What is the role of Aspirin (acetylsalicylic acid) in the treatment of facial palsy (Bell's palsy)?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

Aspirin is not recommended for the treatment of facial palsy, including Bell's palsy, as the standard treatment includes oral corticosteroids such as prednisolone, which has been shown to improve recovery outcomes 1. The use of aspirin in facial palsy is not supported by evidence, and its anti-inflammatory properties do not target the specific pathophysiology of facial nerve inflammation as effectively as corticosteroids.

Key Points

  • The standard treatment for Bell's palsy includes oral corticosteroids such as prednisolone at a dose of 60-80mg daily for 7-10 days, started within 72 hours of symptom onset 1.
  • Antiviral medications like acyclovir or valacyclovir may be added to the regimen in cases where herpes simplex virus is suspected as a cause.
  • Aspirin carries risks of gastrointestinal bleeding and should not replace evidence-based treatments.
  • Eye protection is crucial for patients with facial palsy to prevent corneal damage due to incomplete eye closure, using artificial tears during the day and lubricating ointment at night.
  • Physical therapy and facial exercises may also be beneficial during the recovery phase to maintain muscle tone and prevent contractures.

Treatment Approach

The treatment approach for Bell's palsy should emphasize the use of oral corticosteroids, with the goal of decreasing recovery time and improving facial nerve functional recovery 1.

Important Considerations

  • The diagnosis of Bell's palsy is a diagnosis of exclusion, requiring the careful elimination of other causes of facial paresis or paralysis 1.
  • Patients with Bell's palsy may experience dryness of the eye or mouth, taste disturbance or loss, hyperacusis, and sagging of the eyelid or corner of the mouth 1.

From the Research

Treatment of Facial Palsy

  • The use of aspirin in facial palsy is not directly mentioned in the provided studies, which focus on the treatment of Bell's palsy with corticosteroids and antivirals 2, 3, 4, 5, 6.
  • Corticosteroids are recommended as a treatment for Bell's palsy, with studies showing that they can increase the likelihood of recovery of facial weakness 3, 5.
  • The exact treatment approach for Bell's palsy may depend on the individual case, with factors such as the severity of symptoms and the presence of underlying conditions influencing the choice of treatment 4, 6.
  • Aspirin is not mentioned as a treatment option for Bell's palsy in the provided studies, which instead focus on the use of corticosteroids, antivirals, and other treatments such as acupuncture and physical therapy 2, 3, 4, 5, 6.

Current Management of Bell's Palsy

  • The current management of Bell's palsy involves the use of corticosteroids, with or without antivirals, to increase the likelihood of recovery of facial weakness 3, 5.
  • The diagnosis of Bell's palsy is typically made by exclusion, with a comprehensive examination and complete history necessary to rule out other causes of facial palsy 4, 6.
  • Treatment approaches for Bell's palsy may vary depending on the individual case, with factors such as the severity of symptoms and the presence of underlying conditions influencing the choice of treatment 4, 6.
  • There is no mention of aspirin as a treatment option for Bell's palsy in the provided studies, which instead focus on the use of corticosteroids, antivirals, and other treatments 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Corticosteroids for Bell's palsy (idiopathic facial paralysis).

The Cochrane database of systematic reviews, 2002

Research

Bell's Palsy.

Continuum (Minneapolis, Minn.), 2017

Research

Bell's Palsy: A Review.

Cureus, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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