why it is essential to cleanse hyperhidrotic skin frequently and with shampoos with an acid pH (4.5 - 5.5) for frequent use.

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SEASONAL HAIR LOSS

SEASONAL EFFLUVIUM

The term 'Seasonal Hair Loss' refers to increased hair loss during the spring period (late February to May) and the autumn period (September to November). Both sexes are equally affected.

The causes leading to seasonal hair loss have not yet been fully elucidated, but hypotheses are being made:

• Some scholars recognise a genetic inheritance connected with the seasonal process of coat shedding characteristic of mammals;
• Other scholars, on the other hand, believe that it is due to the variation in the ratio of hours of light to hours of darkness, which influence hormonal balance;
• Other trichologists, finally, give a more 'social' explanation of the phenomenon, linking increased hair loss to the return to the polluted city life after the summer holiday period, characterised by stress, return to work, hectic pace of life, worries.

Considering that any aggression on the scalp generally results in hair loss after two to three months, as far as autumn hair loss is concerned, it is believed that the aggressiveness of the summer sun's rays can cause stress on the hair bulbs, as UV rays accumulate free radicals that accelerate the hair bulbs' entry into telogen, inducing an effluvium that is sometimes very worrying.

For spring hair loss, on the other hand, it is thought that the cold of winter causes a vasoconstriction of the scalp, slowing down the activity of the hair bulbs, resulting in a more or less substantial amount of hair entering telogen, with consequent hair loss in the time span from February to May.

Regardless of the cause, an increase in seasonal hair loss is considered a physiological phenomenon of natural 'replacement'.

STRESS-INDUCED HAIR LOSS

ACUTE OR CHRONIC EFFLUVIUM

There is plenty of scientific evidence that stress causes hair loss. Many people in periods of prolonged stress or two to three months after particularly critical moments, experience more or less intense hair loss.

Psychogenic Alopecia (always understood as a fall) is a phenomenon of psychosomatic origin caused by stress and nervous tension.

Studies have shown that a significant and repeated load of stress induces both the hypothalamus and the pituitary gland (the hypothalamus-pituitary axis connects the nervous system to the endocrine system) to release corticotropic hormones (Cortisol) that enter the circulation reaching the cells deputed to hair growth, causing dermal inflammation, weakening and hair loss.

Every stress or stressful event, whether endogenous (internal) or exogenous (external) in nature, leads to both a psychological and physical reaction, which often manifests itself in hair loss.

Stress Alopecia in Women, Effluvium in acute or chronic telogen, is manifested by thinning of the hair throughout the scalp and especially in the central area connecting the frontal hairline to the top of the head. (Digestive and Nervous Incidence)

Stress Alopecia in MenAlso in this case Telogenic Effluvium, in addition to thinning affecting the entire scalp, is characterised by hair receding at a rapid rate. In this case there will be an overlapping of both Effluvium Telogen and Defluvium Telogen (Androgenetic Alopecia).

The symptoms present in Stress Effluvium are:

• hair loss
• sebaceous hypersecretion
• seborrheic dermatitis
• itching all over the scalp
• deep scalp tension or skin pain.

Obviously, the first strategy to use in such cases is to remove and eliminate the causes of stress, which is sometimes impossible.

Modern life almost constantly brings us stressful situations to deal with and some of them last for a long time.

Let us remember that hair loss is not a disease, but a symptom of a psycho-organic system that no longer works in harmony.

PREMATURE HAIR LOSS

Recent studies have shown that approximately one in five children tends to lose their hair prematurely.  This problem does not only affect boys, but also girls.

In the majority of cases, in males, it is androgenetic alopecia (Defluvium), thus genetic-inherited, progressive and scarring.

It is necessary to bear in mind that factors of psychological origin, such as performance anxiety, traumas and emotional tensions, are the source and cause of Stress Alopecia.

Boys are affected much more (65%) than girls (35%).

Nowadays, the number of girls at pubertal or post-pubertal age who are afflicted by hair loss is considerably and steadily increasing.

