It is important for patients to be referred to relevant specialists early on, to ensure they are receiving the right care for facial palsy related issues, and also so they have some understanding of what treatments and surgery may be offered to them in the future.
There are many surgeries and treatments available to people with facial palsy but whether a particular treatment or surgery is suitable or not will often depend on the cause of the paralysis, every individual is different.
Some types of facial paralysis are temporary and some are permanent, and it can seem frustratingly slow at times waiting for specialists to advise on the best plan of action. However, there are often very good reasons for this ‘wait and see’ approach.
Your GP is often the first person you will contact about your facial paralysis, unless you have been admitted directly to hospital or have had the paralysis since birth.
When approaching your GP, ensure you describe any other changes you may have also experienced recently, even if they seem unrelated to your face.
Specialists who may be involved with your care
There are a number of different specialists or services you may be referred to in connection with facial palsy.
- Cosmetic and reconstructive surgeon
- Maxillofacial surgeon
- Ocular plastic surgeon
- Speech and language therapist
Bell’s palsy diagnosis
If you suspect that you have Bell’s palsy, then you should visit your GP or attend A & E as soon as possible. It is important to seek medical advice within 72 hours of onset, as research indicates that this is the optimum period of time in which Bell’s palsy will successfully respond to treatment. The routine treatment for Bell’s palsy is with steroids.
Please refer to our Bell’s palsy page for further information about the condition.
Your health professional might also consider:
Stroke – Bell’s palsy is the most common cause of sudden facial weakness but a Stroke should always be ruled out by a health professional.
Ramsay Hunt syndrome – If you have severe pain around the ear usually followed by a rash of blisters in or around the ear, scalp or hair line, or in the mouth or throat. Please note that Ramsay Hunt syndrome is treated with antivirals. Steroids may also be prescribed.
Lyme disease – If you have a history of tick exposure/camping holiday, or a rash (not always present). If you have flu like symptoms, joint pain or tiredness. Please note that Lyme disease is treated with antibiotics.
Taking time off work
When first diagnosed with Bell’s palsy you should understand that you are unwell. It is important to get plenty of rest even if you have no other symptoms. You should also maintain a healthy diet. If you are at work or school, it may be necessary to take some time to recover.
Eye care is paramount, you can read more about managing dry eye issues here. Note that excessive watering of the eye may be a sign of a dry eye problem. The video below gives information about how to tape your eye closed.
Eating and drinking
Eating and drinking may be difficult in the early stages. See our eating & drinking patient guide for more information.
When your face is not working as it should, it is very tempting to try and force the muscles back to work by doing facial exercises. Never attempt to carry out exercises without professional help as you may do more harm than good. Most people want to do something but trying too hard may lead to problems later on in your recovery. There is evidence to suggest that exercising the facial muscles too forcefully can lead to a miswiring of the nerves as they recover, leading to longer term complications known as synkinesis. Your facial nerve is no different to any other part of the body and will take time to heal. Gentle facial massage is preferable to forceful exercises, using the pads of your fingers gently massage the brow, temples, cheek, chin and neck. If you are concerned about how your recovery is going after two to three months, ask your GP to refer you to a physiotherapist or speech and language therapist for assessment and treatment. They should have specialist experience in the management and treatment of facial palsy.
Our self-help videos demonstrate techniques to help with your facial nerve recovery whilst your face is floppy. Please note this is a series of 7 short videos in one.
Read more information about facial nerve recovery here: Facial Nerve Recovery
Last reviewed: 16-02-2020 || Next review due: 16-02-2022