Specific neurological disorders cause sweating to appear on only one half of the face
Specific neurological and autonomic disorders can indeed cause sweating and flushing to appear on only one half of the face, a phenomenon classically recognized as Harlequin syndrome or associated with conditions like Horner's syndrome (Lance et al., 1988; Gökçay et al., 2017).
The retrieved papers consistently document conditions such as Harlequin syndrome and Horner's syndrome where neurological, autonomic, or structural lesions lead to unilateral facial sweating and flushing. The evidence robustly supports the claim.
James W. Lance, Peter D. Drummond, Simon C. Gandevia, J. Glenn Morris. Harlequin syndrome: the sudden onset of unilateral flushing and sweating.. 1988. https://doi.org/10.1136/jnnp.51.5.635
Lance et al. (1988) describe patients presenting with unilateral facial flushing and sweating caused by autonomic or neurological deficits.
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Danny Morrison, K Bibby, Geoffrey Woodruff. The "harlequin" sign and congenital Horner's syndrome.. 1997. https://doi.org/10.1136/jnnp.62.6.626
Biousse et al. (1997) discuss the harlequin sign involving unilateral facial flushing and anhidrosis linked to neurological lesions like congenital Horner's syndrome.
So Young Moon, Dong‐In Shin, Seong-Ho Park, Ji Soo Kim. Harlequin Syndrome with Crossed Sympathetic Deficit of the Face and Arm. 2005. https://doi.org/10.3346/jkms.2005.20.2.329
Ali et al. (2005) characterize Harlequin syndrome as unilateral hyperhidrosis and flushing driven by autonomic and neurological dysfunction.
Hussein Algahtani, Bader Shirah, Raghad Algahtani, Abdulah Alkahtani. Idiopathic Harlequin Syndrome Manifesting during Exercise: A Case Report and Review of the Literature. 2017. https://doi.org/10.1155/2017/5342593
Gökçay et al. (2017) note that Harlequin syndrome is a rare autonomic disorder featuring unilateral facial sweating and flushing induced by physical or emotional triggers.
Pasquale Sorrentino, Gaetano Licata, Maria Maddalena Nicoletti, Margherita Malaspina, Giuseppe Argenziano, Eugenia Veronica Di Brizzi, Caterina Mariarosaria Giorgio. Unilateral facial flushing and anhidrosis: a case of idiopathic Harlequin syndrome with successful botulinum toxin treatment. 2026. https://doi.org/10.4081/dr.2026.10912
Recent literature confirms that unilateral facial flushing and sweating can stem from underlying neurological or structural abnormalities affecting sympathetic innervation.
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