Bell’s palsy – symptoms and treatment

Bell’s palsy can cause 1 side of your face to droop and lose movement. Learn why it happens and how it’s treated.

What are the symptoms?

What causes Bell’s palsy?

Who can be affected? 

When to see a doctor

How is Bell’s palsy diagnosed?

What are the treatments?

Self-care tips for Bell’s palsy

Bell’s palsy is a condition that affects your facial nerve, causing 1 side of your face to droop and become paralyzed (lose movement). It can be scary, but with quick diagnosis and treatment, most people make a full recovery. Find out what you need to know.

Bell’s palsy is a nerve (neurological) problem that causes sudden weakness or lack of movement (paralysis) of your facial muscles, usually on 1 side of your face. 

It’s sometimes known as facial palsy, acute peripheral facial palsy of unknown cause, or idiopathic peripheral facial palsy. 

It can be very worrying, especially as the [symptoms can be similar to signs of a stroke](https://www.livehealthily.com/health-library/conditions/stroke) – a medical emergency that involves the blood supply to your brain. 

__You should get emergency medical help if:__

- 1 side of your face has drooped
- you can’t lift both your arms and keep them raised
- you’re having trouble talking – your words may be slurred or garbled

Unlike a stroke, however, Bell’s palsy happens when the main nerve in your face – which controls your facial muscles – is affected by inflammation or injury.  

It’s the most common cause of facial paralysis, affecting up to 40 in every 100,000 people a year.

Most people who get Bell’s palsy will make a full recovery. But if you have symptoms, it’s important to get diagnosed and treated as soon as possible. 


## What are the symptoms?

A couple of days before the main symptoms of Bell’s palsy start, you may notice a dull ache behind your ear, a dry eye, symptoms of a cold, or a mild fever. 

Other symptoms usually come on quickly, often getting worse within 2 or 3 days. 

The main symptom is:

- weakness and/or lack of movement (paralysis) on 1 side of your face. It can look like your face is drooping, affecting your forehead, eye (including brows), and corner of your mouth.

Other symptoms can include:

- trouble speaking, eating, or drinking
- a dry mouth
- drooling
- a dry or watery eye
- pain around the ear or jaw
- headache
- loss of taste
- being more sensitive to sound.

__Go to an urgent treatment center if you have symptoms of Bell’s palsy – the sooner you get treatment, the more effective it can be.
__

Get help with this

## What causes Bell’s palsy?

Bell’s palsy happens when inflammation or pressure affects your main facial nerve, known as the seventh cranial nerve. This nerve carries signals that control the muscles in your face. 

We don’t understand exactly what causes this, but scientists think Bell’s palsy could be triggered by a viral infection. 

Viral infections that have been linked to Bell’s palsy include: 

- [flu](https://www.livehealthily.com/health-library/conditions/flu)
- [glandular fever (mononucleosis, or ‘mono’)](https://www.livehealthily.com/health-library/conditions/glandular-fever)
- [cold sores](https://www.livehealthily.com/health-library/conditions/cold-sore) and [genital herpes](https://www.livehealthily.com/health-library/conditions/genital-herpes) (herpes simplex) 
- [COVID-19](https://www.livehealthily.com/health-library/conditions/coronavirus-covid19)
- [chickenpox](https://www.livehealthily.com/health-library/conditions/chickenpox) and [shingles.](https://www.livehealthily.com/health-library/conditions/shingles)

Other health conditions and factors that could also be involved in triggering Bell’s palsy include: 

- [Lyme disease](https://www.livehealthily.com/health-library/conditions/lyme-disease)
- autoimmune conditions – where your immune system mistakenly attacks your body
- [ear infections](https://www.livehealthily.com/health-library/conditions/ear-infections)
- stress
- sleep deprivation
- physical trauma or illness.


## Who can be affected? 

Anyone can get Bell’s palsy, but it’s most common among people aged 15-45.  

Health conditions that may increase your risk include: 

- [diabetes](https://www.livehealthily.com/health-library/conditions/diabetes)
- [high blood pressure](https://www.livehealthily.com/health-library/conditions/blood-pressure-high)
- [obesity](https://www.livehealthily.com/health-library/conditions/obesity)
- having had it before – about 10% of people will get it again. 

