Prosopagnosia is a condition where you struggle to recognize faces or can’t interpret facial expressions and cues. It usually happens because of brain damage, but some people have it at birth. Treatment focuses on underlying causes or helping you adapt so you can recognize people in other ways.
Prosopagnosia (pro-so-pag-no-zee-ah) is a condition where your brain can’t recognize faces or facial expressions in spite of having normal vision. This can make it hard for you to recognize the faces of familiar coworkers, friends or even close loved ones.
Prosopagnosia falls under a family of conditions, agnosias, which interfere with how your brain processes information from your senses. Most of these conditions happen because of damage to your brain from any number of causes. However, prosopagnosia can also happen without that damage.
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Also known as face blindness, prosopagnosia can happen in two different ways, either as an acquired condition (meaning a person develops it because of damage to part of their brain) or as a congenital problem (this means a person is born with it). Available research suggests the congenital version of this condition might be genetic, as it seems to run in some families.
Experts aren’t sure exactly how common this condition is in either form. There’s little to no data available for acquired prosopagnosia. There is some data available for congenital prosopagnosia (also known as developmental prosopagnosia), with some research showing as much as 2.5% of people have it to some degree.
However, there’s disagreement on whether or not that percentage is accurate. That disagreement exists partly because this condition is so difficult to diagnose. Another part of that disagreement is that there's no clear line between this condition and having a below-average ability to remember faces.
Prosopagnosia is a condition that affects your brain only. However, it doesn't just interfere with your ability to recognize faces. This condition is often a source of anxiety for people. That's because many feel embarrassed or ashamed that they struggle to remember faces while others have no trouble with it. That shame and anxiety lead many with this condition to avoid social situations.
There are two forms of prosopagnosia, and the symptoms depend on the form. The two forms are apperceptive and associative:
The causes of the condition depend on how they happen. Most agnosias are acquired, meaning you develop them at some point in your life. The most common reason people develop agnosias, including prosopagnosia, are injuries to their brain. These injuries, called lesions, can happen for many different reasons.
People with congenital prosopagnosia don't have a brain injury that explains this problem. There are only a few ways — some confirmed and some not — that congenital prosopagnosia can happen.
Potential causes of brain lesions that cause prosopagnosia include, but aren’t limited to, the following:
Researchers have identified several DNA mutations that are more common in people with congenital prosopagnosia. Experts first suspected this condition had a genetic connection because it tends to run in families.
But some of the mutations aren’t inherited. These “de novo” mutations — meaning new, spontaneous mutations that neither parent had — also seem to happen more frequently in people with congenital prosopagnosia.
Prosopagnosia might also have a connection to other developmental conditions like autism spectrum disorder. However, more research is necessary to confirm this.
Prosopagnosia isn't contagious. While some of the infections that can ultimately cause it are contagious, having one of these infections doesn't guarantee that you'll develop this condition.
Diagnosing prosopagnosia takes a combination of a neurological exam, asking questions about your history, diagnostic imaging and testing.
The neurological exam and tests will likely include:
The following tests are possible for prosopagnosia.
Prosopagnosia isn’t curable directly. However, some of the causes of acquired prosopagnosia are curable. Resolving those problems might help with this condition. Prosopagnosia is usually permanent, and these recoveries aren't common.
In cases of congenital prosopagnosia or where acquired prosopagnosia is permanent, there are still options to help you compensate and adapt. Ultimately, healthcare providers will show you ways to work around your condition, limiting its impact on your life.
The treatments and methods depend on what the goal is. The treatments for underlying conditions that cause prosopagnosia are different from treatments that help a person learn to adapt to and live with the condition.
These treatments address the underlying problem that caused your prosopagnosia. They may or may not help your prosopagnosia itself. The possible treatments include, but aren’t limited to, the following:
Even in cases where recovery is possible, healthcare providers may recommend that you participate in therapy and rehabilitation programs that specialize in helping with conditions like prosopagnosia. Those programs aim to help you adapt and compensate for this condition. The ways they teach that include:
The complications from medications, surgery or other treatments depend strongly on the treatments themselves, as well as the severity of your condition, your overall health and other factors. Your healthcare provider is the best person to tell you what side effects or complications you should watch for or expect.
If you develop prosopagnosia partway through your life, it isn't a condition you should try to diagnose or treat yourself. It is difficult to make this diagnosis, even for trained professionals. It may be related to serious neurological conditions, so you should see a healthcare provider.
Many people with congenital prosopagnosia don’t realize they have it because they’re used to it, and they’ve had their whole life to develop ways to adapt to it.
If you’ve had prosopagnosia all your life and learning about the condition makes you suspect you have it, you should talk to a healthcare provider. They can answer questions and refer you to a specialist if necessary, so you can get answers about what you experience. They can also refer you to programs that can help you adapt to this condition, so it is less disruptive to your life.
The time to recover after treatment depends strongly on the severity of your case, the underlying condition and the treatments you received. In some cases, prosopagnosia improves or goes away after a few months, but it can also take up to a year. In most cases, however, this case is permanent to some degree.
Many of the conditions that cause acquired prosopagnosia happen unpredictably, so you can’t prevent them. All you can do is reduce your risk of having these conditions or circumstances. The best things you can do include the following:
In most cases of acquired prosopagnosia and all cases of congenital prosopagnosia, this condition is permanent. However, the condition isn't dangerous to your health or safety on its own. But it does have the potential to affect your mental health. That's because most people with this condition experience anxiety or fear of social situations where they might struggle to recognize someone they’ve met previously.
While this condition is permanent and not directly curable, it’s not dangerous to your health and safety. It’s often treatable. In many cases, it’s possible to learn alternate strategies to help you identify people, which can help you in social situations.
Your healthcare provider is the best person to guide you in living with prosopagnosia. They can provide resources and refer you to specially trained, experienced healthcare providers or qualified programs that can help you adapt to and live with this condition. They can also help monitor this condition to see if it changes in any way.
People with prosopagnosia commonly struggle with anxiety in social situations. This is because of feelings of shame or embarrassment at struggling to recognize people. Some people will go so far as to isolate themselves and limit social interactions, leading to depression and other problems.
Your healthcare provider can also help refer you to behavioral health specialists, such as counselors or therapists. Those trained experts can help you cope with the stress and anxiety that often come with this condition.
Prosopagnosia isn’t a common condition overall. If it develops quickly, you should call your healthcare provider and schedule an appointment. That’s because a fast onset of this condition is possible when the condition happens because of problems like a brain tumor.
You should also talk to a healthcare provider if you notice this problem because it’s interfering with your life. This is true whether you've had problems identifying faces all your life or if this is a new development.
You should get immediate medical attention if you notice a very sudden inability to recognize faces, especially along with any symptom of a stroke or brain injury. The symptoms of stroke include:
A note from Cleveland Clinic
Prosopagnosia can be a source of major anxiety for people who experience it. Many experience shame, anxiety or embarrassment because they struggle to recognize people in social situations. This condition is usually permanent, but modern medicine can help treat underlying conditions, which may help this condition improve. Therapy and rehabilitation can also help you learn ways to compensate for this condition, limiting its impact on your life. That way, you can rest a little easier because you can handle social situations without worrying about this problem.
Last reviewed by a Cleveland Clinic medical professional on 07/07/2022.
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