Facial Masking: A Hallmark Symptom of Parkinson’s Disease

Facial Masking is considered to be a hallmark symptom of Parkinson’s Disease and can have a profound affect on interpersonal relationships and communication in general. Also referred to as hypomimia, facial masking can wreak havoc on one’s confidence when interacting in social settings. While some individuals with Parkinson’s report symptoms of facial masking very early on (even pre-dating an official diagnosis!), others don’t experience facial masking until much later in the disease process.

The Two-Factor Issue of Facial Masking in Parkinson’s Disease.

Firstly, individuals with Parkinson’s often experience stiffness and rigidity in their muscles, including those responsible for facial expressions, leading to increased difficulty in voluntarily moving their facial muscles. Secondly, there is often a lack of awareness or diminished perception of this reduced facial movement, resulting in a reduced effort to exhibit animation in the face. Over time, the facial muscles may weaken due to disuse atrophy, as they are not being actively engaged. As the old saying goes, “If you don’t use it, you lose it”.

The Complex Role of Facial Expression

The human face is a complex canvas of emotions, powered by 43 facial muscles that work harmoniously to convey our feelings and thoughts. For individuals with Parkinson’s disease, the loss of this ability to communicate through facial expressions can have far-reaching consequences. Others may misinterpret the lack of facial expression as disinterest, apathy, or even anger, leading to frustrating communication experiences. This misunderstanding can cause loved ones to withdraw, unintentionally worsening social isolation and potentially contributing to depression.

Breaking the Barrier: Strategies for Improved Communication

While there is no cure for facial masking in Parkinson’s, there are effective strategies to enhance facial animation and movement. Here are some valuable compensatory techniques to consider:

Maintain Good Eye Contact: When facial expressions are limited, strong eye contact becomes an essential tool for conveying interest and engagement.

Use Body Posture: Show your interest and enthusiasm through your body language. Leaning in and facing the person you’re communicating with can help bridge the gap.

Nodding Your Head: Non-verbal cues like nodding or shaking your head can signify agreement or understanding, even when facial expressions are restricted.

Use Your Words: Be explicit about your emotions and intentions. Verbal communication can compensate for the lack of facial expression.

Strategies to Improve Facial Masking

Medication: Dopamine-enhancing medication can alleviate stiffness and rigidity, potentially improving facial muscle control. Finding the right dosage and timing may require some adjustments.

Intense Parkinson-Specific Voice Exercises: Strengthening the vocal cords and improving vocal loudness can make changes in the motor cortex of the brain which can have a trickle down affect on other aspects of communication such as facial expression.

Facial & Emotional Expression Exercises: Speech therapy exercises including direct facial exercises as well as exercises involving exaggerated intonation and emotional expression can help overcome flat monotone speech and flat facial expression.

PRO TIP: Engaging in the following activities can greatly improve symptoms of facial masking.

Theater and Improv Activities: Try our signature ROLE PLAY class HERE.

Musical Activities: Try our signature music and rhythm class for Parkinson’s HERE.

Facial & Emotional Expression Activities: Try our signature EXPRESSONS class HERE.

Facial masking in Parkinson’s disease is a hidden struggle that can significantly impact social interactions and emotional well-being. Understanding the cause of this symptom, engaging in open conversations with loved ones about it, and employing compensatory strategies can greatly improve one’s quality of life. While there may be no cure, a combination of medication, Parkinson specific voice exercises, and lifestyle adjustments can help those with PD regain some control over their facial expressions and, by extension, their ability to connect with others on a deeper level. Through empathy, education, and support, we can all contribute to a more inclusive and compassionate world for those living with Parkinson’s disease.