Bell's palsy: symptoms, treatment, recovery time and when to get help

The NHS lists weakness on 1 side of your face or not being able to move 1 side of your face, which usually happens over a few days, a drooping eyelid or corner of your mouth, drooling, a dry mouth, loss of taste, and a dry or watering eye. You may also find it difficult to close the eye on the weak side. Rarely, you may not be able to move both sides of your face.

North Bristol NHS Trust says the symptoms often occur very quickly, over a few hours or overnight. It adds facial pain around the ear on the affected side, difficulty chewing food with slight dribbling, and sensitivity to noise, where noises may sound louder than usual. When you smile only one side of the face may move, and you may not be able to frown.

• Weakness or drooping on one side of the face.

• Difficulty closing the eye, which may be dry or watery.

• Altered taste, dry mouth or drooling.

• Pain around the ear or sensitivity to noise on the affected side.

The NHS says to call 999 if somebody's face droops on 1 side (the mouth or eye may have drooped), a person cannot lift up both arms and keep them there, or a person has difficulty speaking (speech may be slurred or garbled), because these can be signs of a stroke, which is a medical emergency.

The NHS stroke page uses the FAST test: face, arms, speech and time to call 999. It lists weakness or numbness down 1 side of the body, blurred vision, difficulty finding words, confusion, dizziness or falling over, and a severe headache as other signs, and says to call 999 even if symptoms stop after a short time.

If it is Bell's palsy rather than a stroke, the NHS says to ask for an urgent GP appointment or get help from NHS 111 as soon as possible, because treatment for Bell's palsy is more effective if started early (within 72 hours).

The NHS lists a 10-day course of steroid medicine, sometimes with antiviral medicine, eye drops and ointment to stop the affected eye drying out, and surgical tape to keep the eye closed at bedtime. If you cannot close your eye, you may need treatment to prevent damage to your vision.

North Bristol NHS Trust says oral steroids (prednisolone) may be prescribed if symptoms started in the last 3 days, and that steroids may help to reduce inflammation and decrease the likelihood of damage to the facial nerve. Follow the dose your own prescriber gives you.

It describes eye care as very important if your eye is affected: use eye drops or artificial tears during the day and a thicker solution at night, ask your pharmacist for advice, do not use contact lenses until your eye returns to normal, and you may be advised to wear an eye patch by day and tape the eyelid closed at night. It also advises cleaning around the teeth and gums on the affected side after eating, because food can become stuck.

The NHS says your symptoms should get better within 6 months, but it can take longer for some people, and to go back to see a GP if your symptoms are not getting better after 3 weeks. North Bristol NHS Trust says 75 to 90 in every 100 people start to improve within three weeks and make a full recovery within two to three months.

Some people can have permanent facial weakness, the NHS says, along with symptoms such as pain in the face, around the jaw and behind the ear, a constantly watering eye, difficulty eating and drinking, changes in taste and difficulty with loud sounds. North Bristol NHS Trust gives about 5 to 10 in every 100 people as having some slight weakness that remains, and says that rarely there may be little or no improvement.

The NHS says living with Bell's palsy can make you feel depressed, stressed or anxious, and to speak to a GP if it is affecting your mental health.

North Bristol NHS Trust says Bell's palsy is a medical problem causing weakness of the muscles on one side of the face, which is usually temporary and comes on suddenly with the cause unknown. The facial nerve supplies the muscles in your face, and in Bell's palsy this nerve is affected, leading to weakness or paralysis of the muscles that control smiling, frowning, eating and closing the eyelids. It can also affect taste.

It says Bell's palsy can affect men and women of any age but is most common in 15 to 45 year olds, and in the UK it affects approximately one in 70 people at some point in their lifetime. The NHS says it is the most common cause of facial paralysis, though there are many other types of facial palsy.

North Bristol NHS Trust says the cause of Bell's palsy is unknown. The NHS describes it as one of many types of facial palsy and points to Facial Palsy UK for information on the others. The sources used for this page do not describe Bell's palsy as contagious or something that spreads between people.

The NHS also says that it is rare to have it more than once, and that if it does come back it can be years later. Because other conditions can cause facial weakness, a clinician needs to check your symptoms rather than assuming Bell's palsy.

North Bristol NHS Trust suggests exercises to tone the facial muscles as movement begins to return, performed 10 times each, 4 times a day. These are gently raising your eyebrows (you can help the movement with your fingers), wrinkling your nose, flaring your nostrils, lifting one corner of the mouth and then the other, smiling without and with showing your teeth, and bringing your eyebrows together in a frown.

It gives step-by-step advice for taping the eye closed at night: cut the tape slightly longer than the width of your eye, look down, assist eye closure with the back of your finger, and apply the tape from the inner corner to the outer corner horizontally so the eyelid is fully closed. If you cannot close your eye normally and develop pain, stinging or visual disturbance, it says to seek urgent eye care within 24 hours.

The sources used for this page describe Bell's palsy as affecting men and women of any age. They do not give separate advice for pregnancy or children. The NHS tells anyone with sudden face weakness to seek urgent help, and that applies at any age and in pregnancy.

If you are pregnant, or it is a child with sudden facial weakness, ask for an urgent GP appointment or call NHS 111 so that stroke and other causes can be excluded and any treatment decisions can take account of your circumstances.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have symptoms of Bell's palsy. If your eye cannot close and becomes painful, North Bristol NHS Trust says to attend an eye casualty within 24 hours. Steroids are prescribed in primary care or urgent care, and follow-up is usually with the GP.

Facial Palsy UK is the charity the NHS points to for information on other types of facial palsy. Private ENT, neurology or facial physiotherapy appointments are also available if recovery is slow. Check what each would add before paying.