A non-motor symptom characterised by a mask-like, expressionless face linked to facial bradykinesia.

What is hypomimia?

Hypomimia, also known as masked face, is a common motor symptom of Parkinson’s. It refers to a reduction in facial expressiveness, making the face appear less animated or emotionally responsive. People living with Parkinson’s may find it harder to smile, frown, raise their eyebrows, or show subtle emotional cues through facial movement. People you are speaking to may think you are disinterested in what they are saying.

This symptom can affect both voluntary and involuntary facial expressions, including blinking and reactions to emotions. It’s not a reflection of how someone feels inside, it’s a result of changes in the brain and muscles that control facial movement.

What causes hypomimia?

Hypomimia is caused by reduced dopamine levels in the brain. Dopamine helps control muscle movement, including the fine muscles of the face. When dopamine-producing neurons are damaged, facial muscles can become rigid, slow, or unresponsive.

Other contributing factors include:

  • Bradykinesia (slowness of movement)
  • Muscle stiffness or rigidity
  • Reduced blink rate
  • Changes in emotional processing and recognition

Recent research suggests hypomimia may also be linked to changes in brain regions responsible for emotion recognition, not just motor control.

How hypomimia impacts daily life

Hypomimia can affect many aspects of life, including:

  • Communication: Facial expressions are a key part of non-verbal communication. Reduced expressiveness can lead to misunderstandings or assumptions that someone is disinterested, sad, or angry.
  • Social interaction: Friends, family, and colleagues may misinterpret facial masking for disinterest, which can lead to social isolation or strained relationships.
  • Mental health: People living with Parkinson’s may feel frustrated or misunderstood. Hypomimia can also be mistaken for depression, even when mood is unaffected.
  • Workplace challenges: In job interviews or meetings, reduced facial expression may impact how others perceive engagement or confidence.

How is hypomimia treated or managed?

While there is no cure for hypomimia, several strategies can help manage its effects:

1. Optimising Parkinson’s medication

  • Medications like levodopa can improve motor symptoms, including facial movement.
  • Work with your neurologist or Parkinson’s nurse to adjust your treatment plan.

2. Speech pathology

  • A speech pathologist can help with facial exercises, voice volume, and communication strategies.
  • Programs like LSVT LOUD® and LSVT BIG® may improve both speech and facial expressiveness.

3. Facial exercises

  • Regular facial exercises can help maintain muscle tone and responsiveness.
  • Try smiling, raising eyebrows, and exaggerating expressions in front of a mirror.

4. Education and support

  • Educate family, friends, and care partners about hypomimia to reduce misunderstandings.
  • Use verbal cues to express emotions when facial expressions are limited.
  • Neurologists: Diagnose and manage Parkinson’s symptoms, including medication.
  • Parkinson’s nurses: Provide ongoing support and care coordination.
  • Speech pathologists: Help with facial movement, speech, and communication.
  • Occupational therapists: Support daily function and social engagement.
  • Support groups: Connect with others who understand the lived experience of Parkinson’s.

Key Statistics

  • Up to 70% of people living with Parkinson’s experience hypomimia at some point.
  • Hypomimia can affect emotion recognition, making it harder to interpret others’ facial expressions.
  • Hemihypomimia (one-sided facial masking) occurs in about 6.4% of people with Parkinson’s and may be under-recognised.
  • Automated facial analysis tools using AI have shown up to 99% accuracy in detecting hypomimia, offering promise for early diagnosis.

How do I access support?

It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:

  • getting a GP referral to someone with Parkinson‘s experience
  • your state-based Parkinson’s organisation for advice on local services to access
  • private health to see what is covered in relation to consultations and expenses
  • DVA, NDIS or My Aged Care plan supports.

Infosheet under review

References

  • Rodríguez-Antigüedad, J., et al. (2024). Facial emotion recognition deficits are associated with hypomimia and related brain correlates in Parkinson’s disease. Journal of Neural Transmission. https://link.springer.com/article/10.1007/s00702-023-02725-3
  • McNamara, P. (2025). Facial Masking in Parkinson’s Disease. GHRS. https://ghrs-group.com/news/facial-masking-in-parkinsons-disease
  • Guerra-Hiraldo, J. D., et al. (2023). Hemihypomimia in Parkinson’s disease: an under-recognized clinical sign? Journal of Neurology. https://link.springer.com/article/10.1007/s00415-022-11292-8
  • Vinokurov, N., et al. (2016). Quantifying Hypomimia in Parkinson Patients Using a Depth Camera. MindCare 2015. https://link.springer.com/content/pdf/10.1007/978-3-319-32270-4_7.pdf
Happy middle aged man with neat white beard and glasses looking at a laptop

Donations

Your donation helps us to achieve our core business, to improve the lives of people affected by Parkinson’s in Australia through national advocacy, raising awareness and connecting people living with Parkinson’s, their families and carers, researchers and health professionals in the Parkinson’s community.