What is facial droop?

Facial droop is when your face muscles are not working properly.

Your face may look asymmetrical (uneven). You may have trouble moving your eyes and mouth.

Facial droop can affect one or both sides of your face.

What symptoms are related to facial droop?

The symptoms associated with facial droop depend on its cause. The main symptoms of facial droop are:

• not being able to smile
• drooping eye
• drooping mouth

Bell's palsy

Bell's palsy symptoms usually appear quickly (often overnight) and get better gradually. Symptoms may include:

• having trouble closing your eye or blinking on the affected side
• difficulty smiling or chewing food
• mild pain near your ear
• change in taste

Brain tumour

Facial droop caused by a brain tumour normally develops slowly. A brain tumour can cause other symptoms including:

• headache
• loss of balance
• seizures
• loss of hearing or smell
• nausea and vomiting
• feeling irritable or drowsy

Stroke

If you have any of the stroke symptoms below, no matter how long they last, 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.

In the case of a stroke, facial droop usually comes on suddenly. Other muscles on one side of your body might also be affected.

Stroke symptoms can include:

• a severe headache
• a seizure
• blurred vision or changes in your vision
• being unable to lift one or both arms because they are weak and numb
• being unable to walk due to weak legs
• speech that is slurred or confused

What causes facial droop?

Facial droop can be caused by conditions that:

• damage the nerves in your face
• damage to the part of your brain that sends nerve signals to your face muscles

This damage can be temporary or permanent.

Bell's palsy

A common cause of facial droop is Bell's palsy. This occurs when a nerve in your face called the facial nerve is inflamed. This is usually due to an infection with a virus.

Bell's palsy is usually temporary. But it can take up to a year for your face to return to normal.

Tumours

Facial droop can be caused by tumours, such as a brain tumour. The tumour can press on your facial nerve.

Stroke

A stroke can also cause facial droop. A stroke is when blood is blocked from reaching a part of your brain.

Other causes of facial droop

Sometimes babies are born with facial droop, also known as facial nerve palsy.

Other causes of facial droop can include:

• complications from surgery
• infection and inflammation, such as from Ramsay Hunt syndrome
• brain injury or facial injury
• conditions affecting your nervous system, such as multiple sclerosis

How is the cause of facial droop diagnosed?

If you have a facial droop, your doctor will examine your face and look at how it moves. They will also do a full neurological examination. Some causes of facial droop are more common in older people.

Your doctor may order tests to diagnose the cause of your facial droop, including:

• CT scan
• MRI scan
• blood tests

When should I see my doctor?

If you have a facial droop that appears gradually, see your doctor immediately, or go to your nearest emergency department.

When to seek urgent care

Call triple zero (000) immediately and ask for an ambulance if you:

• have a sudden facial droop
• have symptoms of a stroke

Even if your symptoms quickly come and go, you should seek emergency care. Short-lasting symptoms can be a sign of a transient ischaemic attack (a mini-stroke).

How is facial droop treated?

Treatment depends on what is causing your facial droop.

If a facial droop is affecting your emotional wellbeing, you might be referred for counselling or support.

What are the complications of facial droop?

If you have a facial droop, you can have problems with:

• your eyes
• your hearing
• talking
• eating and drinking

Talk to your doctor if you have any of these concerns. They may refer you to a speech pathologist or another healthcare professional.

Eye complications

If you have facial droop, it is important to look after your eyes to prevent damage.

If your facial droop prevents you from shutting one eye, you will need to take steps to avoid complications.

• always wear sunglasses outdoors
• wear a patch to prevent things from getting in your eye
• use lubricating eye drops or ointments
• 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. They will probably refer you to an ophthalmologist (a doctor who specialises in eyes).

Can facial droop be prevented?

Facial droop caused by conditions such as Bell's palsy or a brain tumour cannot be prevented.

You can reduce your risk of stroke by:

• eating healthily
• exercising regularly
• not smoking
• limit how much alcohol you drink

It's also important to get treatment for any conditions that can increase your risk of stroke, such as:

• high blood pressure
• diabetes
• high cholesterol
• atrial fibrillation

Resources and support

The Stroke Foundation has information on stroke and support services — call the StrokeLine on 1800 787 653.

The Emergency Care Institute has a factsheet on Bell's palsy, available in different languages.

Cancer Council has information and support for people with cancer.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.