Steroids, Antivirals and Antibiotics

Where facial paralysis is thought to be caused by an infection, various medical treatments may be prescribed.

Caution: This information is intended just to explain how and when these treatments may be used. You should always seek advice from your GP before taking any medication.



Relevant to: Bell’s palsy, Ramsay Hunt syndrome.

A steroid called Prednisolone is commonly used to treat patients with Bell’s palsy. This should be administered within 72 hours of the symptoms appearing and works by helping to reduce inflammation. There is no evidence at present to suggest that there is any benefit in taking steroids beyond the 72-hour time window. The sooner the steroids are started the better. People with Bell’s palsy are usually advised to take prednisolone tablets twice a day for 10 days.

It is important to remember that even treatment with steroids within 72 hours of onset of symptoms will not guarantee a full recovery in all cases. However this treatment will give you the best possible chance of making a full recovery and should be taken if prescribed by your GP.

Recent studies suggest that antiviral drugs do not improve the outcome for a patient with a typical Bell’s palsy.

Where a diagnosis of Ramsay Hunt syndrome is suspected, as well as antiviral drugs, steroids can be prescribed. The effectiveness of the use of steroids for treatment of Ramsay Hunt syndrome is not proven but unlikely to do harm and can potentially help with pain and recovery.


Frequently asked:

Question: Are steroids safe for children to take?

Caution: You should always seek advice from the health professional in charge of your child’s care before giving them any medication as they will know your child’s full medical history.

Answer: Steroids are safe in children in short courses. 1-2mg/kg for 5 days tailing off for 5 days was the protocol suggested by the Alder Hey Endocrinology department.

Question: Are steroids safe to take when I have another health condition?

Answer: You should always tell your health care provider if you have another health condition when being prescribed steroids. Examples might be diabetes, osteoporosis, high blood pressure, stomach ulcers, pregnancy and mood or psychiatric disorders. Your GP or other doctor will then discuss the pros and cons of steroid treatment with you, and you may need additional monitoring while taking steroids.

Question: What time of day should I take steroids?

Answer: It is best to take steroids with breakfast or lunch (not on an empty stomach) and not later in the day as the medication can cause insomnia.


Relevant to: Ramsay Hunt syndrome.

Where Ramsay Hunt syndrome is suspected, antiviral medications such as Valacyclovir (also known as Valtrex), Aciclovir (previously known as Acyclovir, also known as Zovirax) or Famciclovir (also known as Famvir) are usually prescribed for 7 to 10 days. This medication may reduce the severity and duration of Ramsay Hunt syndrome if given promptly after onset of symptoms.


Relevant to: Lyme disease.

When a patient is diagnosed with Lyme disease, they are treated with antibiotics because this is a bacterial infection.

Patients should discuss the side effects of medications with their GP and ensure they read the medicine information leaflet.

Last reviewed: 20-03-2020    ||    Next review due: 01-08-2020