Treating Bell's palsy
Prednisolone is recommended as the most effective
treatment for Bell’s palsy, and it should be started
within 72 hours of the symptoms appearing.
Most people recover fully from Bell's palsy within nine
months, but it's important to maintain good eye care
during this time.
Antiviral medications are not recommended as a
treatment for Bell's palsy.
Prednisolone
Prednisolone is a corticosteroid which works by helping
to reduce inflammation (swelling), helping to speed up
your recovery.
People with Bell's palsy are usually advised to take
prednisolone tablets twice a day for 10 days.
Possible side effects of prednisolone include:
 nausea (feeling sick)
 headache
 increased sweating
 indigestion
 increased appetite
 difficulty sleeping
 oral thrush
 dizziness
These side effects should improve within a few days as
your body begins to get used to the medication.
Some people also experience mood changes, such as
anxiety or depression, after taking steroids for a short
period of time. You should visit your GP immediately if
you experience mood changes, or if you have other side
effects that are particularly troublesome.
Read more about the side effects of corticosteroids.
Speak to your GP before taking prednisolone if you
are pregnant or breastfeeding.
Eye care
Tears play an important role in protecting your eyes and
keeping them free of the dirt and bacteria that can cause
eye infections.
If you have Bell’s palsy, you might find it difficult to close
your eye, which can cause your tears to evaporate and
leave your eye vulnerable to infection. So it's very
important to keep your eye lubricated.
Your GP may prescribe eye drops that contain 'artificial
tears' for daytime use, plus an ointment that you should
use at night. If you're unable to shut your eye at night
time, your GP will give you some surgical tape to close
your eye.
If your eye symptoms get worse, you should ask your
GP to refer you to the facial palsy clinic or
ophthalmology department of your local hospital for
assessment. If ointments and taping are not effective
you may benefit from surgery to help protect your eye.
Further treatment
Most people with Bell's palsy will make a full recovery
within nine months. However, if you have not recovered
by this time, there is a risk of more extensive nerve
damage and further treatment may be needed.
Physiotherapy
Physiotherapy may be recommended. Your
physiotherapist will teach you a series of facial
exercises that will strengthen the muscles in your face
to improve their co-ordination and range of movement.
Physiotherapy has been successful in a number of
Bell's palsy cases, although it may not be suitable or
effective for everyone.
Plastic surgery
Plastic surgery is another possible option. Plastic
surgeons work as part of a team of facial palsy
specialists to help manage your facial weakness.
Surgery may not be able to restore nerve function, but
may be able to protect your eye, improve your function
and improve the appearance of your face.
Eye procedures include surgery to help you close your
upper eyelid or improve the position of your lower
eyelid. A brow lift can improve your vision and facial
appearance.
A number of procedures can improve the position of
your mouth and help with speech, eating and drinking
and facial symmetry. Some can restore a smile,
including cross-facial nerve grafts, nerve transfers and
muscle and tendon transfers.
Botulinum toxin injections
Botulinum toxin (Botox) injections can be used to treat
either the affected or the unaffected side of the face in
some people with long-term Bell's palsy.
Botox may be injected into the affected side of the face
to relax any facial muscles that have become tight, or to
reduce any unwanted muscle movements.
If the muscles in the unaffected side have become
overactive or dominant, Botox may be injected into this
side of the face to reduce muscle activity and balance
the movement of the face.
Some of the long-term complications of Bell’s palsy can
also be treated using Botox injections. These include:
 tears when eating

 eye-mouth synkinesias – where the facial nerve

grows back in a different way, which can lead
to a winking eye when eating, smiling or
laughing

Read more about the complications of Bell’s palsy.

The Botox injections can help ease any discomfort
experienced while eating and can also help to improve
the overall appearance of the face. The injections need
to be repeated every four months.

Other treatments
Research has suggested that facial exercises,
relaxation techniques and acupuncture may help speed
up the recovery of Bell’s palsy and restore facial nerve
function.