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Bell's palsy

Bell's palsy is a temporary weakness or paralysis in one side of your face. Read more about the symptoms and how it's treated.

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 appear to droop or stiffen, cause difficulties fully closing your eye and make your smile seem unbalanced.

How long does Bell's palsy last?

Bell's palsy is temporary, and most people make a full recovery within six to nine months.

Bell's palsy causes

The exact cause of Bell's palsy isn't known, but it's thought to be linked to the nerve that controls your facial muscle becoming inflamed following a viral infection. Viruses that may cause the condition include:

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

  • Chickenpox and shingles

  • German measles (rubella)

  • Mumps

  • Flu

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

Is Bell's palsy contagious?

Bell's palsy is a temporary type of muscle weakness in the face. It isn't contagious, but the underlying cause of Bell's palsy is often a virus, which may be contagious.

Can you get Bell's Palsy twice?

Most people only get Bell's palsy once, but in some cases, it can return. The chances of this happening are higher if someone in your family has had the condition.

Bell's palsy symptoms

The main symptom of Bell's palsy is weakness or paralysis on one side of your face that develops rapidly 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 the 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

When to see a doctor

If you experience any of the signs of Bell's palsy it's essential to see 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. This is a medical emergency and needs urgent medical attention.

Bell's palsy diagnosis

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, for example:

  • Closing your eyes

  • Smiling

  • Raising your eyebrows

  • Frowning

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.

Bell's palsy treatment

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

  • Corticosteroids – These are strong anti-inflammatories that help to reduce facial swelling. Treatment needs to begin within three days of your symptoms starting

  • 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 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

Bell's palsy outlook and complications

Most people see symptoms start to improve within a few weeks and make a full recovery within six to 12 months. In a few cases, the symptoms don't clear up, although they usually improve to some degree. 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 your GP to see what support they can offer.

Can you drive with Bell's palsy?

It's not advisable to drive when your Bell's palsy symptoms are severe. This is a time to rest and give yourself time to recover. As your symptoms ease you can talk to the doctor about whether it's safe to return to driving. Avoid driving if you're experiencing any symptoms that affect your eyes or your vision and inform the DVLA if you plan to drive with a medical condition that could affect your driving.

Reviewed by:

Dr Rhianna McClymont

Lead GP at Livi

Last updated: