Your first days with Bell’s palsy

What you need to know

Being told you have facial palsy can be an overwhelming and emotional experience. One side of your face may suddenly feel weak or frozen. You might notice changes in your smile, your ability to blink, or even how clearly you speak. These first few days can bring a lot of questions — and that’s completely normal.

This guide is here to help you understand what’s happening, what to expect early on, and how to take care of yourself during this crucial time.

What is facial/Bell’s palsy?

Facial palsy happens when the nerve that controls the muscles of your face (called the facial nerve) becomes inflamed, compressed, or damaged. This causes weakness or paralysis on one side of your face.

The most common cause is Bell’s palsy, which usually comes on suddenly and is often linked to a viral infection. Other causes include Ramsay Hunt syndrome, trauma, stroke, or complications after surgery. Your healthcare team will help identify the cause in your case.

What to expect in the first few days:

• Facial weakness or paralysis: You may find it hard to smile, raise your eyebrow, or close your eye on one side.
• Eye dryness or irritation: If your eyelid isn’t closing fully, your eye may feel gritty, watery, or sore.
• Changes in eating and drinking: You may struggle to drink from a cup or chew comfortably.
• Speech changes: Some words might be harder to say clearly.
• Sensitivity to sound or taste changes: You might notice sounds feel louder or that food tastes different on one side.

These symptoms are common — and most people will start to improve within weeks. For some, recovery may take longer, but support is available throughout.

Eye care comes first

One of the most important things to focus on early is protecting your eye, especially if it won’t fully close.

Here’s what you can do:

• Use artificial tear drops during the day to keep the eye moist.
• Apply a lubricating ointment at night to prevent dryness.
• Close the eye gently with your hand when blinking feels incomplete.
• Wear protective glasses or an eye patch during the day to shield your eye from wind and debris.
• Tape your eyelid closed at night (as advised by a healthcare professional) to prevent damage while sleeping.

Never ignore eye discomfort — unprotected eyes can develop serious complications. Always ask your doctor or optometrist if you’re unsure how to care for your eye.

Medication and early treatment

If you have Bell’s palsy, your doctor may prescribe:

• Steroid tablets (prednisolone) — these reduce nerve inflammation and work best if started within 72 hours of symptom onset.
• Antiviral medication, often used alongside steroids in certain cases (like Ramsay Hunt syndrome).

Always take medication exactly as prescribed, and let your healthcare provider know if you experience side effects.

Gentle facial care

You may feel tempted to “exercise” your face right away, but in the early stages:

• Avoid forceful or repeated movements — these can do more harm than good.
• Stick to relaxation techniques, and gentle facial massage and stretching. Please see the useful Facial Palsy UK videos to help guide you through this.
• If your recovery is slow, you should be referred to a facial physiotherapist later on to guide safe exercises.

Talking and eating tips

Simple strategies can help with common early challenges:

• Straws may help you drink more easily.
• Try soft foods that require less chewing.
• Eat slowly and chew on the unaffected side.
• Use small bites and avoid foods that are difficult to manage (like dry crackers or sticky rice).
• If your speech is affected, speak slowly and clearly. Most people will understand if you explain what’s happening.

Look after your emotional health too

Facial palsy can be a real shock. You may feel anxious, frustrated, self-conscious, or isolated. These feelings are valid — and you’re not alone.

It can help to:

• Talk to family or friends about how you’re feeling.
• Join a facial palsy support group — online or in person.
• Speak to your GP if you’re struggling emotionally. Counselling or therapy may help.
• Remind yourself: your face doesn’t define you — you’re still you.

When to seek help

Contact your doctor urgently if you experience:

• New weakness affecting your arm or leg (could suggest stroke)
• Sudden, severe pain in your ear or rash around the ear (may be Ramsay Hunt syndrome)
• Ongoing eye redness, pain, or blurry vision
• Worsening symptoms after the first few days

Early assessment and treatment can make a big difference, especially for your eye health.

What happens next?

Everyone’s recovery journey is different. Some people recover in a few weeks, while others need months — or ongoing support. Unfortunately, some don’t fully recover.

Your healthcare team may refer you to:

• A facial therapist for tailored exercises and massage
• An ophthalmologist for eye care
• A plastic or ENT surgeon for further assessment and surgical treatment if required
• A neurologist for further evaluation
• A psychologist or counsellor for emotional support

Don’t be afraid to ask questions or ask for referrals. The more informed and supported you are, the better your journey can feel.