Bell's palsy

What is Bell's palsy?

Bell's palsy is a condition where the muscles on one side of your face temporarily become weak or paralysed. This can make the affected side of your face look droopy or stiffened. Some people might also find it difficult to fully close their eye or their smile may look unbalanced.

If someone’s face droops on one side, they cannot lift up both their arms, or have difficulty speaking, this could be the sign of a stroke, so call 999 immediately.

How long does Bell's palsy last?

Bell's palsy is temporary, and a mild case of Bell’s palsy usually goes away within a few months. 

Some cases may be more severe, but according to the NHS, most people make a full recovery within 6-9 months. 

What causes Bell's palsy?

Doctors don’t know the exact cause of Bell's palsy. It's thought to be linked to an infection of the nerves that control your facial muscles. 

Viruses that may cause the condition include:

• Herpes simplex virus (this virus also causes cold sores and genital herpes)

• Chickenpox and shingles

• Measles

• Mumps

• Flu

• Hand foot and mouth disease

Certain factors can increase your chances of getting Bell's palsy, including:

• Pregnancy – especially during the third trimester and the first week after giving birth

• Diabetes

• Upper respiratory infections, like flu

Bell's palsy symptoms

The main symptom of Bell's palsy is weakness or paralysis on one side of your face. This usually develops quickly over 72 hours. 

This can include:

• Mild weakness to complete paralysis

• A drooping eyelid

• Drooping in the corner of your mouth

• Difficulty smiling or closing your eye on the affected side

• Drooling

• Tears or sensitive/irritated eyes

You may also experience:

• Dry mouth

• Loss of taste

• Ringing in your ears (tinnitus)

• Difficulty eating, drinking or talking

• Headache

• Sensitivity to sound

How is Bell's palsy diagnosed?

Diagnosis for Bell's palsy starts with a physical examination of your symptoms. The doctor may ask you to move your facial muscles in different ways to determine the cause.

Bell's palsy is usually diagnosed by ruling out other possible conditions that could be causing the symptoms, like stroke. This might involve tests such as hearing and balance tests, CT scans and MRI scans.

How is Bell's palsy treated?

There's no cure for Bell's palsy but different treatments are available to help reduce symptoms. These include:

• Corticosteroids – these help to reduce facial swelling. Treatment needs to begin within three days of your symptoms starting and generally needs to be taken for 10 days

• Eye treatments – including ointments and drops to prevent the eye drying out and surgical tape to help close your eye at night

• Physical therapy – working with a therapist to learn how to massage and exercise your facial muscles

• Painkillers – over the counter painkillers like paracetamol and ibuprofen can help to reduce any pain

• Alternative medicine – some people find acupuncture (where thin needles are used to stimulate nerves and muscles) helps improve the symptoms of Bell's palsy, although this isn't scientifically proven

When should I speak to a doctor about Bell’s palsy?

If you experience any of the signs of Bell's palsy, speak to a doctor as soon as possible, as treatment is more effective if it's started early.

A stroke doesn't cause Bell's palsy, but the symptoms can appear similar. If one side of your face suddenly droops, it can be a sign of a stroke, so call 999 immediately.

Living with Bell's palsy can affect your mental health, making you feel low, anxious, and depressed. If you experience a change in your mental health, talk to a doctor to see what support they can offer.