From the Research
Unilateral axillary hyperhidrosis can be caused by several conditions, with the most common being primary focal hyperhidrosis that happens to affect one armpit more severely than the other, as well as secondary causes such as neurological disorders, thoracic outlet syndrome, certain medications, infections, endocrine disorders, and malignancies. When sweating occurs exclusively on one side, secondary causes should be considered, including neurological disorders like stroke, spinal cord injury, or peripheral nerve damage that can disrupt normal sympathetic nervous system function, leading to asymmetric sweating 1. Thoracic outlet syndrome or brachial plexus injuries may also cause unilateral hyperhidrosis, and certain medications such as antidepressants, opioids, or antipyretics can sometimes induce asymmetric sweating as a side effect 2. Infections like tuberculosis or localized skin infections may trigger excessive sweating in one armpit, and endocrine disorders including hyperthyroidism, diabetes, or pheochromocytoma can occasionally present with unilateral symptoms 3. Malignancies, particularly lymphomas or tumors affecting the sympathetic chain, should be ruled out, and treatment depends on identifying and addressing the underlying cause, but may include topical antiperspirants containing aluminum chloride (20-25%), anticholinergic medications like glycopyrrolate, botulinum toxin injections, iontophoresis, or in severe cases, sympathectomy surgery, with microwave therapy being a newer option that has shown promise in treating axillary hyperhidrosis with minimal damage to surrounding tissues 4. Some key points to consider in the management of unilateral axillary hyperhidrosis include:
- Identifying and addressing the underlying cause of the condition
- Considering secondary causes such as neurological disorders, thoracic outlet syndrome, and certain medications
- Using topical antiperspirants, anticholinergic medications, botulinum toxin injections, iontophoresis, or sympathectomy surgery as treatment options
- Evaluating the effectiveness of microwave therapy as a newer treatment option for axillary hyperhidrosis.