researchers found that primary focal hyperhidrosis was not a sex-linked gene, since male-to-male transmission was seen in multiple families. Instead evidence supported an autosomal dominant pattern of inheritance with an incomplete disease penetrance. 21 patients in this study reported a positive family history of hyperhidrosis (62%). Researchers were able to uncover this by creating pedigrees of all the participants in the study. Not every member of the pedigree exhibited forms of hyperhidrosis, which allowed the researchers to track the patterns of inheritance. The findings in this study indicated that primary focal hyperhidrosis is typically an hereditary disorder. Diagnosis Typical regions of excessive sweating include the hand palms, underarms, the sole of the foot, and sometimes groin, face, and scalp. Indeed, profuse sweating is present mostly in the underarms, followed by the feet, palms and facial region. Sweating patterns of focal hyperhidrosis are typically bilateral or symmetric and rarely occur in just one palm or one underarm. Night sweats or sweating while sleeping is also rare. The onset of focal hyperhidrosis is usually before the age of 25 years. This is in contrast to generalized hyperhidrosis which tends to occur in an older age group. Evidence demonstrates that a positive family history is also present (see the Genetics part). Treatments The Canadian Hyperhidrosis Advisory Committee has published a comprehensive set of guidelines which outlines key aspects of treatment related to this condition. Topical hyperhidrosis gels containing aluminum chloride hexahydrate are usually first choice treatments for this condition. Topical agents for focal hyperhidrosis therapy include formaldehyde lotion and topical anticholinergics. These agents reduce perspiration by denaturing keratin, in turn occluding the pores of the sweat glands. They have a short-lasting effect. Contact sensitization is increased, especially with formalin. In addition to topical antiperspirants (whose main active ingredients usually are aluminum or zirconium salts) treatment options include: iontophoresis (hands, feet), onabotulinumtoxinA (Botox) injections (underarms, hands, feet, and other localized areas), electromagnetic/microwave energy thermolysis of underarm sweat glands (miraDry), laser-assisted removal of the sweat glands (underarms), other local procedures such as liposuction and curettage of the sweat glands (underarms), medications of the anticholinergic type that are taken by mouth, and sympathectomy surgery for sweating of the hands or head that can't be controlled by other means. References External links Cutaneous conditions