Most people with Bell’s palsy recover within a few weeks. An improvement in facial expressions or facial tingling may indicate recovery. However, if there is severe damage to the facial nerve, recovery may take longer.
Bell’s palsy is a disorder that affects the facial nerve, leading to weakness or paralysis on one side of the face. Symptoms include drooping of the eyebrow and mouth, drooling, and difficulty closing one eye.
In most cases, Bell’s palsy is temporary, and people will show signs of recovery within a few weeks. In severe cases, recovery may take longer, and individuals may need surgery or rehabilitation to improve facial symmetry and function.
This article looks at the typical recovery times for Bell’s palsy, the stages of recovery, and tips to help improve recovery.
In most cases, Bell’s palsy is a temporary condition. Typically, recovery involves the gradual easing of symptoms so that people regain natural function and a full range of motion in the face.
A delayed recovery means that some symptoms remain longer than expected. Recovery may depend on the severity of facial nerve damage. However, in the following cases, a complete recovery may not be possible:
- Congenital facial palsy: If people have facial paralysis at birth, people may require surgical treatment.
- Severe damage to the facial nerve: Severe injury to the facial nerve may cut or sever the nerve. This may occur through trauma or surgery. People may require a longer treatment plan to help restore facial function.
- Nerve grafts: If people have had nerve grafts, they may require specific rehabilitation programs, and recovery times may vary.
Of people presenting with initial symptoms of Bell’s palsy, 71% show obvious signs of recovery within 3 weeks. If individuals do not improve in the first few weeks, their recovery may take longer. The United Kingdom’s National Health Service (NHS) states that in most cases, full recovery can take up to 9 months.
The stages of recovery may vary but usually include the below.
The flaccid stage occurs when symptoms begin and may include the following:
- the facial muscles become weak, lose tension, and become floppy
- weakened facial muscles cause features, such as the eyebrows, to droop
- the eye may not be able to close properly or blink, which may make it sore and dry
- the corner of the mouth may droop, making it difficult to eat, drink, or speak as usual
If people show no improvement or cannot close their eyes after 3 weeks, they will need to talk with a doctor. A doctor may refer them to a facial paralysis specialist.
During the paretic stage, the facial nerves begin to recover. As the facial muscles become firmer and regain their typical shape, a person’s facial symmetry may improve.
People may experience:
- an improvement in facial expressions, although this may worsen over the day as the facial muscles tire easily
- facial muscles that improve at different rates — they may be able to close an eye but find it difficult to smile, for example
- tingling in the face, which may indicate nerve recovery
People must inform a doctor if they experience twitching at this stage. Twitching may indicate recovery or nerve compression.
For delayed recovery, the synkinetic stage is the final stage and causes involuntary movements. During this stage, people may experience:
Beginning treatment as quickly as possible after the first symptoms of Bell’s palsy may help improve recovery. People will need to contact a doctor right away if they have signs of facial paralysis.
Starting prescription medication, such as oral steroids, within
Antiviral medications alongside steroids may help improve recovery. Additionally, over-the-counter (OTC) drugs, such as acetaminophen or ibuprofen, may help relieve pain. However, people must always check with a doctor first in case these OTC medications interact with prescription medications.
To help improve recovery, people can:
- try to stay calm, relaxed, and patient during the recovery period
- follow a doctor’s advice regarding treatment and using eye protection
- avoid trying exercises other than those a healthcare professional recommends, as cases of Bell’s palsy differ
- avoid forcing weak muscles or any area of the face to move
- allow the face to recover in its own time
- gently massage the face with the tips of the fingers, focusing on the brow, temples, cheek, chin, and neck
While people with Bell’s palsy often recover within a few weeks, full recovery can take up to 9 months. People should speak with a doctor as soon as they notice symptoms of the condition.
Certain medications, such as oral steroids, may help recovery, and it is important to rest and allow the body to recover in its own time.
If people do not show improvement in the first few weeks, they may have a longer recovery time. In some cases, individuals may need medical procedures and rehabilitation to help regain facial function.