Managing Bell’s palsy involves taking corticosteroids to increase the chance of full recovery. It also involves eye care and rigorous oral hygiene to prevent complications. The condition can affect a person’s mental health as well.
Bell’s palsy is a neurological disorder that can cause weakness or paralysis on one side of the face. This may result in drooping of the affected side of the face, difficulty or inability to blink one eye, and other changes.
Most people fully or partially recover from Bell’s palsy, but some experience continuing symptoms.
This article looks at treatment for Bell’s palsy, including medication, physical therapy, surgery, and home management. It also looks at how to manage the disorder’s impact on a person’s emotional and mental well-being.
Eye care is also essential and involves using lubricating eye drops and taping the eye shut at night.
Doctors may prescribe various medications to treat Bell’s palsy — corticosteroids, antiviral drugs, or a combination of the two. Doctors also typically prescribe eye drops and eye ointments or gels.
Doctors do not know the exact causes of Bell’s palsy but believe inflammation plays a role. Corticosteroids may help treat Bell’s palsy because of their anti-inflammatory effect.
Although 70–75% of people make a full recovery without treatment, taking a corticosteroid called prednisone increases the chance of full facial recovery to 82%.
Corticosteroids are most beneficial to people with Bell’s palsy when taken within 72 hours of the start of symptoms.
Antiviral drugs and combination therapy
Although research does not support the effectiveness of antiviral drugs as a treatment for Bell’s palsy, some
More research is necessary to determine the effectiveness of antiviral drugs in treating Bell’s palsy.
If antiviral drugs are a beneficial treatment when people use them in combination with corticosteroids, the benefit may be too slight to outweigh the potential side effects of the medication. These side effects include abdominal pain, dizziness, nausea, and vomiting.
Eye drops, gels, and ointments
A doctor may prescribe lubricating eye drops for use during the day and ointments and gels for use at night.
These products help counteract eye dryness, as someone with Bell’s palsy may not be able to blink or close their eye. A person may also need to tape the eye shut, particularly at night.
A physical therapist may provide exercises to help a person with Bell’s palsy:
- support the recovery of facial movement
- maximize symmetry in the face
- limit overuse of the side of the face unaffected by the disorder
- speed up recovery by providing the sensation of movement to the affected side of the face
Exercises for Bell’s palsy include:
- stroking the affected side of the face in a gentle upward motion, starting from the corner of the mouth toward the cheekbone
- using one finger at the corner of the mouth on the weakened side to gently pull the mouth out and into a smile
- using one finger to lift the eyebrow and then gently close the eyelid
The physical therapist can provide guidance on how often to perform these exercises.
If a person’s symptoms have not improved after
Surgical options may include transferring muscles from other areas of the body to the face and inserting weights into the eyelid to help it close.
In rare cases, doctors may consider facial nerve decompression, which involves a surgeon opening the nerve sheath and bony canal to relieve pressure on the nerves.
However, researchers have not found this procedure to be a recommended treatment option, as it may be unsuccessful.
Some people with Bell’s palsy cannot close one eye. This can lead to dryness and, in turn, infection, irritation, and damage to the eye.
Lubricating eye drops
Lubricating eye drops, which people also refer to as artificial tears, can help treat or prevent dryness when a person is unable to blink.
A person may have to use eye drops at least every 2 hours, or as often as their doctor instructs, to prevent the eye from becoming too dry.
At night, a person may need to dispense a thicker substance, such as a lubricating eye ointment or gel, into the eye.
Taping the eye closed when sleeping
A person may need to tape the eye closed before sleep to protect the eye from dryness or damage during the night.
This involves placing a piece of surgical or soft silicone tape horizontally over the eye to keep it closed. A person may also use a soft cloth patch over the closed eye and tape it in place diagonally.
A person should tape their eye closed according to a doctor’s instructions.
A person should wear eye protection during the day to protect the eye from wind, strong light, and debris that may damage it. They may wear glasses, sunglasses, goggles, or an eye patch.
Learn more about eye care for Bell’s palsy.
People with Bell’s palsy may have an
Due to numbness, a person with Bell’s palsy may be unaware if they have bitten their inner gums or cheek, which may increase their risk of infection.
People with Bell’s palsy need to maintain a regular mouth hygiene routine. This involves thoroughly brushing the teeth twice daily, flossing, and using an antibacterial mouthwash.
To relieve any pain Bell’s palsy may cause, a person can:
It is important for a person with Bell’s palsy to monitor their mental health.
Some people who experience physical changes due to Bell’s palsy
A person may feel a sense of loss and unfamiliarity and may feel unsure of themselves as their appearance and speech change.
If someone notices that Bell’s palsy is affecting their mental health, they should consult a mental health professional or doctor.
- Engaging in a peer support group: Finding an online or in-person support group may help a person share their experiences with Bell’s palsy and gain support and knowledge from people who understand the challenges of the disorder.
- Seeking counseling or therapy: Therapeutic techniques such as cognitive behavioral therapy may help people understand and change their thoughts and behaviors. Therapy can be a beneficial treatment for anxiety, depression, and other mental health conditions.
- Connecting with friends and family: A person with Bell’s palsy may feel anxiety about social situations, which could lead to isolating behavior. Isolation can worsen feelings of anxiety and depression. Maintaining communication with loved ones may help a person feel that they do not have to face the challenges of the disorder alone and can turn to others for support.
A person should contact a doctor as soon as they notice symptoms of Bell’s palsy. Treatment may be most effective if it begins within
It is also important to contact a doctor if a person’s symptoms:
- do not respond to treatment
- do not begin to improve within 2 weeks
- become more severe
Additionally, a person should contact a doctor if they experience symptoms of severe dry eyes or eye infection, such as:
- redness in or around the eye
- discharge from the eye
- eye pain or irritation
- swelling around the eye
- blurred vision
- a feeling as if something is in the eye
- light sensitivity
Below are the answers to some frequently asked questions about Bell’s palsy.
What are the chances of recovery?
What are the recovery signs of Bell’s palsy?
As a person recovers, they may feel their facial muscles firm and begin to regain their shape. They may be able to form expressions more easily and may experience tingling in their face.
Is it safe to drive with Bell’s palsy?
Someone with Bell’s palsy may be able to drive safely as long as the disorder does not affect their vision.
Some medications, such as lubricating eye drops, may cause blurry vision, which may prevent a person from driving.
If the disorder or a medication affects a person’s vision, they may not be able to drive until their symptoms improve.
A person should speak with their doctor about whether it is safe for them to drive.
Bell’s palsy can affect a person’s physical health, appearance, speech, and emotional and mental well-being.
Treatment for Bell’s palsy includes medication, such as corticosteroids; eye care, including eye drops and ointment; and, in some cases, surgery.
Home care for Bell’s palsy may include eye care, such as taping the eye closed at night; rigorous oral hygiene; and facial exercises.
A person may need to seek mental health care, as the changes in their appearance and ability to communicate may lead to feelings of low self-esteem, loss of identity, anxiety, and depression. Therapy or counseling, support groups, and contact with loved ones may be beneficial.