Treatment of Facial Nerve Paralysis (Bell's Palsy) with Softlaser
From one day to the next you cannot close your eye, one side of your mouth droops, and a stranger is staring back at you in the mirror. Facial nerve paralysis – medically called Bell's palsy – is a frightening experience, but in most cases it is treatable. The key is to start a comprehensive treatment as soon as possible, in which softlaser therapy and electrostimulation can play an important role.
What is facial nerve paralysis?
Facial nerve paralysis is a dysfunction of the seventh cranial nerve (nervus facialis) that causes partial or complete paralysis of one side of the face. This nerve controls the movement of the facial muscles and also plays a role in taste sensation, as well as tear and saliva production.
The condition is named after Sir Charles Bell, a British neurologist who first described it in detail in the 19th century.
Important to distinguish from trigeminal neuralgia: while trigeminal neuralgia primarily causes pain in the distribution of the fifth cranial nerve, Bell's palsy is paralysis of the seventh cranial nerve, resulting in motor impairment. If you are experiencing facial pain, read the treatment of trigeminal neuralgia with softlaser article.
Symptoms of facial nerve paralysis
Symptoms usually appear suddenly and reach their maximum severity within 24–48 hours:
- Weakness or complete paralysis of one side of the face
- Inability to raise your eyebrow or wrinkle your forehead on the affected side
- Your eye does not close completely – this can lead to dryness
- One side of your mouth droops
- Difficulty smiling, speaking, and eating
- Reduced or absent tear and saliva production on the affected side
- Altered taste sensation on the anterior two-thirds of the tongue
- Pain behind the ear or in the facial area (often occurs before the paralysis)
- Increased sound sensitivity on the affected side
Causes and risk factors
The exact cause of Bell's facial paralysis is often unknown (idiopathic), but several factors may play a role:
Most common cause: viral infection
Inflammation caused by the herpes simplex virus (HSV) is the most likely trigger. The inflammation causes the facial nerve to swell, and because it runs through a narrow bony canal, the swelling exerts pressure on the nerve.
Other possible causes
- Bacterial infections
- Autoimmune reactions
- Metabolic diseases (e.g., diabetes)
- Physical trauma or injury
- Less commonly: tumors
Risk groups
It occurs more frequently in:
- Pregnant women (especially in the third trimester)
- People with diabetes
- People with weakened immune systems
- Those over 50 years of age
Why is quick treatment important?
Time is a critical factor in the treatment of facial nerve paralysis. Muscle health depends on contraction – if the nerve connection is lost and the muscle does not contract for months, it remodels, atrophies, and the paralysis may become permanent.
The first 5–10 treatments are usually given in a clinic, but that alone is not enough. You must continue therapy at home – sometimes for 6–12 months – until full recovery.
How can softlaser help?
Softlaser therapy (photobiomodulation) can support recovery through several mechanisms:
Anti-inflammatory effect
It reduces swelling and edema around the nerve, relieving the pressure on the nerve within the bony canal.
Improved blood circulation
It enhances microcirculation in the treated area, helping nutrients and oxygen reach the nerve.
Support for nerve regeneration
It stimulates cellular energy production (ATP), which may positively influence the regeneration of nerve fibers.
What does the science say?
Several clinical trials have demonstrated the effectiveness of softlaser therapy in Bell's palsy. A 2013 randomized controlled trial found that both high-intensity (HILT) and low-level laser therapy (LLLT) significantly improved recovery in Bell's palsy patients compared to the control group that received only exercises (PubMed: 23709010).
A 2017 study showed that softlaser therapy combined with facial exercises produced significantly better results than exercises alone (PubMed: 28337563).
Studies in diabetic patients are particularly encouraging – softlaser may be a safe alternative for those where steroid treatment would be risky (PMC: 7369545).
The three pillars of home treatment
Home treatment for Bell's facial paralysis consists of three main elements:
1. Facial physiotherapy
Facial physiotherapy is a key part of the treatment. Perform it 3–4 times daily, 10–15 minutes each time, in front of a mirror.
Basic exercises:
- Try to move your mouth symmetrically as if you were smiling
- Practice raising your eyebrow
- Inflate your cheeks, then release the air
- Purse your lips, then stretch them apart
- Try whistling or drinking through a straw
Perform the exercises slowly and with concentration. If you feel pain, stop immediately.
2. Softlaser therapy
Treatment should ideally begin immediately after symptoms appear.
Treatment areas:
Treat along the course of the facial nerve, paying special attention to the area behind the ear (where the nerve exits the skull).
Treatment parameters:
- Device: Class 3 laser (Personal Laser L400 or Energy Laser L500 Pro)
- Treatment time per point: 10–30 seconds (depending on the device)
- Energy: 4–8 Joules per point
- Frequency: initially once daily, later every other day
3. Electrostimulation (denervated current)
Electrical stimulation helps prevent muscle atrophy and maintains muscle function while the nerve regenerates.
