Outlook and Lifestyle Modifications
For the first few weeks following surgery the scalp
is swollen and tender, and the replacement sites
may bleed with strenuous physical activity. Sur-
geons recommend refraining from intense exercise
or activity and contact sports for two or three
weeks after the procedure. The scalp remains ten-
der (though the swelling subsides within a few
weeks) for up to three or four months, depending
on the replacement method. Transplanted hair
growth does not look exactly the same as the hair
that previously grew from the transplant site,
though most people experience satisfactory results
when a qualified and experienced cosmetic sur-
geon performs the surgery. It generally takes a
year or two from the final hair replacement proce-
dure to see the full effects.
There must be abundant healthy hair on the
back and sides of the head to serve as donor hair.
Men in whom male pattern hair loss begins early
in life are more likely to experience severe or total
hair loss as they age. Satisfactory results from hair
replacement surgery are less certain when this is
the case, as the transplanted follicles may also
experience hair loss. Hair loss from follicles native
to the site generally continues, particularly in
male pattern hair loss, which can result in irregu-
lar growth patterns and the need for further hair
replacement.
See also ANALGESIC MEDICATIONS; PLASTIC SURGERY;
SURGERY BENEFIT AND RISK ASSESSMENT.
hidradenitis suppurativa A condition of chronic
INFLAMMATIONresulting from blockage of the HAIR
follicles (follicular occlusion). The inflammation
may involve the apocrine glands, SWEAT GLANDS
that secrete fluid into the hair follicles. The hair
follicles then channel the sweat to the surface of
the SKIN. When sebum or cellular debris plugs the
apocrine gland’s opening, fluid backs up into the
gland. The situation results in an INFECTION that
produces a hard, painful, reddened NODULEbelow
the skin’s surface. Though the nodules will heal in
three or four weeks without treatment, they often
SCAR and recur. Treatment with oral ANTIBIOTIC
MEDICATIONS may help control the condition
though does not always clear it up. Occasionally
the dermatologist needs to lance (surgically open)
the nodule to allow it to drain. Dermatologists do
not know what causes hidradenitis suppurativa to
develop, though it is more common in people who
have OBESITY.
See also ABSCESS; CELLULITIS; FOLLICULITIS.hives See URTICARIA.hyperhidrosis Excessive sweating that results
from abnormal functioning of the nerves or BLOOD
vessels that supply the eccrine SWEAT GLANDS.
Hyperhidrosis characteristically involves the hands
(palms), feet (soles), and axillae (underarms),
though can affect eccrine sweat glands anywhere
in the body. The eccrine sweat glands produce
most of the body’s sweat and play a key role in
thermoregulation (regulating body heat). They
empty their fluids (perspiration) directly to the
SKIN’s surface for rapid evaporation and cooling.
Stress and physical activity tend to exacerbate
hyperhidrosis, particularly when it affects primar-
ily the hands and feet. The portion of the BRAIN
that regulates sweating in these areas, the cerebral
cortex, is not part of the body’s thermoregulation
system but rather responds to emotional signals
such as anxiety and fear. Hyperhidrosis may also
occur as an undesired SIDE EFFECTof medications
or a symptom of metabolic disorders such as
HYPERTHYROIDISMand DIABETES, or health conditions
such as TUBERCULOSIS and Hodgkin’s LYMPHOMA.
Most hyperhidrosis that arises from structural or
functional anomalies of the nerves or blood ves-
sels first appears in ADOLESCENCE, when the hor-
monal changes of PUBERTYstimulate sweat gland
function. Hyperhidrosis that begins later in life
generally arises from underlying health condi-
tions.Symptoms and Diagnostic Path
The primary symptom of hyperhidrosis is pro-
fusely excessive sweating. The hands and feet,
when involved, may be continually wet. Sweating
from the underarms and other areas of the body
typically drenches clothing, requiring frequent
clothing changes. The diagnostic path typically
includes a comprehensive NEUROLOGIC EXAMINATION
and blood tests to measure HORMONElevels. The
doctor may conduct further diagnostic procedures,
depending on the individual’s health circum-
stances.164 The Integumentary System