Among the causes leading to hair loss in girls could be thehe 'bad' sleep, incorrect nutrition (very restrictive or unvarying diets) cigarette smoking, use and abuse of alcohol, drugs and medication, anxiogenic-depressive states.

Hair loss often manifests itself in excessive sebum production and thinning hair, which becomes thinner and more fragile. They eventually fall out and do not grow back.

Hair loss has serious psychological consequences in both adults and young people.

Thinning, receding hairline, miniaturisation of the hair shafts and a decrease in the number of hairs cause a sense of shame and inadequacy, leading young people to isolate themselves.

Many children end up not attending school precisely to avoid contact with their peers.

Furthermore, it is clinically proven that hair loss causes a sense of inadequacy that seriously impairs an adolescent's psychological development.

In addition to a problem that is initially only aesthetic, there is a deep psychological crisis that often results in severe depression; a young person in that situation feels uncomfortable because of concern for the judgement of others.

The mirror becomes an enemy that, paradoxically, one can no longer do without because it allows one to control the progress of thinning or receding hairline, generating a chronic state of anxiety and obsessive compulsive disorder.

Guys with such a problem try to 'fix their hair' so that the receding hairline is noticed as little as possible.

All this leads young people to a reduction in their self-esteem and confidence and to losing sight of their goals, leading them to drop out of studies or work, and also contributing to the loss of friendships and love relationships.

The best weapon always remains prevention.

In fact, it is necessary to solve the problem at the root, before it manifests itself irreversibly, through the application of trichological treatments and targeted regenerating paths, which guarantee the restoration of a good scalp condition, regulating sebum secretion, stimulating the metabolisms of the reproductive cells and at the same time keeping the skin detoxified and oxygenated.

BALDNESS - ANDROGENETIC ALOPECIA

ANDROGENETIC DEFLUVIUM (AGA)

It is the most frequent of the non-scarring definitive alopecias: hence the term 'Common Baldness'.

Androgenetic Alopecia is a chronic, hormonally-based (-androgens are male hormones), genetically determined condition characterised by the progressive involution of hair follicles on the scalp and miniaturisation of the resulting hair.

Androgenetic Alopecia is the consequence of Androgenetic Defluvium, which consists of a progressive superficialisation, depigmentation and miniaturisation up to total atrophy, of the hair follicles of the frontoparietal and vertex area.

Clinically it is defined (according to Hamilton) by:

• progressive retreat of the hair insertion line
• opening of the frontoparietal angles (hairline) that gives the frontal line its characteristic male M-shape,
• slow loss of vertex hair up to the alopecic involvement of the entire upper part of the scalp with typical sparing of the nape of the neck and supra-ear temporal areas, finally leading to 'crown baldness'.

Androgenetic Alopecia is often accompanied by seborrhea and desquamation (dandruff) and for this reason is also called Male Seborrheic Alopecia.

Androgenetic Alopecia is sustained by the presence of normal plasma androgen hormone levels and by familial genetic inheritance (hence the term Androgenetic)

ALOPECIA AREATA

L'Alopecia areata is a fairly common autoimmune-type problem. It affects in its most intense forms about 1% of the Caucasian and Asian population without distinction between male and female. In its milder forms, however, it is estimated that between 15 and 25% of the population is affected.

The problem is characterised by the appearance of one or more round, hairless patches of skin that appear suddenly, even within 24/48 hours, without any particular symptoms.

Only in rare cases do sufferers complain of itching, pain, irritation, redness or swelling.

It is often associated with other autoimmune problems such as Vitiligo and Thyroid.

This anomaly rarely affects those who already have Androgenetic Alopecia.

Alopecia Areata falls into the category of non scarring alopecia, as there is no formation of fibrous connective tissue that completely destroys the pilo-sebaceous apparatus.

The affected area is said to suffer an (as yet unknown) causal 'insult' with rapid arrest of cell regeneration and subsequent Anagen hair loss. For this to occur, it is necessary for what is called an 'insult' to find follicles and hair in the affected areas that are susceptible to attack.

