Bell's palsy is a sudden weakness or paralysis on one side of the face. It is usually a temporary condition however, recovery rate decreases with increasing age.

Bell's Palsy: Facial Droop

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The exact cause of Bell's palsy is unknown. It occurs as a result of pressure on the nerve, or an infection or inflammation in the nerve.

Pressure may be caused by:

  • Tumors or cancers pressing on the nerve
  • Trauma from head or facial injuries

Nerve infections include:

Risk Factors

Factors that may increase your risk of Bell's palsy include:


Bell's palsy symptoms may come on suddenly or develop over a few days. Initial symptoms may include:

  • Pain behind the ear that is followed by weakness and paralysis of the face
  • Ringing sound in the ears
  • Slight hearing impairment
  • Slight increase in sensitivity to sound on the affected side.

Symptoms of full-blown Bell's palsy may include:

  • Facial weakness or paralysis, most often on one side
  • Numbness just before the weakness starts
  • Drooping corner of the mouth
  • Drooling
  • Decreased tearing
  • Inability to close an eye, which can lead to:
    • Dry, red eyes
    • Ulcers forming on the eye
    • Infection
  • Problems with taste on one side
  • Sound sensitivity in one ear
  • Earache
  • Slurred speech

Late complications can occur 3-4 months after onset and can include:

  • Long-lasting tightening of the facial muscles
  • Tearing from eye while chewing

The doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis is usually made with just the physical exam. The doctor may use information from health and medical history to determine a potential cause.

Concern about infections or other specific causes may require further testing.


For most, treatment is not needed. Symptoms will often go away on their own within a few weeks. Bell's palsy may completely resolve after a few months in many people. However, for some people, some symptoms of Bell's palsy may never go away. Your doctor may refer you to a specialist if you have eye problems, if your symptoms worsen, or if your recovery takes longer than expected.

If an underlying cause of the Bell's palsy is known, it may be treated. Treatment for underlying conditions may include medication or surgery.


Your doctor may prescribe corticosteroids if your symptoms have been there less than 4 days. This is a medication that can decrease swelling and pain.

Antiviral medications along with corticosteroids may be recommended if there is a specific virus like herpes or chickenpox/shingles that has caused the palsy.

Antibiotics will be given if Lyme disease is the cause.


If the paralysis includes your eyelid, you may need to protect your eye. This may include:

  • Lubricant or eye drops
  • Covering and taping eye closed at night
  • An eye patch to keep the eye closed

Massaging of the weakened facial muscles may also help.


Physical therapy may be advised to improve function.

Symptoms can be very distressing. Counseling can help you manage emotional issues and make appropriate adjustments.

If you are diagnosed with Bell's palsy, follow your doctor's instructions.


There are no current guidelines to prevent Bell's palsy.