Bell's palsy

Bell's palsy is weakness or paralysis (being unable to move) on one side of your face. It may cause facial drooping and is usually temporary.

Most people start to get better over several weeks or months. Some people do not recover fully. They are left with some weakness or paralysis of the muscles on the affected side of their face.

Bell’s palsy is not a stroke, but it can look similar when symptoms start. Seek emergency care if you have facial drooping with symptoms that do not generally occur with Bell’s palsy or start suddenly.

The main symptom of Bell’s palsy is weakness or paralysis of one side of your face. Symptoms can get worse over minutes, hours or days. You will usually have the worst symptoms within 2 days after symptoms first appear. Symptoms can be mild or severe.

Bell’s palsy is not the same as a stroke. Bell’s palsy rarely starts suddenly and symptoms more often develop over minutes to hours.

Bell’s palsy is caused by inflammation or pressure that affects the facial nerve. This nerve controls the muscles of your face and the glands that make tears and saliva (spit).

It is not known exactly why the nerve becomes inflamed. It often happens with a viral infection.

If you have been diagnosed with Bell’s palsy, see your doctor if your symptoms are getting worse or if your facial control does not fully recover within 3 months.

When to seek urgent care

Sometimes, serious conditions such as stroke can cause similar symptoms to Bell’s palsy. Seek immediate care if you have symptoms that do not generally occur with Bell’s palsy.

Call triple zero (000) and ask for an ambulance if you or someone you know has:

• sudden facial drooping that develops within seconds
• weakness or numbness of your arm or leg
• sudden changes in your vision
• difficulty speaking or understanding speech
• severe headache
• difficulty walking or loss of balance

Read more on stroke, including FAST signs and symptoms.

See your doctor as soon as possible or visit a Medicare Urgent Care Clinic if your symptoms develop gradually (over minutes to hours), such as:

• weakness or paralysis on 1 side of your face that develops over many minutes or hours
• a drooping eyelid or mouth on 1 side of your face
• difficulty closing 1 eye or a dry eye
• changes in your facial expression (for example, trouble smiling)
• pain around your ear or jaw on 1 side

There is no specific test for Bell's palsy, but your doctor can diagnose the condition by examining you carefully.

Bell's palsy is diagnosed by ruling out other causes of your symptoms. If your doctor thinks there is another cause, you may need further tests.

Tell your doctor if you have had Bell’s palsy more than once, or if you have symptoms on both sides of your face. If the diagnosis is unclear, or if your symptoms do not improve within 3 months, your doctor may refer you to a neurologist.

Your doctor will probably prescribe you a steroid medicine such as prednisolone. This can improve your chance of a full recovery. It works best if you start treatment within 3 days of noticing symptoms.

Some people may also be prescribed an antiviral medicine.

Most people recover from Bell's palsy within about 6 months, with or without treatment. Early treatment is recommended for adults to help you recover fully.

Your doctor may also recommend physiotherapy, face massage or acupuncture.

Eye care

If you have trouble closing your eye, your doctor will prescribe lubricating eye drops (eye drops that make your eye moist and easier to close) or an eye ointment to protect your affected eye.

You can help protect your eye by:

• using eye drops and ointment as prescribed
• wearing sunglasses or an eye patch when you go outside
• taping your eyelid closed or covering your eye with a pad while you sleep

Bell's palsy may stop you from closing one eye properly. If you do not take care of your exposed eye, you may develop complications such as:

• dry eyes
• damage from objects entering the eye
• keratitis (inflammation of the eye)
• vision loss

If there is concern about damage to your eye, your doctor will refer you to an ophthalmologist (eye specialist).

You may experience involuntary (unintended) movements of your facial muscles after having Bell’s palsy.

Some people do not make a full recovery. This can at times lead to mental health problems, such as anxiety or depression.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 22 4636.

Bell's palsy cannot be prevented. You may be able to lower your chance of having Bell’s palsy by maintaining a healthy weight, blood pressure and blood sugar levels.

The Emergency Care Institute (Opens in new tab) has information on Bell's palsy, including symptoms, causes and treatment options.

The Royal Children’s Hospital has information about Bell’s palsy in children (Opens in new tab).

Languages other than English

The Emergency Care Institute (Opens in new tab) also offers information on Bell's palsy in several community languages.