The vertex and nape areas generally have a longer Anagen and this is perhaps why they tend to be the areas most affected by this skin anomaly.

The discovery of a blotch or blotches literally throws the sufferer into panic, who, if not properly supported and calmed, ends up living with great anxiety, leading to depression and social isolation.

NO PANIC!

SCARRING ALOPECIAS

Scarring alopecias occur when, for often unknown reasons, hair falls out and does not grow back due to the destruction of the hair follicle and the germinative papilla with the formation of scar tissue.

FRONTAL FIBROSING ALOPECIA

What is Frontal Fibrosing Alopecia?

Frontal fibrosing alopecia, first described in 1994,

is a scarring alopecia selectively affecting the frontotemporal hairline region, and is considered a variant of Lichen Planopilare.

It mainly affects women after the menopause, and has a slow ex-progressive course.

The frontal hairline recedes progressively and the forehead becomes higher and higher.

More or less severe thinning of the eyebrows is often associated.

Frontal fibrosing alopecia is manifested by a band of scarring alopecia localised at the level of the frontal, temporal and parietal hairline.

receding hairline of the periauricular area is also common

The occipital region is only rarely involved. The skin of the alopecic region is distinguished from the skin of the forehead by the absence of signs of photoageing: the skin is clear, thin and smooth.

Temporal and frontal veins are often very noticeable due to thinning of the skin.

The distance between the nose hairline and the hairline can be up to 9-10 cm. In addition, there is a total disappearance of the hair of the fleece at the new hairline.

Hairline hair shows mild perifollicular hyperkeratosis (keratotic papules around the follicular ostium) associated with erythema.

Complete or partial alopecia of the eyebrows is observed in 50-75% of the persons who manifest this anomaly (true disease).

a lack of body hair is also common.

Trichoscopy shows absence of follicular ostia in the alopecic band.

The hair bordering the back of the alopecia shows sleeves of keratinous material  and the skin is erythematous.

It is also common to observe twisted and fractured hairs at various distances from the follicular ostium.

Scarring Alopecia is the consequence of an inflammation of the hair follicles in the hairline, but why this inflammatory aggression develops is still unknown.

The fact that the disease almost exclusively affects the female sex suggests that the trigger may be a chemical used predominantly or exclusively by women, but studies to date have not yielded any clear results.

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The scalp consists of skin  with a particular structure, different from that of the rest of the body. It has densely innervated hair follicles and a rich network of blood vessels capable of nourishing the skin with its innumerable structures  and hair.

When the scalp shows abnormalities related to an inflammatory state, one may be faced with reddened, itchy, painful, greasy or extremely dry tissue.  It is of paramount importance to find a solution to the problem by also searching for the cause in the person's diet, lifestyle and emotions.

Inflammation of the scalp is a fairly common abnormality that often goes unnoticed if not accompanied by other skin conditions.

For example, it can be the origin  of other anomalies such as:

• itching,
• pain,
• seborrhea,
• psoriasis,
• dandruff,
• hair loss,
• skin dryness,
• atopic dermatitis,
• sensitivity of the scalp,
• alopecia,
• lichen,
• folliculitis,
• psoriasis,
• dermatitis,
• seborrheic...

Despite the undeniable advances in trichological cosmetics, scalp inflammation can be a major challenge for the hairdresser due to the many possible variables.

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Seborrhoea or hyperseborrhoea is a scalp problem due to excessive sebum production caused by overactivity of the sebaceous glands.

Immediate effects of seborrhoea are:

• a shiny, greasy appearance of skin and hair
• a characteristic rancid olfactory note (bad smell)
• itching
• sometimes scalp pain
• touching the scalp and hair makes the fingers oily

Delayed effect from incorrect treatment of the problem is hair loss!

In normal quantities, sebum is a fatty substance that has the function of protecting the skin from dehydration, has antibacterial properties and maintains the integrity of the hydro-acid-lipid mantle, lubricates, protects and waterproofs the hair shaft.

