How might Parkinson's affect the skin and sweating?

People with Parkinson’s often experience changes to their skin. The most common change is increased oiliness, particularly around the forehead, nose and scalp, where the sebaceous glands are most prolific. Parkinson’s can cause an excess secretion of an oily substance called sebum from these glands, resulting in the skin looking greasy and shiny. If the condition becomes severe, the skin may also become red, flaky and itchy - this is known as seborrheic dermatitis (‘dermatitis’ means that the skin is inflamed). Such skin problems are most common with Post Encephalitic Parkinsonism, although they can occur in other types of Parkinson’s Disease. Interestingly this type of skin complaint is more frequent in men too. There is no direct connection between the severity of Parkinson's disease and the degree of oiliness, but it is thought that the greater increase in sebum secretion in men is connected to male sex hormones.

Skin health may also suffer during the later stages of Parkinson's disease when factors such as reduced mobility, poor nutrition, urinary incontinence and friable, sensitive skin can result in pressure sores if nursing is not of the highest standard.

Another common skin change is related to patients’ perspiration. Such changes vary from under secretion (hypohidrosis) whereby the skin is very dry, to over secretion (hyperhidrosis) when sweating may be excessive. Many people also experience drenching night sweats. Perspiration helps regulate the body’s temperature (normal sweating is a way to help keep the body temperature steady in hot weather, during a fever, or when exercising) so any changes can be harmful to health.

Often, people with Parkinson's find sweat production to be reduced in the extremities of the body, such as hands and feet, and this can lead to overproduction in the rest of the body as a compensatory mechanism. Moreover, there is evidence to suggest that this worsens as Parkinson’s progresses - research has shown that in patients where Parkinson's symptoms affect one side of the body, over time, there are differences in sweating in the affected side compared to the other side. However, as yet, published research does not confirm this.

Changes in sweating may also be caused by Parkinson’s medications – some cause hypohidrosis (where the body does not sweat enough), others cause hyperhidrosis (where the body sweats too much). Anticholinergic medications can block the secretion of sweat, resulting in a rise in body temperature. So during hot weather this medication may need to be reduced or avoided totally when treating older people. Levodopa, on the other hand, can lead to excessive sweating and some people experience drenching sweats during the ‘wearing-off ’ stage, just before the next dose is due. The dosage of Levodopa should therefore be altered to minimise this excessive sweating, although this can of course mean that other Parkinson’s symptoms may be less well controlled. In this situation, controlled release Levodopa or COMT inhibitors may be introduced. But, as with all medications, always check with your healthcare professional before altering any of your medications .

 

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