More recently, researchers have identified a specific gene that is 'overexpressed' resulting in a greater production of aquaporin proteins. These proteins sit within sweat glands and are responsible for pumping water into sweat gland ducts. Another often forgotten cause is the greater number of acetylcholine receptors. Acetylcholine is a well known neurotransmitter that facilitates the travel of signals between nerve cells. Nerve signals are transmitted when acetylcholine binds to nerve cell surface receptors. A greater number of receptors on a nerve cell surface renders these cells more sensitive. Essentially, a greater number of acetylcholine receptors translates into a stronger nerve signal which in turn instructs glands to sweat more 'aggressively'.

Identifying the multiple causes of focal hyperhidrosis is particularly important to help researchers focus of multiple avenues as possible targets of therapy.
*Clin Auton Res. 2017 Dec;27(6):379-383

​​Luckily, the hyperhidrosis gene is not dominant which means that not all children will inherit the condition. The gene penetration rate is 25% which means 1 in 4 children will inherit the condition. While I am not an expert in statistics, this risk ratio does not necessarily guarentee that if you have 4 children, one will inherit hyperhidrosis. Conversely, there is a risk that 2 of 4 children could develop hyperhidrosis. But the likelihood of having two children inheriting the condition is only 1 in 16. And the likelihood of having 3 children with the condition becomes almost improbable, that is, 1 in 64. To a degree, this explains why only a small percentage of the population have hyperhidrosis. For more information go to our Hyperhidrosis Heredity Survey page.

While the study** used an animal model, it does raise the issue of the ability of Botox spreading in human nerve tissue. The notion that Botox could spread has always been discarded, the prevailing thought being that Botox remains in the region it is injected.
Most people would be surprised that the US Food and Drug Administration (FDA) added a safety warning in 2009 that mentions the toxin “may spread from the area of injection to produce symptoms of botulism”. These include muscle weakness and the possibility breathing difficulties that can occur hours or weeks after an injection.
More recently, an outbreak (8 cases) of botulism was reported from Egypt after injections of the neurotoxin in a variety of patients (including 1 in hyperhidrosis)***. The injectable was sold under the name Neuroxin. Click the following link for more on the symptoms of botulism.
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While Abilify might help to neutralize anti-depressant induced hyperhidrosis, clinical investigators from Turkey have recently reported that Abilify might cause excessive sweating**.  The authors report on two female case studies that developed hyperhidrosis while being treated with Abilify. The good news is the patients stopped experiencing hyperhidrosis after their Abilify was discontinued.
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A positive outcome was found in 84% of children. A measure of sweating severity, the HDSS score, was reduced from 3.5 to 2. In other words, pre-treatment sweating was rated as barely tolerable or intolerable. After treatment, sweating was rated as tolerable. If you are a parent, make sure you try topical gels and/or iontophoresis before you consider surgical options. Remember that a topical gel can be used together with iontophoresis to maximize topical treatment. 

​Most commonly reported comments/complaints from the children include negative self-esteem, inhibited physical and social contacts, problems with clothing, and practical impact on school work. Avoidance of social events, career opportunities, jobs or meeting a partner are also consequence-related symptoms mentioned by the children.
This study underscores the importance of identifying and treating focal hyperhidrosis in children. Over and above the excessive sweating, its long-term effects can have a serious impact on a child's future. 
* Acta Derm Venereol. 2017 Aug 1. doi: 10.2340/00015555-2755. [Epub ahead of print]

more realistically mimic the natural organization of cells within tissues. After all, sweat glands are 3-dimensional physiological units. ​

Not only are the 3D cultures more lifelike, they also respond and function like real sweat glands. A numbers of tests have shown that 3D cultures behave more like real sweat glands. For example, adding acetylcholine (a neurotransmitter) to the 3-d cultures results in the influx of calcium within the cells. This process is normally observed within sweat glands. Cells cultures organized in typical 2D cultures do not respond to acetylcholine in this manner. Scientists are hoping the use of 3D sweat cell cultures will help determine which bioactive substances will best regulate the sweating process within these cells.

*A novel organotypic 3D sweat gland model with physiological functionality. PLoS One. 2017 Aug 10;12(8):e0182752

Based on cases* reported from the UK, 'menopausal hyperhidrosis' appears to be localized or limited to the facial and scalp regions. It also seems to be resistant to typical treatment. Patients failed to respond to oral or topical glycopyrrolate. Response was also poor with Botulinum toxin injections. The good news is that its duration does not seem permanent. The average duration in the cases reported was eight years. This type of sweating should not be confused with night sweats or hot flashes. 
*Australasia J Dermatol. 2012 May;53(2):158-9

And the increase in compensatory sweating was significant. With most individuals, the increase in sweating was several fold. In some cases the increase was five-fold. For more information, you can consult our compensatory hyperhidrosis webpage.

​As the  frequency of visits increases, the forum perpetuates exchanges including invaluable observations, comments or answers to your posted discussion points. One of the more rewarding aspects of such a forum is the opportunity to talk to other individuals that live with an excessive sweating condition. Ultimately, a hyperhidrosis support group is created. We hope many of our website visitors will include stopovers to the Sweating Matters Forum. Look for our Sweating Matters Forum icon below for access to the forum. We will keep the icon on our Home page for easy access to the forum. Welcome to our the Sweating Matters Forum, a focal hyperhidrosis forum. Happy discussions!