The excessive presence of sebum on the skin over a long period of time, on the other hand, leads to an alteration of the hydro-lipid balance with sometimes even serious consequences: simple blemishes, greasy and floppy hair, shiny skin, acne, comedones or folliculitis, or much more complex problems such as dermatitis or Seborrheic Alopecia.

The secretion of sebum within certain limits is considered useful and is therefore referred to as physiological seborrhoea.

When sebum production is in excess, the normal function of the sebaceous glands turns into an abnormality of the skin, giving rise to Hyperseborrhea.

When one experiences hyperseborrhoea for short periods, one should not speak of a 'pathological' condition, but an occasional and transitory one, as this problem can be resolved in a short time.

External environmental factors such as heat, which by increasing vasodilation of the scalp capillaries, leads to increased blood flow and increased sebum production.

Wrong hair treatments such as:

• improper hygiene practices,
• overly aggressive treatments or shampoos,
• or infections of the scalp, can be causes of momentary hyperseborrhoea.

The causes of hyperseborrhoea have not yet been conclusively clarified.

Factors that favour the appearance of hyperseborrhoea include:

• Genetic factors: the abnormality often occurs in members of the same family
• Hormonal imbalances related to the metabolism of Androgens (male hormones), Cortisol, Adrenal Hormones), hormonal imbalances of the Thyroid and Pituitary gland, polycystic ovary syndrome, can lead to hypersebborea
• Replacement disorders (nutrition and elimination): a diet excessively rich in fat ends up altering the metabolic activity of the body, which protects itself by eliminating a small part of the excess fat through the sebaceous glands (exocrine glands).
• Digestion disorders (liver and intestinal dysfunction): these alterations change the chemical composition of the sebum, making it too rich in fatty acids, which oxidise on contact with air and change its natural protective function, turning it into an irritant and inflammatory element.
• Nervous factors and stress: when the nervous system is involved, there is an increase in blood circulation and sebum secretion that triggers hyperseborrhoea.
• Autointoxication: a condition caused by toxic agents of internal origin, i.e. processed by the organism itself or by parasites. They are distinguished:
  . Self-intoxication due to the accumulation of toxic catabolites
  (organic waste substances), produced in excess of
  the body's disposal and detoxification capacities
  (e.g. autointoxication from fatigue due to excessive sport);
  . Autointoxication by reabsorption of intestinal materials (in the case of
  prolonged constipation),
  . Disease-related autointoxications affecting the main detoxifying organs
  of the body, such as the liver and kidneys, favouring the accumulation of toxic products.

• The use of the wrong shampoos, alcoholic lotions, the abuse of alkaline substances, vigorous and prolonged brushing and continuous friction of the hair can lead to excess sebum.
• Inadequate diet: excessive consumption of alcohol, fatty and fried foods can lead to digestive difficulties with overloading of the liver.
• Pathogenic microorganisms including the Follicle Demodecium (Demodex folliculorum) which is a parasitic larva that causes the chemical composition of sebum to change, stimulating the glandular apparatus to hyperseborrhea.
• Drugs: contraceptive pill, cortisone, anabolic drugs
• Seborrhoea, especially pathological seborrhoea, can cause hair loss and accelerate baldness, as the bulbs immersed for a long time in an excessive amount of sebum end up suffocating and gradually reducing their activity.

In addition, oily and greasy hair, oily, malodorous skin, folliculitis, acne or blackheads, oily dandruff, seborrhoeic dermatitis, are imperfections that are difficult to manage, especially from a psychological point of view, often leading to states of real depression and social discomfort.

Specific treatment paths are needed to deal with the problem, gradually recovering the skin balance and regularising gland activity (provided that situations of overeating (obesity), alcohol intake, drugs, etc. do not persist).

In addition to aesthetic reasons, seborrhoea, if not properly treated, may lead to bacterial proliferation capable of triggering even serious infections, with often devastating consequences for the hair population on the head.