Some people with Parkinson’s disease (PD) experience changes in their skin, mainly in how much or how little they sweat, excessive oiliness, and increased irritation. Changes of this nature can cause considerable discomfort and even embarrassment for the person with Parkinson’s.

 

Sweating

Parkinson’s disease can present two different problems related to sweating: hyperhidrosis (excessive sweating) and hypohidrosis (inadequate sweating).

Hyperhidrosis can be caused by changes in the autonomic nervous system (ANS) associated with Parkinson’s disease. The ANS controls sweating and many other processes within the body, such as blood pressure, heart rate, digestion, and respiration. People with Parkinson’s often experience a decreased ability to naturally regulate some of these processes, including sweating. Additionally, people with PD might find that their excessive sweating worsens when their Parkinson’s medication wears off (Parkinson’s UK, 2015). They may also experience hyperhidrosis more frequently at night (Parkinson’s UK, 2015).

Consider some of the following strategies for managing hyperhidrosis:

  • Use a topical antiperspirant containing aluminum chloride, which helps stop sweating, rather than a deodorant, which just masks odour.
  • Avoid tight-fitting clothing made of synthetic materials (such as polyester, silk, or nylon). Choose 100% cotton whenever possible, or a cotton-predominant blend.
  • Avoid using bedding that is made of synthetic materials.
  • Wear clothing that wicks moisture away (several athletic and travel clothing companies have good options).
  • Avoid situations, drinks, or food that trigger sweating (e.g. crowded rooms, caffeine, spicy foods, or alcohol – monitor what is a trigger for you).
  • Go barefoot when possible.
  • Drink plenty of water and fluids to maintain hydration.

Hypohidrosis can also be caused by changes in the ANS, but most typically occurs as a side effect of a type of PD medication called anticholinergics, such as amantadine (Parkinson’s UK, 2015). If you are taking this kind of medication and you experience inadequate sweating, you may want to speak to your doctor. . It can also occur during an “on” period if the person experiences dyskinesia (the uncontrolled wave-like movement of the upper body). Reduced ability to sweat may put you at risk of over-heating.

 

Skin Protection

People with Parkinson’s have an increased risk of developing melanoma, a type of skin cancer linked to sun exposure. While researchers have known about the link between PD and melanoma for many years, it was recently discovered that a protein called alpha synuclein is the shared connection between the two conditions. An excess of this protein contributes significantly to the development of Parkinson’s disease, as demonstrated by elevated levels not only in the brain, but also the skin, thereby elevating the risk of melanoma (UCLA Health, 2021).

The person with Parkinson’s may also have more difficulty changing position in bed or while seated, which can result in skin breakdown.

Consider these recommendations to protect the skin:

  • Avoid hot, mid-day sun and seek shade when outside. Make sure to wear sunscreen, hats, and sunglasses. Consider sun-protective clothing, such as items with an Ultraviolet Protection Factor (UPF) indicated on the tag. UPF 50+ is the highest protection available from clothing.
  • Change position every two hours. If you are in a wheelchair, get a cushion to lessen the risk of pressure sores. See an occupational or rehab therapist to make sure the right cushions are used.
  • Check skin regularly for redness, blisters, and open sores. Report any changes promptly to a member of your healthcare team.
  • Avoid skin contact with plastic coating and tapes from incontinence products; these can irritate the skin.
  • Use lotion to prevent dryness.
  • Consider an egg-crate or alternating pressure mattress pad to reduce pressure points.

 

Oily Skin

People with Parkinson’s may produce more oil (known as sebum) from their glands, especially in the face and scalp. This condition, which causes the skin to become greasy and shiny, is referred to as seborrhoea.

Consider these strategies for managing seborrhea:

  • Try to avoid any products such as shaving creams, soaps, or cosmetics that contain alcohol, as they can irritate the skin.
  • Try using a gentle cleanser and water, mild soap, or an oil-free soap substitute. 
  • It might be helpful to ask your doctor, neurologist, or dermatologist for some product suggestions.

 

Seborrheic Dermatitis

People with Parkinson’s disease are at an increased risk for developing this condition, also known as dandruff when present on the scalp, which can cause red, itchy, and sore skin or scalp rashes. The main areas affected include the face, scalp, ears, chest, and folds of skin. Stress may cause flare ups of seborrheic dermatitis (Parkinson’s UK, 2015). This condition can be long-lasting and uncomfortable, and while there is no cure for it, there are treatments options. Dandruff can be treated with the strategies below.

For the scalp and beard:

  • Bathe or shower daily using a medicated shampoo containing coal tar or salicylic acid (e.g. dandruff shampoos like Head and Shoulders or Selsun Blue), or tea tree oil products.
  • Rubbing oil on the scalp and over any crusts or scales before shampooing can be helpful.
  • For severe itching of the scalp, ask your doctor about prescription steroid-based ointments.

For the face and body:

  • A mild steroid cream can be used to reduce inflammation and pain. 
  • For eyelids, special products are available at drugstores (e.g. Lid-Care Towelettes), or you may consider a mild baby shampoo as a cleanser.
  • Soak cotton pads in water and tea tree oil for an anti-bacterial treatment.
  • Medicated ear drops can be used for ears.

 

Sources

Hyperhidrosis Management | www.sweatmanagement.ca

The International Hyperhidrosis Society | www.sweathelp.org

Parkinson’s Foundation. Skin Changes. bit.ly/pf-pdskinchanges

Parkinson’s UK (2015, May). Skin and sweating problems in Parkinson’s. bit.ly/parkinsonsuk-skin

UCLA Health (2021, August 9). Understanding the connection between Parkinson’s disease (PD) and melanoma. bit.ly/ucla-melanomapd


Last updated: August 16, 2023