Initial Advice and Guidance

This information is appropriate for people who have been given a diagnosis of Bell’s palsy (BP), within the last 6 weeks.

Feelings/emotions you may be experiencing

• Disbelief/shock – why has this happened?
• Fear – what will happen/will my face go back to normal? How long before I get better?
• Isolation – you have been given little help/support from health care professionals.
• Bewilderment – you are unsure what to do to help yourself get better.
• Self-conscious – how will other people react?
• Sadness – you want your face to go back to normal.

All these feelings are normal and understandable. So, let’s address each one:

Disbelief/shock

Why has this happened?

Some people who develop BP may have experienced any of the following prior to the onset of their symptoms:

• Flu/a cold/sore throat/ear infection/chest infection.
• A prolonged period of stress.

OR

• You may have been completely healthy and stress-free prior to developing BP.

There is nothing you could have done to prevent developing BP.  It can happen to anyone, at any time.

How long before I get better?

This is the million-dollar question which everyone wants to know, and nobody can tell you the answer but there are some facts to remember:

• Approximately 70% of people diagnosed with BP will make a full recovery within the first three weeks following the onset of symptoms.
• If you notice signs of recovery within the first three weeks, then it is likely that you will make a full recovery over the ensuing weeks.
• The rule of thumb is that the earlier you show signs of recovery the more likely you are to make a full recovery even if it is slower.
• If you are approaching the 6-weeks and have not experienced any recovery at all, then your recovery is delayed. This does not mean you won’t make a good recovery, but it does mean that you will have to manage your symptoms for longer. You can find out more information about this on our ‘delayed recovery’ page.

Read more about the 3 different types of nerve injury and watch this video to find out about how the nerve recovers.

Fear, isolation, and bewilderment

You have been given little help/support from health care professionals.

Usually, people obtain their diagnosis of BP from their GP or in the Accident and Emergency department where you may or may not have been seen by an ENT specialist and/or you may have undergone some further tests.

You should have been prescribed a course of steroids and given some eye lubrication and tape to help protect the affected eye whilst eye closure is weak.  Normally there is very little aftercare and people are sent away without any further instruction, at best you may be directed to the Facial Palsy UK website.  There is lots of reliable and evidence based advice on the Facial Palsy UK website.

You probably won’t know anyone else who has been in your situation and left to your own devices will search the internet for information and help.  Swamped by the range of information at your fingertips you will flounder in an abundance of advice.  The information on the following link about how to manage your facial palsy in the early weeks when your face is floppy, has been put together by highly experienced clinicians who have specialised in the management of facial paralysis.  The link includes videos on how to tape your affected eye closed, facial massage for both sides of your face, and how to look after the working side of your face so it does not get too dominant. Management of flaccid facial paralysis.

Further information about eye care advice can be found here:

Eye lubrication

Dry eye advice

If you feel you would like more support, you can join our community and access virtual and local support groups.  Join our community here.

Self-Consciousness and Sadness

Bell’s palsy not only alters your appearance, but it can make everyday activities difficult.  You may find it difficult to eat and drink, your speech may be slurred, your eye may water and feel sore/gritty.  These symptoms may increase feelings of self-consciousness and add to a reluctance to go about your daily life.

People with BP react in different ways.  There is no right or wrong about how to feel.  Some people are so overwhelmed by their symptoms that the thought of going back to work, socialising, or just going about their normal daily life feels impossible.  Others may just soldier on despite their feelings or because there is simply no alternative.

This page on our website is very good at explaining the psychosocial challenges of living with facial palsy with lots of help and links to useful resources.

What should you be doing?

Never practice movement exercises when the face is paralysed or weak.

• There is no need to ‘exercise’ your face. This will not speed up any recovery and can make things worse. It is helpful to massage your facial muscles to maintain their flexibility and suppleness as shown on the videos for ‘the floppy face’, and relaxation. Click here for help with relaxation exercises.
• Eye care as described in the links above.
• Brush your teeth after eating to clear any food residue that may have collected in the weak cheek. Find more guidance about eating and drinking with Bell’s palsy here.
• If you are finding it difficult to talk just slow down and give yourself more time to speak.

What you should avoid doing?

• Chewing gum
• Forcing facial movements
• Trying to squeeze your eye shut
• Acupuncture which uses electrical stimulation through the needles
• Practising any facial movement

These activities can cause unintentional side effects and may do more harm than good.