Why is it important? The impulse delivered by the stimulator causes the muscle to contract just as it would in response to a signal from the brain. Contraction is vital for maintaining muscle health, strength, and mass.
Treatment procedure:
- Use small (about 25 mm), round electrodes
- Always place the negative pole near the mastoid region (behind the ear)
- Move the positive pole to different facial muscles
- Gradually increase the current intensity until you feel a slight muscle twitch
Important: Not every point needs to be treated in every case – ask your physiotherapist for guidance!
Before you start treatment
For safe use, know the contraindications. For more information, read the softlaser contraindications article.
When NOT to use the softlaser?
- Never shine directly into the eye – always use protective goggles
- Do not apply over cancerous areas
- In case of active infection or fever, wait for recovery
- Do not use over the thyroid gland
Contraindications for electrostimulation
- Implanted pacemaker
- Epilepsy
- Active infection in the treatment area
- Thrombosis
Possible side effects
Both softlaser and electrostimulation are generally very well tolerated. Rarely, you may experience:
- Mild redness of the treated area (temporary)
- Mild discomfort during electrostimulation
- Muscle fatigue after treatment
Practical everyday advice
Eye protection
If you cannot fully close your eye:
- Use artificial tears during the day
- Apply an eye ointment at night
- Consider taping the eyelid closed at night with a special adhesive strip
Eating
- Choose easily chewable foods
- Eat smaller bites
- Use a straw for drinking
General advice
- Avoid cold and drafts around the face
- Reduce stress – it can slow healing
- Be patient – recovery can take 3–12 months
When to see a doctor immediately?
- If symptoms develop suddenly within minutes (this may indicate a stroke)
- If paralysis affects both sides of the face
- If other neurological symptoms appear (speech difficulty, limb weakness, severe headache)
- If symptoms do not improve or worsen despite treatment
Prognosis
The prognosis for Bell's facial paralysis is generally good. In 70–80% of cases, patients recover completely or nearly completely.
Better chances of recovery if:
- You start treatment as soon as possible after paralysis begins
- The paralysis is incomplete
- You are younger
- You have no significant underlying illnesses
Recommended devices
Softlaser devices
Personal Laser L400
A class 3 laser device, 808 nm wavelength, 400 mW power. Compact size, easy to use, ideal for home treatment.
Energy Laser L500 Pro
A class 3 laser device, 880 nm wavelength, 500 mW power. Higher output, shorter treatment time.
Denervated current (selective current) devices
PeroBravo
A stimulator specialized for peripheral paralysis with 20 different programs. With a special foot sensor, it is also suitable for peroneal nerve paralysis treatment.
Globus Genesy 1500
A professional-level device with a denervated current program. Suitable for treating denervated (nerve-disconnected) muscles.
Other applications of softlaser
Softlaser therapy can support the treatment of many other conditions and complaints. For a full overview of all home application areas, read the Softlaser therapy at home – Treatable conditions article.
If you are not familiar with the basics of softlaser therapy, start with the Comprehensive guide to softlaser therapy article.
Summary – Quick overview
What is this article? A comprehensive guide to home treatment of facial nerve paralysis (Bell's palsy) using softlaser therapy and electrostimulation.
Who is it for? Patients with Bell's facial paralysis who want to continue rehabilitation at home in addition to clinic-based treatment.
Main message: Time is critical in treating facial nerve paralysis – the sooner you start a comprehensive therapy (facial physiotherapy + softlaser + electrostimulation), the better your chances of recovery. Home treatment must be continued for months until full recovery is achieved.
Related topics
- Softlaser therapy – Comprehensive guide to home laser treatment
- Softlaser contraindications – When not to use it?
- Trigeminal neuralgia treatment with softlaser
- Causes and treatment options for peripheral neuropathy
- Consequences of nerve damage and chances of recovery
Sources
- Alayat MS, et al. Efficacy of high and low level laser therapy in the treatment of Bell's palsy: a randomized double blind placebo-controlled trial. Lasers Med Sci. 2014;29(1):335-42. PubMed: 23709010
- Ordahan B, Karahan AY. Role of low-level laser therapy added to facial expression exercises in patients with idiopathic facial (Bell's) palsy. Lasers Med Sci. 2017;32(4):931-936. PubMed: 28337563
- Aghamohamdi D, et al. The Efficacy of Low-Level Laser Therapy in the Treatment of Bell's Palsy in Diabetic Patients. J Lasers Med Sci. 2020;11(3):310-315. PMC: 7369545
- Bernal G. Six years of experience in low-level laser therapy in the treatment of Bell's palsy. Laser Ther. 1993;5:87-90.
The information in this article is for guidance only. Home therapeutic devices are intended to complement medical treatment and do not replace specialist care. In case of facial nerve paralysis, consult a neurologist for an accurate diagnosis and treatment plan.
