Procerus Sign - Wrinkles psp

Much has been published already about the facial wrinkles in psp

and how it can be a early diagnostic tool. MSA and Parkinson's does not feature the same type of wrinkles. The wrinkles form a triangle just above the nose and also form several lines on the forehead like you get when you squint to focus/see something. My question is- Does it also form crows feet wrinkles on the outside of the eyes?

20 Replies

  • What an interesting question. Crows feet are the result of muscles involved in smiling, squinting and sleeping (but mainly smiling). The crows feet themselves are the breakdown of collagen etc under the skin caused by the constant muscle movement around the eyes of smiling etc. I'm guessing that if PSP causes "less muscle movement" in facial muscles (hence around the eye area), it will prevent (to some degree) further damage that causes crows feet. I would welcome others correcting me if I have come to the wrong conclusion.



  • I asked because I am Dx psp and do have the wrinkles on forehead and the triangle above nose very pronounced BUT also have totally obvious Crow's Feet wrinkles of the eyes. I always thought it was from squinting in the outdoor sun as I try and protect my eyes.

  • This is a bit disturbing. My husband has an almost wrinkle free forehead and no triangle but I have 3 very deep vertical wrinkles on my forehead between my eyes. Should I be worried?

    Nanna B

  • We are the same here,PSP husband 8 years older than me is almost unlined but I have the triangle and lines like you.I think my husbands extreme apathy saves him from lines and as I worry for two I have the lines for two! I think this apathy is so much better and saves my husband frustration he would feel so while I miss the old Des I find the new Des easier to look after.When he chooses the wrong words we both have a good laugh,like asking me to put a battery in his razor blades,should have been hearing aides.Although my husband spends little time outside,by choice, he would prefer indoors he has a good colour which people remark on assuming he has been in the garden .If this wretched disease was not so cruel it would be interesting Glad i have got this site to share experiences.Keep going everyone,

  • That's made me feel better. Remember all the funny things your husband says. My husband used to do that but rarely says anything now. We do still have a laugh though. He has deteriorated over the last 3 weeks and although he has a chair lift, am awaiting the OT as I think he should move downstairs now as I have difficulty getting him out of bed and will soon need a hoist. This had been on my mind during the night. I managed to get him out of bed in the morning and he shuffled the few feet to the chairlift. At the bottom of the stairs I bought his walker towards him, put my arm under his, told him to push himself up on 3 and counted, 1,2,3. He never budged. We tried again and again, and although I tried to pull him up, still nothing. What surprised me was he was doing his funny humming laugh all the time. I was getting really worried and was wondering who to call. I told him it was alright for him to laugh but it was him who would be on the chairlift seat all day. We tried once more, nothing except the laugh. It was then I saw he was still strapped in! I laughed then, apologiesed, undid the strap.....1,2,3, and up with no problem. I've told several friends and family members and each time he laughs. What would we do without laughter?

    Nanna B

  • Oh NannaB, what a laugh, I can just imagine the scene, no doubt you were getting more and more wound up, while hubby was finding it more and more funny! You're right, how could we cope with life, if we didn't laugh. I'm sure some people would think us barmy, laughing at such things, but what else can you do!!!!

    Life is obviously getting harder for you, my thoughts are with you and your husband, so it's lovely that neither of you have lost your sense of humour!

    Keep it up!

    Lots of love


  • Thanks nannab. It, like everything with PSP, depends on the individual. Jimbo

  • Interesting indeed Strelley as I have a 'wrinkle free' face but then I don't have a definitive diagnosis of PSP. BTW did u & your wife go to 'choir of king's college Cambridge on Thursday night in Perth concert Hall? There was a man + wife sitting in front row next to me - I said to him in the car park on exit 'In Paradisium - that is the finale of Faure's Requiem - that is worth perusing as his work is described as a 'lullaby of death' - his work - the text begins & ends with the requiem - rest' Mary tea 13

  • Hi Mary

    Sadly my wife is not well enough to go to such entertainment at places like the Perth concert hall as you mention. Glad to know you enjoyed it.


  • Thanks Strelley for your reply The woman was not 'well' but we were able to have a conversation. Do u know the Faure work? Its been a favourite of mine for many years & while a friend was visiting yesterday it was broadcast from Sydney Opera not as good acoustically as Perth concert hall. Melbourne today, Brisbane 29 July Canberra July 31 Adelaide August 2 - I recommend listening if possible. Mary


  • someone sent me

    If you scroll down to Figure Six you will se a picture of the deep furrows (wrinkles) this man with psp has.

    Thanks ....

  • Thanks for this mcfly. I can see what they mean now.

    Nanna B

  • Hi, I have looked at the picture, yes, S has a few vertical wrinkles, but so have I!!! In fact I would think mine are worse. Like Loppylugs, my husband has apathy, so it's me who gets to worry, hence the wrinkles!!!

    I think people are clutching at straws, if that's how they are going to diagnose PSP!!! When S has his "mask" on, most of his wrinkles (only has a few anyway) go away! I hope we are not going to go down the "Aids" road, like in South Africa, where they went through a stage of stupid remedies, "eat lots of beet root" "shower at the appropriate time" etc., etc., to cure Aids!!!! On the other hand, they have now found medication that is working, so perhaps, we need to travel that same road, but we do need somebody to come up with the money first!!!

    Here's hoping!!!

    Lots of love


  • Thanks.. I think the point of the wrinkles is to explain how psp has a distinct facial look or stare --the forehead wrinkles might be from trying to keep their eyes open.

  • Good question - looking at various photos of Tony, he always had a pronounced vertical crease, even when I first knew him in the late 50s. As he didn't use glasses until the last year or two, I had thought that might be the reason.


  • We must remember that PSP is not a one-size-fits-all disease. My wife didn't have any wrinkles that were not normal aging. None on the forehead. Only the amount of expected crow's feet on the sides that could be expected at her age. There are so many variables in that question. Generally smokers have more of a tendency for any wrinkles. Some drinkers also develop wrinkles that one wouldn't call "normal". I would think that is a very subjective thing (wrinkles). IMHO Jimbo

  • I believe that your wife is an exceptional case in PSP as she does not have symptoms related to this disease. Most of those who have PSP does. My dad had the wrinkles way way back...

  • I've noted that only a few people have responded positive to your post about wrinkles. I don't consider anyone who has or had PSP to be an "exceptional case" because all cases are different in many ways. If you read the posts on this site you will soon come to realize, as I posted previously, PSP is NOT a one-size-fits-all disease. Because you don't have a symptom does not make you an "exceptional case" in my humble opinion. If we were to post a list of all the many symptoms of PSP on this site and asked the question "How many of these diseases do NOT apply to your family member?" my guess is that many patients would say that as least 25% of the symptoms on the list their loved one didn't have. Just my guess with no facts at this time. Hugs! Jimbo

  • I guess you're right. . Looking back there are symptoms which my dad didn't have. Thanks for clarifying jim :)

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