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Hyperhidrosis and the Role of Genetics/Heredity
It is only in the last few years that we have learned genetics may play a role in the development of primary or focal hyperhidrosis. In the study of genetics, it has been demonstrated that traits (e.g. eye color, skin pigmentation etc.) and medical conditions can be inherited in different manners. In others words, there are numerous mechanisms by which parents can pass along genes that code for traits and/or conditions to their offspring.
Primary or Focal Hyperhidrosis - Evidence for Autosomal Dominant Inheritance
There is evidence* that primary or focal hyperhidrosis follows a pattern of inheritance called an autosomal dominant mode of transmission. As such, one parent is unaffected while the other is affected or carries a dominant gene for hyperhidrosis. In such a case, the likelihood of receiving the gene that translates into a hyperhidrosis condition is 1 in 2. This is in contrast to autosomal recessive inheritance whereby both parents carry a recessive gene (neither have a dominant gene) and the chances of inheriting the trait or condition in this case is 1 in 4.
Following is chart that shows how a condition such as primary hyperhidrosis is passed along from parent to child in an autosomal dominant fashion.
* Kaufmann H et. al. Primary hyperhidrosis - evidence for autosomal dominant inheritance. Clin Auton Res. 2003; (2): 96-8. **Ro KM et. al., J Vasc Surg, 2002; (35)2: 382-6
The Concept of Genetic Penetrance
This whole aspect of genetics and hyperhidrosis gets a little more complicated. The idea of genetic or disease penetrance refers to the proportion of individuals that inherit a medical condition and also go on to develop its symptoms. Conversely, some individuals inherit a condition but do develop the clinical signs or symptoms associated with the problem.
In other words, if primary hyperhidrosis has 80% genetic penetrance, that means that 8 out of 10 individuals that inherit the autosomal dominant gene will also have clinical signs and symptoms, in this case, excessive sweating. This also means that the balance of individuals or 20% will not exhibit the classic signs of hyperhidrosis. There is evidence to suggest that penetrance of primary hyperhidrosis is in fact incomplete or reduced (25% according to one study**).
This actually brings up an interesting point. A person who apparently does not suffer from hyperhidrosis may in fact pass along the condition to their offspring. This person is likely an individual that has not been 'penetrated' by the condition but carries the genetic material that can be passed along to his or her children. This may provide an explanation for those individuals having hyperhidrosis that do not seem to have any history of the condition in their immediate family.