Bell's Palsy: Facial Exercises and Recovery

You wake up and one side of your face won't move properly. You can't close one eye fully, your smile is lopsided and drinks dribble out of one side of your mouth. This is a frightening experience, and the first thing to do is get checked by a doctor.

Get urgent medical assessment first

Sudden facial weakness can also be a sign of stroke. Call emergency services immediately if facial weakness comes with arm or leg weakness, speech problems, confusion, severe headache or loss of balance.

A doctor will confirm whether it's Bell's palsy, a weakness of the facial nerve, and may prescribe steroid medication. Steroids work best when started within the first 72 hours, so don't wait.

What Bell's palsy is

Bell's palsy is a sudden weakness of one side of the face caused by inflammation of the facial nerve. The cause isn't always clear, but viral infections are thought to play a role.

The good news

Most people with Bell's palsy recover fully or nearly fully. Many start to see improvement within a few weeks, and most recover within about three to six months. Some people recover more slowly or are left with some weakness.

Protecting your eye

When the eyelid doesn't close fully, the eye can dry out and get damaged. This is the most important thing to manage early.

• Use lubricating eye drops during the day, as advised by your doctor
• Use eye ointment and tape the eye shut gently at night if advised
• Wear glasses or sunglasses outdoors to protect from dust and wind
• See a doctor promptly if the eye becomes red or painful

Facial exercises

In the early stage, gentle and controlled movement is better than forceful effort. Use a mirror and try to keep the movement symmetrical.

1. Raise your eyebrows gently
2. Close your eyes gently, without squeezing
3. Smile gently with closed lips, then show your teeth
4. Pucker your lips as if to kiss
5. Puff out your cheeks and hold air in

Do each movement slowly, 5 to 10 times, a few times a day.

Avoid

• Strong, forced facial exercises or squeezing the face hard in the early stage
• Electrical stimulation on the face without specialist advice

Overworking the face early may contribute to synkinesis, where unwanted movements happen together (for example, the eye closing when you smile).

Gentle facial massage

Light upward and outward massage of the cheeks, forehead and around the mouth can help comfort and awareness.

When to seek physiotherapy

If recovery is slow, movements are uneven, or you notice unwanted linked movements, a physiotherapist experienced in facial rehabilitation can guide targeted exercises.