Medicines for Prosopagnosia

What it is

Prosopagnosia, commonly known as "face blindness", is a condition in which a person has difficulty recognising faces — sometimes to the point of being unable to recognise familiar people, close family and friends, or even their own face in a mirror or photograph — despite having otherwise normal vision, intelligence, and memory. The difficulty is specifically with recognising faces (and, for some, other aspects of processing faces, such as reading expressions or telling faces apart), rather than with seeing or with general memory or thinking. The severity varies widely — from mild difficulty recognising less familiar faces, to a profound inability to recognise even the most familiar people. There are two main types: developmental prosopagnosia, which is present from early life (without any brain injury), is thought to be more common than previously realised, and can run in families; and acquired prosopagnosia, which develops after damage to the specific area of the brain involved in recognising faces (for example after a stroke, head injury, or other cause). Because so much of everyday social interaction relies on recognising faces, prosopagnosia can have a significant impact — it can cause difficulty and anxiety in social situations, embarrassment, difficulty following people in films or keeping track of characters, and challenges in personal and working life; people may fail to recognise, or appear to "snub", people they know, or feel anxious about social encounters. People with prosopagnosia often develop strategies to recognise people by other means — such as voice, hairstyle, clothing, gait, context, or other distinguishing features — to compensate. There is no cure for prosopagnosia (particularly the developmental form), but understanding the condition, and using strategies and support, help people manage it. Recognising the condition — and knowing that difficulty recognising faces is a real, recognised condition, not rudeness or a poor memory — is itself helpful and reassuring. The key messages are that prosopagnosia (face blindness) is difficulty recognising faces (including familiar people or even oneself) despite otherwise normal vision and thinking, and that strategies to recognise people in other ways help people manage it.

How it is treated

Prosopagnosia is managed by understanding the condition and developing strategies to recognise people by means other than the face; there is no cure, but these strategies and support help people cope, and recognising the condition is itself helpful. Because prosopagnosia is a specific difficulty with recognising faces (not a problem with vision, memory, or thinking generally), and because it can significantly affect social life, understanding the condition is an important first step — recognising that difficulty recognising faces is a real, recognised condition (not rudeness, unfriendliness, or a poor memory) is reassuring and helps both the person and those around them. For developmental prosopagnosia (present from early life), there is no cure, and the main approach is developing and using compensatory strategies; for acquired prosopagnosia (after brain damage), the underlying cause is managed, and strategies are used similarly. The mainstay of managing prosopagnosia is using strategies to recognise people by features other than the face: people with prosopagnosia often learn to identify others by their voice, hairstyle, clothing or style, body shape and gait, distinctive features (such as glasses, facial hair, or accessories), and context (where and when they expect to see someone), and consciously using and developing these strategies helps. Practical measures can also help — for example, explaining the condition to family, friends, and colleagues (so they understand and can help, for example by identifying themselves), and, in social or work situations, having others introduce themselves or provide context. Support and understanding from those around the person are important, as prosopagnosia can cause social difficulty and anxiety, and knowing that others understand relieves the worry of appearing to snub people. Support for any associated anxiety about social situations can help. There is ongoing interest and research into whether training can improve face recognition, though this is not a straightforward treatment. For acquired prosopagnosia, assessment and management of the underlying brain condition, and rehabilitation, are relevant. Support organisations and information about prosopagnosia can help people understand and manage the condition and connect with others who share the experience. It is worth seeking assessment if prosopagnosia is suspected, both to understand the condition and to consider any underlying cause (particularly if it develops suddenly, which could indicate an acquired cause needing assessment). The reassuring messages are that prosopagnosia is a real, recognised condition (not rudeness or a poor memory), that understanding it is itself helpful and reassuring, and that strategies to recognise people by other means (voice, hair, clothing, context, and distinctive features), explaining the condition to others, and support help people manage it; so understanding the condition and developing compensatory strategies are the keys to living with prosopagnosia.