Skin and sweating problems

The skin has glands that produce an oily substance called sebaceous matter or sebum. Sebum is important as it protects the skin and keeps it supple.

People with Parkinson’s may produce more sebum than normal. This condition is known as seborrhoea. It means the skin, particularly the face and scalp, becomes greasy and shiny. If you experience this, remember that oily skin can affect anyone and there are a number of treatments available.

How to manage oily skin

Try using a mild soap or a gentle cleanser and water, or an oil-free soap substitute. Avoid cosmetic products that contain alcohol, or that irritate your skin. Speak to your GP or pharmacist for more advice on suitable products.

This is a condition where areas of the skin that have lots of sebaceous glands become red, itchy and sore. The skin also peels and flakes, and may develop thick crusts or scales. Seborrhoeic dermatitis is a common problem, although people with Parkinson’s are more likely to develop it.

The main areas affected include:

• the scalp – in mild cases skin can flake off as dandruff. In more severe cases, people may have a red, scaly scalp, sometimes with a weeping rash
• the face – this can look red and sore, and sometimes scaly. Skin around the nose and inner parts of the eyebrows are often affected. Eyelids can also become red and sensitive. This is known as blepharitis
• the ears – areas around and in the ears can be affected. If the inner canal becomes inflamed this can cause it to become blocked
• the front of the chest
• the bends and folds of skin – such as under the breasts and arms, and in the groin

It is not known what causes seborrheic dermatitis, but it’s thought that a type of yeast found on the skin may play a part. It is not caused by poor personal hygiene.

How to manage seborrhoeic dermatitis

There is no cure for seborrhoeic dermatitis but there are treatments that can control it. Be aware that if you stop the treatments the condition may come back. It can also flare up when you are stressed.

Try to avoid cosmetics that contain alcohol, and soaps and shaving creams that irritate your skin. You should also switch to using non-greasy special moisturising creams (emollients) and emollient soap substitutes. Some people may find certain foods make the condition worse, so you could try keeping a diary to see if anything in your diet is causing problems.

The following treatments are recommended for the scalp and beard.

• Loosen any crusts or scales on the scalp by rubbing on olive or mineral oil several hours before washing your hair. Or you can also use a de-scaling agent containing coal tar or salicylic acid – these can be brought over the counter in your local pharmacy.
• Wash your hair and your beard, if you have one, with a medicated shampoo, or those containing coal tar or salicylic acid, which you can buy over the counter. Alternatively, your GP can prescribe shampoos containing ketoconazole and selenium sulphide.
• If you have severe itching on your scalp, your GP can prescribe a steroid-based cream or ointment, for you to use as a short-term solution.
• Use shampoos that contain tea tree oil.

The following treatments are recommended for the face and body.

• A cream containing ketoconazole can be prescribed by your GP. You can use this until the skin has improved.
• A mild steroid cream, which may contain an antifungal agent, can also be used to reduce inflammation and soreness. However, if the symptoms have not cleared up within six months you should see your GP or a dermatologist (skin expert) for advice.
• If your eyelids are affected, clean them daily with cotton buds moistened with baby shampoo. If this does not help, see your GP or a dermatologist for advice.

Talk to your GP if your symptoms do not improve with treatment. They may refer you to a dermatologist – a doctor who specialises in skin conditions. You can also ask your pharmacist for advice on treatments that may be available.

People with Parkinson’s may have problems with the part of the nervous system that controls sweating. This can lead to excessive sweating (known as hyperhidrosis), which most often happens if your Parkinson’s drugs ‘wear off’. Sometimes, people with Parkinson’s can also experience sweating at night.

Sweating excessively can also happen in the ‘on’ state (when your Parkinson’s drugs are working at their best) especially if you have dyskinesia (uncontrollable muscle movements or spasms).

Because some people with Parkinson’s may have a reduced sense of smell, they may not be aware of body odours caused by excessive sweating.
 

Sweating too little

Some people with Parkinson’s may not sweat enough, which is caused by a condition known as hypohidrosis. This may be a side-effect of anticholinergics, a type of medication used to treat Parkinson’s. Lack of sweating may affect parts, or all of the body.

Sweating is normal and helps your body regulate its temperature. If you sweat very little or not at all, particularly when it is hot or when you feel hot, speak to your GP, specialist, or Parkinson’s nurse. This is because a lack of sweating, or reduced ability to sweat, may put you at risk of over-heating.

British Association of Dermatologists

For information on dermatology services and support groups.

Hyperhidrosis Support Group

UK-based support offering information and advice for people that suffer from excessive sweating.

National Eczema Society

Advice and support for people with itchy, sore skin. This charity also has a local support groups.

Psoriasis Association

A national charity that helps people whose lives are affected by psoriasis.