Like everything in science, the answer is no doubt going to be complicated. There was an excellent article in Sunday's NY Times about the role of epigenetics in disease. It's not simply about inheriting genes: it's about how and why these genes are turned on or off, and it is here that processes of methylation seem to play a pivotal role. This no doubt helps explain, at least partially, why you'll often get such variations even within families of hyperhidrosis sufferers. The challenge for research in hyperhidrosis is not just finding the many genes responsible but finding the triggers for these. The dream for me would be to find a way to turn off some of the genes responsible for hyperhidrosis - but we are a long, long away from that, since we don't have a clue what genes and how many are involved. I'm guessing more than a dozen, at the very least. Do any of you know rich individuals who could be persuaded to donate some of their millions to hyperhidrosis research? (Sorry for the sarcasm here, but mega-donations are probably what it'll take.)