Asymmetrical Skin Changes: Common Concerns in Family Medicine

Q: Asymmetrical Skin Changes: Common Concerns in Family Medicine

Hello： 1. <br>Although your right axilla appears more prominent than your left, if you haven't felt any lumps and this has persisted for over ten years, it is likely not a serious issue. <br>It may be related to the increased muscle development in your right chest, right back, an

Inquiry Consultation

Dear Dr.
Lin,
I have two questions for you:
Q1.
I have noticed for over a decade that the skin in my right armpit appears slightly more protruded than in my left armpit, giving the visual impression that the muscles in my right armpit are larger.
This condition has persisted for many years, so it should not be related to lymph nodes under the armpit.
Upon palpation, both armpits feel like soft tissue without any hard lumps (or tumor-like masses), and there is no pain or itching; it is simply a difference in appearance between the two armpits.
In your opinion, what could be the reason for the slight protrusion of the skin in my right armpit compared to the left? I suspect that since my dominant hand is my right hand and I frequently played basketball using my right hand during my youth, the muscles in my right armpit have developed more over time, resulting in the slight protrusion.
I would appreciate your clarification on this matter.
Q2.
I have noticed that the area behind both of my cheeks (behind the cheekbone) has some dark pigmentation, and the skin in that area is also somewhat rougher.
The right side of my cheek is slightly darker than the left side.
This condition has been present for a long time, at least over ten years.
In your opinion, what could be the cause of the dark pigmentation in the area behind both of my cheeks (behind the cheekbone)?
Thank you, Dr.
Lin.

Kris, 40~49 year old female. Ask Date: 2023/08/12

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
Although your right axilla appears more prominent than your left, if you haven't felt any lumps and this has persisted for over ten years, it is likely not a serious issue.
It may be related to the increased muscle development in your right chest, right back, and right upper limb.
If you have concerns, it is advisable to consult a physician for an ultrasound or other examinations targeting the deeper layers of the skin.
2.
The darker and rougher skin on the back of your cheeks may be related to sun exposure, or it could be due to localized acne and pimples causing skin inflammation and pigmentation.
However, if this has lasted for over ten years, it is likely not a serious issue.
If you have concerns, it is recommended to see a dermatologist.

Reply Date: 2023/08/12

More Info

Dear Patient,
Thank you for your questions regarding the asymmetrical skin changes you've noticed over the years. Let's address each of your concerns in detail.

Q1: Asymmetry in Axillary Appearance
You mentioned that your right axilla appears slightly more prominent than your left, which has been consistent for over a decade. Given that you have no associated pain, itching, or hard lumps, this is likely not indicative of a serious underlying condition such as lymphadenopathy. Your hypothesis regarding muscle development due to your dominant right hand and activities like basketball is plausible.
Muscle hypertrophy can indeed lead to noticeable differences in appearance, especially in areas like the axilla where muscle and soft tissue are closely related. The right side may have developed more muscle mass due to repetitive use, leading to a more pronounced appearance. Additionally, factors such as genetics, body composition, and even posture can contribute to asymmetries in the body.
If there are no other symptoms or changes, this asymmetry is likely benign. However, if you notice any new symptoms or changes in the texture or color of the skin, it would be prudent to consult a healthcare professional for further evaluation.

Q2: Hyperpigmentation on Cheek Areas
Regarding the darker pigmentation on the posterior sides of your cheeks, this could be attributed to several factors. The skin's appearance can change due to sun exposure, hormonal changes, or even certain skin conditions. Hyperpigmentation is often a result of increased melanin production, which can be triggered by UV exposure, inflammation, or even certain medications.

Given that this pigmentation has persisted for over ten years, it may also be related to chronic sun exposure, especially if you have spent significant time outdoors without adequate sun protection. The fact that one side is darker than the other could suggest uneven sun exposure or even differences in skin thickness or texture between the two sides of your face.

To address this issue, consider the following steps:
1. Sun Protection: Use a broad-spectrum sunscreen with at least SPF 30 daily, even on cloudy days. This is crucial in preventing further darkening of the pigmentation.

2. Topical Treatments: Products containing ingredients like hydroquinone, retinoids, or vitamin C can help lighten hyperpigmented areas. However, these should be used under the guidance of a dermatologist.

3. Professional Treatments: If over-the-counter options do not yield results, consider consulting a dermatologist for treatments such as chemical peels, laser therapy, or microdermabrasion, which can effectively target hyperpigmentation.

4. Regular Check-ups: Since skin changes can sometimes indicate underlying issues, regular dermatological check-ups are advisable to monitor any changes in your skin's appearance.

In conclusion, while the asymmetry in your axilla is likely benign and related to muscle development, the hyperpigmentation on your cheeks warrants attention, particularly regarding sun protection and potential treatment options. If you have further concerns or if these conditions change, I recommend consulting a dermatologist for a thorough evaluation and personalized treatment plan.

Best wishes for your skin health!
Sincerely,
Doctor Q&A Teams

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