Before this year's I'm a Celebrity...Get Me Out Of Here! few people had heard of Bell's Palsy the facial paralysis affecting the latest queen of the jungle, Scarlett Moffatt. It is not a serious condition in terms of the physiological impact but because it affects the face, usually down one side, it is highly visible and this can impact the sufferer severely from a psychological perspective.
Affecting about one in 5,000 people a year, Bell's Palsy is caused by inflammation or infection of the facial nerve that controls muscles on one side of the face, causing that side of the face to droop.
The cause of Bell's Palsy is not clear, although it has been linked to the same herpes virus which is responsible for cold sores, infecting the facial nerve as it passes through a tight bony canal in the ear. It swells but has no space left so gets squashed which causes the damage.
The damage to the facial nerve prevents signals from the brain travelling to the face instructing facial muscles to move. As the muscles sit there idle it can lead to muscle wastage, which causes further distortion of the features. The nerve damage may also affect the sense of taste and how tears and saliva are produced.
Patients with Bell's Palsy tend to fall into three groups: group A get movement back within a couple of weeks, for group B it can take an average of two years for movement to return and for group C, worst-case scenario, movement never returns, although this is rare.
So what does treatment look like for these different groups?
The condition comes on suddenly, often overnight and immediate medical attention is advised as steroid tablets can often cure the problem, if used quickly enough.
For those people for whom steroids are not successful, there is a range of treatments available that can offer some relief, from one end of the non-invasive spectrum to the other. Interestingly enough, many modern treatments developed to combat the effects of ageing, can be highly effective in the treatment of facial paralysis.
As a loss of facial volume, in the cheek for example, can be a side effect of Bell's Palsy, Hyaluronic Acid (HA) fillers can be used to bulk out the area. If it is a large area, tissue growth agents such as Platelet Rich Plasma, made famous by celebrities for it's rejuvenating properties, are also an option. Studies and real world experience have shown that PRP stimulates and increases healing, as well as promoting new collagen production encouraging cells to rejuvenate and stimulating new growth of tissue and blood vessels.
Sagging skin can be addressed with the use of PDO threads or cogs, which are inserted below the skin in the affected areas and are then pulled up to match the unaffected side of the face, the treatment was developed to lift aging skin but can be extremely effective in this application.
For the upper eyelid and brow there is a new treatment called Plasma IQ. It involves the use of a machine which makes tiny plasma beam punctures in the excess skin of the eyelid or brow which may be sagging and heavy making it shrink and tighten. The result is very close to a surgical eyelift.
Traditional treatments such as physiotherapy and electrical stimulation can be helpful and can reduce the amount of muscle wastage in cases where the nerve endings do grow back. High doses of vitamin B by IV infusion can also promote nerve regrowth.
Whilst currently we cannot improve the strength of the affected muscle, we do have tools at our disposal to weaken the muscle on the unaffected side of the face, a procedure which can help to make the appearance less pronounced by balancing out the features.
Static suspension of the corners of the mouth, for example, uses a tendon like structure taken from the thigh to support and create a laugh line and improve symmetry of the lips, blepharoplasty (eyelid surgery), and facelift are also commonly utilised to address facial paralysis.
I have also heard tales of olive oil massage, castor oil, garlic, celery and hot compresses delivering beneficial effects, but the evidence in favour of these alternative therapies is undoubtedly based more in faith, than in science.