Facial droop concern

Overview

Facial droop is when one side of your face sags or feels weak. It can happen suddenly or slowly. This may affect your ability to smile, close your eye, or control your mouth.

Facial droop is not extremely common, but it is a well-known symptom that many people worry about. It affects people of all ages.

Facial droop can happen to anyone, but it is more common in adults over 40, people with high blood pressure, diabetes, or who smoke. Bell's palsy often affects people between 15 and 60.

Symptoms

Common symptoms

• One side of the face feels weak or droops
• Difficulty smiling or making facial expressions
• Drooling from one side of the mouth
• Difficulty closing one eye
• Pain around the ear or jaw

Symptoms in children

• Children may also have facial droop from Bell's palsy or infections like Lyme disease.
• Look for trouble drinking from a cup or uneven crying.

Symptoms in older adults

• Older adults with facial droop should always be checked for stroke, especially if they have high blood pressure or heart disease.
• They may also have a harder time eating or talking.

Causes

Main causes

• Stroke: a blood clot or bleeding in the brain affects facial nerves.
• Bell's palsy: inflammation of the facial nerve, often linked to a virus.
• Infection: such as Lyme disease, shingles, or ear infections.
• Injury: trauma to the face or head.
• Tumor: rarely, a growth pressing on the facial nerve.

Risk factors

• High blood pressure
• Diabetes
• Smoking
• Obesity
• Heart disease
• Pregnancy (for Bell's palsy)
• Stress or lack of sleep

When to see a doctor

See a doctor urgently if:

• Any sudden facial droop, even if you are not sure it is a stroke.
• Facial droop with arm weakness, speech problems, or vision changes.

Book a routine appointment if:

• Facial droop that came on slowly over days or weeks.
• Facial droop that has been present for a while but is not changing.

Diagnosis

A doctor will ask about your symptoms, examine your face, and check your strength and reflexes. They may also check your blood pressure and listen to your heart.

Tests that may be done

• Blood tests to check for infection or other conditions
• CT scan or MRI of the brain to look for stroke or tumor
• Electromyography (EMG) to measure nerve function

What to expect at your appointment

Your doctor will first make sure it's not a stroke. If it is not, they will look for other causes. You may need to see a neurologist (nerve and brain doctor) for further testing.

Treatment

Treatment depends on the cause. If it is a stroke, you need emergency care. For Bell's palsy, treatment helps protect the eye and may speed recovery. Most people improve without long-term problems.

Self-care at home

• Protect your eye: use artificial tears or lubricating ointment if you can't blink fully.
• Wear sunglasses or an eye patch if light bothers you.
• Do gentle facial exercises, like raising your eyebrows and smiling in the mirror.
• Eat soft foods and chew on the unaffected side.

Medical treatments

For Bell's palsy, doctors may prescribe a short course of steroid medicine to reduce nerve swelling. Antiviral medicine may be added if a virus is thought to be the cause. For stroke, treatments include clot-dissolving medicine or procedures to restore blood flow. Pain relief and physical therapy may help.

When is surgery considered?

Surgery is rarely needed for facial droop. It may be considered for a tumor pressing on the nerve or for severe Bell's palsy that does not improve.

Living with this condition

If you have facial droop, you may need to adjust how you eat, drink, and speak. Using a straw can help with drinking. Rest your eye with a patch or tape if it does not close fully.

Lifestyle tips

• Avoid driving if your eye is affected or if you feel dizzy.
• Avoid smoking and limit alcohol to help nerve healing.
• Get plenty of rest and manage stress.

Diet and exercise

Eat a balanced diet rich in fruits and vegetables. Stay hydrated. Gentle exercise like walking is fine, but avoid activities that might strain your face.

Mental health and emotional wellbeing

Facial droop can affect your self-esteem and confidence. You may feel self-conscious or anxious. Talk to friends, family, or a counselor. You are not alone.

Prevention

You cannot always prevent facial droop, but you can lower your risk of stroke by keeping your blood pressure, cholesterol, and blood sugar under control. Not smoking and being active also help.

Vaccines

Getting vaccinated against infections like shingles and Lyme disease (where available) may reduce some causes of facial droop.

Screening programmes

Regular check-ups with your doctor can catch high blood pressure or diabetes early, which reduces your risk of stroke.

Complications

If left untreated

• If a stroke is not treated quickly, it can cause permanent weakness or paralysis.
• Untreated Bell's palsy may lead to eye damage from dryness or infection.
• Rarely, facial droop that does not improve can affect speech and eating long-term.

Long-term outlook

Most people with facial droop from Bell's palsy recover fully within 3 to 6 months. For stroke, early treatment greatly improves the chances of recovery. Even if recovery takes time, many people regain most of their facial function.

Find support

International organisations

• World Stroke Organization ↗

Local organisations

• National Health Service (NHS) UK – Stroke ↗ · United Kingdom
• Bell's Palsy UK ↗ · United Kingdom

Helplines

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