Let’s discuss facial masking as a symptom of Parkinson’s

When it comes to weird and unexpected symptoms, Parkinson’s disease is the gift that keeps on giving. My grandfather had Parkinson’s, yet when I was diagnosed with it, the only symptom I’d heard of before was tremors. As I eventually learned, that was just the tip of the iceberg.

As a brain disease, it makes sense that Parkinson’s would have such a wide range of symptoms, because the brain is an integral part of everything we do and experience. I’ve written previously about unexpected symptoms I’ve experienced, such as micrographia, or small handwriting, and bradykinesia, or abnormally slow movement. Another unexpected symptom is hypomimia, or facial masking.

I first learned of hypomimia when I was diagnosed. While other symptoms like tremor and gait freezing were much more problematic at the time, my face was giving me away to my doctors. At one of my first appointments with a neurologist, she asked my husband if he’d noticed a lack of expressiveness or less smiling from me. He said he had, but he just figured I’d been annoyed with him for months!

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Bringing awareness to this symptom is important because while the mechanism behind hypomimia is not well understood, hypomimia is recognized as a potential early diagnostic tool. In 2022, a young woman named Erin Smith was nominated for an innovation prize for creating FacePrint, an “algorithm that analyzes videos of faces to spot, with 95% accuracy, minute signs of early-onset Parkinson’s and early-stage disease,” Parkinson’s News Today reported.

In addition to clinicians and doctors, it’s also crucial for friends and caregivers of Parkinson’s patients to be aware of this symptom. I didn’t want my friends and family to think I was annoyed all the time! Have you heard of resting “b***h face”? Well, I have resting Parkinson’s face.

The growth of Zoom meetings and other video calls brought the issue to my attention. Seeing myself on screen every day made me realize how often I seemed to be scowling or looking like I was zoned out. Over time, I’ve learned to smile with what feels like a huge grin, knowing it comes off to others as a standard smile. I’ve always been fairly smiley and optimistic, so being robbed of that “friendly mask” is something I really care about.

While there’s no specific treatment or cure for hypomimia, some research indicates the condition might be the result of an impaired ability to control the muscles, a common root cause of other Parkinson’s symptoms.

New research is also looking into potential emotional causes of masking. A Parkinson’s News Today story about one study noted that “Parkinson’s patients often exhibit a lack of facial expressiveness due to motor impairments, a condition known as facial masking, or hypomimia. This condition, in turn, may impair emotional facial recognition, as the ability to recognize the emotions of others is partly based on facial mimicry.”

Whatever the cause, facial masking is another subtle symptom of Parkinson’s disease that we all need to be aware of. If you have it, don’t let it get you down. You can compensate for it once you’re aware of it. I feel great now when I see my neurologist and she says I look like my smiley self again. So keep on smiling!

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.