Bell’s Palsy: Symptoms, Causes, Diagnosis, Treatment, and Prevention
Health ConditionsNeurological Disorders

What Is Bell’s Palsy?

What Is Bell’s Palsy?
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Published on September 10, 2025
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Bell’s palsy, also known as Bell palsy and facial nerve palsy, is a neurological disorder that causes sudden, temporary weakness or paralysis of the muscles on one side of the face, resulting in a drooping appearance. It is the most common cause of facial paralysis and thought to develop from injury to a specific nerve in the face, such as from inflammation. While it can be alarming, Bell’s palsy is usually not permanent, and most people recover fully in weeks to months.

Types of Bell’s Palsy

Bell’s palsy is a type of facial nerve palsy (paralysis). It was previously — and sometimes still is — known as idiopathic facial nerve palsy, meaning it arises without an identifiable cause, though some cases have now been linked to viral infections.

Bell’s palsy is usually acute (occurs suddenly and lasts a relatively short amount of time) or recurrent (occurs again after the first episode resolves).

Signs and Symptoms of Bell’s Palsy

Bell’s palsy symptoms typically appear suddenly and may include:

  • Muscle weakness or paralysis on only one side of the face
  • Drooping of the mouth and eyebrow
  • Inability or difficulty closing the eye (including blinking and squinting), which may result in excessive tearing or dryness
  • Inability or difficulty smiling on the affected side
  • Drooling from the affected side of mouth

  • Headache

  • Loss of taste on the front two-thirds of the tongue
  • Heightened sensitivity to sound in one ear (hyperacusis)
  • Pain in or behind the affected ear

  • Neck pain

  • Tinnitus, or ringing in the ears

Symptoms typically worsen over 48 to 72 hours after they begin, before gradually improving.

Causes and Risk Factors of Bell’s Palsy

While its exact cause is unknown, Bell’s palsy is thought to be linked to injury or dysfunction of the facial nerve. Also known as the seventh cranial nerve, the facial nerve controls muscles in the face and plays a role in the tear and saliva glands, sensations in the ear, and more.

This facial nerve dysfunction may be due to inflammation caused by a viral infection, most commonly herpes simplex virus, which causes cold sores.

Other potential triggers include:

  • Epstein-Barr virus
  • Varicella-zoster virus, which causes shingles and chickenpox
  • Coxsackievirus
  • Cytomegalovirus
  • Mumps virus
  • SARS-CoV-2 virus
  • Rubella virus
  • Influenza viruses
Risk factors for Bell’s palsy include:

  • Pregnancy
  • Severe preeclampsia (dangerously high blood pressure during pregnancy)
  • Diabetes
  • Hypertension
  • Obesity
  • Upper respiratory tract infections
  • Family history of Bell’s palsy
  • Lowered immunity such as from stress, illness, or lack of sleep

  • Traumatic injury to the face or head

How Is Bell’s Palsy Diagnosed?

There is no specific test for Bell’s palsy. Instead, healthcare providers diagnose the condition based on your symptoms and by ruling out other potential causes of facial paralysis, such as brain tumors, stroke, and Lyme disease.

Your provider will ask you about your medical and family history to identify your symptoms and when they began, recent infections that could cause your symptoms, and risk factors you may have. They will also conduct a thorough physical examination to assess your facial muscle function, such as how your facial muscles respond when you try to make different expressions or close your eyelids.

Laboratory or imaging tests are usually not necessary to diagnose Bell’s palsy, but your provider may order them to help confirm a diagnosis, rule out other potential causes of your issues, or determine how serious the disorder is and your chances of recovery. These may include:

  • Electromyography to assess your nerve function

  • Lumbar puncture to check for meningitis
  • Computerized tomography (CT) and magnetic resonance imaging (MRI) scans to rule out other conditions that cause nerve damage such as stroke and multiple sclerosis
  • Blood tests to check for conditions like Lyme disease and sarcoidosis

Treatment and Medication Options for Bell’s Palsy

Bell’s palsy usually resolves on its own over time, and treatment focuses on reducing inflammation and supporting recovery. This may include:

  • Corticosteroids, such as prednisone, which help reduce swelling of the nerve and possibly improve recovery speed, especially when started within 72 hours of symptom onset
  • Antiviral medications, which are sometimes prescribed alongside steroids, though it’s unclear how much they actually help improve recovery

  • Pain medications including ibuprofen, aspirin, and acetaminophen, as needed to control pain
  • Lubricating eye drops, ointments, or an eye patch to keep the eye moist and protect the cornea from damage
  • Physical therapy, facial massage, and acupuncture to help improve facial function and reduce pain

If your symptoms don’t resolve on their own, you may need long-term treatment with physical therapy, Botox injections, or various types of surgery.