Pregnancy is another risk factor. If you’re pregnant, you’re 3 times more likely to get Bell’s palsy than a non-pregnant woman. 

It’s thought that this could be due to things such as water retention, hormonal changes, and a weaker immune system during pregnancy.  


## When to see a doctor

Go to an urgent treatment center if you have [symptoms of Bell’s palsy](https://www.livehealthily.com/health-library/conditions/bells-palsy#symptoms), as treatment needs to be given as soon as possible. 

A doctor will be able to check for other health conditions that have similar symptoms, too.

You should go to your doctor if you’ve been diagnosed and treated for Bell’s palsy and your symptoms haven’t improved after 3 weeks. 

__Get emergency medical help if you have [symptoms of a stroke](https://www.livehealthily.com/health-library/conditions/stroke#symptoms).__

You can remember the key symptoms of a stroke or TIA with the word FAST:

Face – someone’s face may droop on 1 side, or become numb, and they may not be able to smile evenly
Arms – 1 arm may be weak or numb, and raising it may be difficult
Speech – may be slurred or garbled
Time – call an ambulance immediately if you or someone else has these symptoms. Paramedics can start treatment for a suspected stroke right away, before you get to the hospital.


## How is Bell’s palsy diagnosed?

There’s no specific test to check for Bell’s palsy.

Your doctor will discuss your symptoms with you. They will do a physical exam to see how your facial muscles move, and the level of weakness on the affected side. 

You may also have tests to help rule out other conditions, such as Lyme disease or a tumor. These may include blood tests, an MRI or CT scan, or electromyography – which checks your nerves. 


## What are the treatments?

The sooner you get treatment for Bell’s palsy, the more effective it’s likely to be. 

The main aim is to reduce the inflammation.  For this, your doctor will prescribe a course of steroid medication, sometimes with antiviral medication as well. Steroids need to be started within 72 hours of your symptoms appearing.

If something is thought to have triggered Bell’s palsy, your doctor may also treat this. For example, if you have an ear infection, you could be prescribed antibiotics. 

Other treatments can minimize the symptoms of Bell’s palsy, to help you feel better and prevent complications. Your doctor may recommend:

- eye drops – to help keep the affected eye moist if you can’t blink
- wearing an eye patch or tape – to protect your eye, especially at night
- over-the-counter pain medication – check with your doctor before taking these.

If you are unable to close your eye then you may need treatment to prevent damage to your eyesight. 

For many people with Bell’s palsy, symptoms go away completely within 6 months, but it can sometimes take longer. 

Up to 10% of people will be left with slight facial weakness, and other symptoms such as a watering eye or pain in the face, around the jaw and ear area.

Go back to your doctor if your symptoms aren’t getting better after 3 months.


## Self-care tips for Bell’s palsy

Self-care steps you can try during your recovery include:

- __engaging in good dental hygiene__ – chewing and swallowing can become more difficult when you have Bell’s palsy, so make sure you clean your teeth well to help prevent food and bacteria build-up 
- __doing facial exercises__ – as you start to get movement back in your face, daily gentle facial exercises can help your muscles. This can include things like frowning, smiling, raising and lowering your eyebrows, and alternately raising the corners of your mouth. A physical therapist can also help with muscle-strengthening exercises and facial massage. 


error

 There was an error when submitting your feedback – have a screen break then try again in a few minutes.

Oh no, something’s gone wrong

ANY COMMENTS OR SUGGESTIONS?

initial

This isn’t helpful

This isn’t relevant

Something is wrong

This isn’t accurate

Please select one.

loading

success

We're listening – we use your feedback to improve your experience, and make our content more helpful.

Thank you for your feedback

References

Chantelle Pattemore

Susie Parker

Dr Tamer T Malak

Article information

All of Healthily's articles undergo medical safety checks to verify that the information is medically safe. View more details in our <a href="/safety" target="_blank" rel="noopener noreferrer">safety page</a>, or read our <a href="/legal/editorial-policy-principles" target="_blank" rel="noopener noreferrer">editorial policy</a>.