Bell's Palsy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Bell's Palsy?
A neurologist, a doctor who treats nerve and brain problems, usually diagnoses and manages Bell's palsy. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Bell's palsy?
Bell's palsy is a neurological disorder that causes sudden weakness or paralysis on one side of the face. It happens when the facial nerve, the seventh cranial nerve that connects the brain to the muscles of facial expression, becomes injured or stops working right. It is the most common cause of facial paralysis.
The exact cause is unknown. Some evidence suggests the facial nerve becomes swollen or inflamed. The nerve travels through the bones of the skull, so swelling inside that tight space can press on the nerve and keep it from working.
Symptoms
Symptoms appear suddenly, over about 48 to 72 hours, and are almost always on one side of the face only. They can be mild or severe. Common signs include:
- Drooping of the face, such as the eyebrow, eyelid, or corner of the mouth.
- Difficulty closing one eyelid, which causes eye dryness.
- Drooling from one side of the mouth.
- Twitching or weakness of the facial muscles.
- Problems with taste.
- Excessive tears in one eye, or dry eye and dry mouth.
- Sensitivity to loud noises.
- Pain around the jaw and behind the ear, often before the weakness starts.
- Trouble eating and drinking, or slurred words from lip weakness.
In rare cases, both sides of the face are affected. Most people begin to get better within two weeks and recover some or all facial function within a few weeks to six months. Sometimes the weakness lasts longer or is permanent.
Causes and who gets it
Bell's palsy can affect anyone of any sex or age, but it most often affects people ages 15 to 45. Possible triggers include a dormant viral infection such as herpes simplex or varicella, the virus that causes chickenpox, and impaired immunity from stress, sleep loss, minor illness, or autoimmune syndromes. Lyme disease and other conditions can also inflame the facial nerve. Pregnancy, obesity, high blood pressure, diabetes, and upper respiratory ailments raise the risk.
How doctors diagnose it
Often, a doctor can diagnose Bell's palsy with a health history and a physical exam. The doctor checks for upper and lower facial weakness on one side, including the forehead, eyelid, and mouth, and rules out other causes. There is no specific lab test to confirm it. Blood tests can look for problems such as Lyme disease, and tests like electromyography, which checks the health of muscles and nerves, can show how serious it is. Imaging such as a CT or MRI may be used if another cause is suspected.
Treatment
Often, no treatment is needed, but medicines can improve the chances of recovery when started right away. Steroids may be prescribed for new-onset Bell's palsy. In most cases, oral steroids should be started within three days of the first symptoms to reduce inflammation and swelling. Sometimes antiviral medicines, such as valacyclovir, are also prescribed to help increase the chance of recovery. Pain relievers like acetaminophen or ibuprofen may help with pain. If the eyelid does not close fully, lubricating eye drops, eye ointments, or an eye patch while sleeping keep the eye moist and protected. Physical therapy, facial massage, or acupuncture may help improve facial nerve function and pain. Surgery to relieve pressure on the nerve has not been shown to benefit most people, but surgery can sometimes fix a permanent crooked smile or an eyelid that will not close.
When to see a doctor
Call 911 right away if one side of your face suddenly droops or feels weak or numb. Also call 911 for sudden weakness in an arm or leg, trouble speaking, trouble seeing, dizziness, loss of balance, confusion, or a very bad headache. These can be signs of a stroke, and a drooping face is one of them.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can do the first evaluation, start the referral to a neurologist quickly, and follow your recovery over the weeks and months it takes.
Common questions
Does Bell's palsy go away on its own?
Often, yes. People with Bell's palsy usually recover some or all facial function within a few weeks to six months. Sometimes, the facial weakness may last longer or be permanent.
How is Bell's palsy different from a stroke?
Both can make one side of the face droop, so call 911 right away if it starts suddenly. Bell's palsy happens when the facial nerve becomes inflamed. A stroke is a different problem that needs emergency care, and doctors check for it during an exam.
How is Bell's palsy treated?
Oral steroids, started within three days of the first symptoms, are the most common medicines. Antivirals may be added. Eye drops or patches protect the eye if it cannot close. Physical therapy or massage may help lingering weakness.
Can Bell's palsy be prevented?
No. There is no known way to prevent Bell's palsy. Managing conditions like diabetes may lower some of the risk.
What happens to the eye?
If you cannot close the eyelid, the eye surface can get dry, which can lead to eye sores, infections, and vision loss. Lubricating drops, ointment, and a patch while sleeping protect it.
Sources
- NINDS - Bell's Palsy
- MedlinePlus Medical Encyclopedia - Bell palsy
- CDC - Signs and Symptoms of Stroke
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