 In some cases, facial nerve transplantation via surgery is an option.

Prevention of Bell’s Palsy

There is no guaranteed way to prevent Bell’s palsy. The best way to reduce your risk of developing Bell’s palsy is to reduce your risk factors, such as by:

  • Managing chronic conditions like diabetes and hypertension
  • Staying up to date with vaccinations
  • Avoiding exposure to viral infections
  • Reducing stress through mindfulness meditation, relaxation exercises, positive self-talk, and other techniques

Lifestyle Changes for Bell’s Palsy

Bell’s palsy typically resolves on its own over time, but supportive habits may help you find relief, including:

  • Lubricating eye drops to prevent dryness
  • Heat pads and warm compresses to relax the muscles in the face

  • Facial exercises (such as repeatedly tightening and relaxing your facial muscles), massage, and electrical stimulation to improve facial muscle strength and prevent long-term weakness

  • Eating more slowly to prevent swallowing problems

  • Brushing and flossing often to remove food that may get stuck and cause issues (if Bell’s palsy affects feeling and salivation on the side of your tongue)

How Long Does Bell’s Palsy Last?

About 80 percent of people with Bell’s palsy begin to improve within three weeks and show little-to-no signs of symptoms within three months. But some people may take up to a year to recover.

However, about 2 in 10 people with Bell’s palsy don’t fully recover and have symptoms that never go away. You are less likely to recover completely if you:

  • Experienced severe or “complete” facial paralysis
  • Are 60 years or older
  • Have decreased salivation or taste from Bell’s palsy
  • Are pregnant
  • Have diabetes
  • Have had dental work done recently

Additionally, the longer it takes for your recovery to begin and the slower your recovery occurs, the more likely you are to have lasting symptoms.

Complications of Bell’s Palsy

Though usually temporary, some people experience complications, such as:

  • Residual facial weakness
  • Involuntary facial movements (synkinesis)
  • Damage to the cornea from prolonged dryness

  • Emotional distress or self-consciousness

Research and Statistics: Who Has Bell’s Palsy?

Bell’s palsy affects 15 to 40 individuals per 100,000 people annually. It affects people of all ages, sexes, and ethnicities.

About 8 to 12 percent of people who experience Bell’s palsy have a recurrent episode, which can develop years later.

Related Conditions

Several other conditions can cause partial or complete facial paralysis that may be confused with Bell’s palsy, particularly:

  • Stroke
  • Ramsay Hunt syndrome, a complication of a varicella-zoster virus infection
  • Lyme disease
  • Sarcoidosis, an inflammatory autoimmune disease


The Takeaway

  • Bell’s palsy is a sudden, temporary facial paralysis that usually resolves on its own within a few months.
  • It’s often associated with inflammation of the facial nerve caused by a viral infection, particularly herpes simplex virus.
  • Early treatment with steroids can improve your chances of a full recovery.

Common Questions & Answers

Is Bell’s palsy the same as a stroke?
No. While it’s often mistaken for a stroke, Bell’s palsy only affects the facial nerve and doesn’t cause other stroke-related symptoms like weakness in the arm or leg.
The majority of cases resolve over time, though some people may have permanent facial weakness or paralysis.
It can, but it’s not common. If you’ve had Bell’s palsy once, there’s an up to 12 percent chance it could return.
Bell’s palsy itself isn’t contagious, but some of the viruses linked to it — like herpes — are.
Stress doesn’t directly cause Bell’s palsy, but it can lower your immune defenses and make you more vulnerable to viral triggers.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Jason Paul Chua, MD, PhD

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Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.

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