When you have facial droop, your face doesn’t look symmetrical and you may have trouble moving an eye or your mouth. Often, facial droop will get better by itself, but sometimes the cause is a serious problem — such as a stroke — so you should see a doctor if you notice your face is drooping.

In the case of a stroke, the facial droop will come on suddenly, and other muscles on one side of the body might also be affected.

What is facial droop?

Facial droop occurs when there is damage to the nerves in the face, preventing the facial muscles from working properly. The nerve damage can either be temporary or permanent. Facial droop can also be caused by damage to the part of the brain that sends nerve signals to the facial muscles.

Sometimes just the lower half of the face is affected, sometimes the whole side, and sometimes the entire face. The problem might also affect how you move your eyes and/or mouth.

What causes facial droop?

If you are otherwise healthy, the most common cause of facial droop is Bell’s palsy. This occurs when the nerve in the face becomes inflamed due to infection with a virus. It’s usually temporary, but it could be 3 to 9 months before the face returns to normal.

When should I call an ambulance?

If you have any of the symptoms below, call triple zero (000) immediately and ask for an ambulance. If calling triple zero (000) does not work on your mobile phone, try calling 112.

You should call triple zero (000) immediately and ask for an ambulance if:

• a severe headache
• a seizure
• blindness
• being unable to lift one or both arms because they are weak and numb
• speech that is slurred or garbled

Facial droop can also be caused by a brain tumour. The droop normally develops slowly. There may also be other symptoms including headaches, seizures or loss of hearing.

Sometimes babies are born with facial droop. This can happen because of birth trauma, abnormal development in the womb, or a rare genetic syndrome.

Other causes include a brain infection and a tumour pressing on the facial nerve.

How is facial droop treated?

The treatment will depend on what is causing the face to droop. If you have facial droop, your doctor will examine your face, look at how it moves, and may order tests, including electromyography (a test to study the muscles and nerves), imaging scans and blood tests.

If your facial droop is caused by a stroke, brain tumour or illness, that condition will be treated.

If the droop prevents you from shutting one eye, you will need to keep the eye well lubricated and covered by a patch to avoid complications.

It is possible to have surgery to close your eyelid or correct a lopsided smile if the facial droop doesn’t go away. If you also have uncontrolled muscle movements in your face, botox injections and physiotherapy can help.

How is facial droop managed?

It is very important, if you have facial droop, to look after your eyes to prevent damage. Always wear sunglasses outdoors, use lubricating eye drops or ointments and tape your eyelid shut when you go to sleep. Let your doctor know right away if you have eye irritation, pain or changes to your vision.

People with facial droop can also experience emotional issues or problems with their eyes, hearing, speech, teeth, eating and drinking. Talk to your doctor if you have any of these concerns, so they can refer you for support and counselling.