How Bell's Palsy is Treated

Why Simple Therapies like Time and Steroids are the Most Effective

Prednisone tablets used to treat Bell’s palsy.
Prednisone tablets used to treat Bell’s palsy. Daryl Solomon/Getty Images

Bell’s palsy is the paralysis of the face due to a mysterious loss of function in the facial nerve. The facial nerve also controls aspects of taste, hearing, sweating and eye tearing, so these may also be changed in Bell’s palsy.

People with Bell’s palsy usually recover well without any complications. The main focus for doctors when someone comes to them with a facial droop is to rule out more serious causes like stroke.

If no other cause is found, the diagnosis of Bell’s palsy is made.

Bell’s palsy is usually so benign that nothing more than managing symptoms is usually required. However, recovery may be quicker if medications like steroids are given. Other options may be necessary if someone fails to improve as expected.

Managing the Symptoms of Bell's Palsy

The most important thing in treating Bell’s palsy is to try to prevent the palsy from leading to more serious problems. For example, many people with Bell’s palsy have difficulty closing their eye on the weaker side of the face. This can lead to eye irritation and even infection, unless precautions are taken.

Care needs to be taken to protect the eye with gauze or an eye patch. It is probably best to do this throughout the day, but many patients prefer to just wear the eye patch at night. Protective goggles or glasses should be used during the day to prevent the eye from getting scratched.

Because the facial nerve also controls tearing, the eye may become dried out unless artificial tears are used every hour while the afflicted person is awake. Ointment on the eye can be used at night.

Medications to Treat Bell's Palsy

Steroids are the mainstay of medical management for Bell’s palsy. Scientific studies have shown that administering steroids can shorten the average time to recovery and improve overall outcomes in Bell’s palsy.

The effects are greatest if the steroids are given early in the disease course.

Because dysfunction of the facial nerve is commonly attributed to a viral infection, many studies looked at prescribing an antiviral medication to those suffering from Bell’s palsy. After much debate, the consensus is now that antiviral medications have little to no benefit in Bell’s palsy, even if used together with steroids.

However, as the antiviral medications used in Bell’s palsy do not have many side effects, many doctors still prescribe them for a brief period of time in early and severe Bell’s palsy.

Surgery to Treat Bell's Palsy

In the past, bony tissue around the facial nerve was removed in an attempt to treat Bell’s palsy. The thought was that the nerve was inflamed and swollen, and could be damaged if it was pressing against bone in narrow canals. However, the few studies that evaluated the benefit and safety of these procedures had methodological flaws, and they found no clear benefit to the surgery.

Permanent hearing loss on the side of the surgery is the most common serious side effect of this procedure. Less common side effects are seizures and facial nerve injury. At this time, surgical decompression of the facial nerve is not a recommended treatment for Bell’s palsy.

Electrical Stimulation to Treat Bell's Palsy

Stimulation of the facial nerve has been attempted as a way of promoting the regrowth of the nerve. However, the studies evaluating this procedure were very small and did not actually compare the treatment with a control group not receiving electrical stimulation. At this time, no data clearly shows a benefit to electrical stimulation in Bell’s palsy.

Complementary and Alternative Medicine to Treat Bell's Palsy

Techniques such as acupuncture and biofeedback have been attempted to treat Bell’s palsy. There is not much evidence to support either treatment, though research is ongoing.

Bottom Line

In summary, Bell’s palsy usually gets better on its own, without help of any kind. Steroids seem to be the best medical treatment, and should be used early on in the disease course. In cases where symptoms do not improve, or if complications develop, a multidisciplinary approach can be helpful. The most important thing to consider with Bell’s palsy is that a more serious diagnosis, like stroke, is not being missed.


Lockhart P, Daly F, Pitkethly M, Comerford N & Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.

McAllister, Walker D, Donnan PT & Swan I. Surgical interventions for the early management of Bell's palsy. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD007468.

Salinas RA, Alvarez G, Daly F & Ferreira J. Corticosteroids for Bell's palsy (idiopathic facial paralysis. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD001942. 

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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