Skin Challenge: Facial Paralysis

Older gentleman showing facial weakness on one side of face. FACIAL PALSY IN RELATION TO LYME DISEASE

While five percent of people with Lyme disease is not a high statistic, this population will develop some degree of sudden facial weakness/paralysis known as facial palsy, where one or both sides of the face droop or become weak. Known as Lyme disease-associated facial palsy, this tends to occur 7–21 days after tick exposure in infected people.

Lyme disease-associated facial palsy may look a lot like Bell’s palsy—another cause of sudden facial weakness. But the two conditions are not the same. Though more research is needed, it is suggested that Lyme disease-associated facial palsy might develop worse long-term outcomes when treated with the same medical regimen used to treat patients with Bell’s palsy.

LD Facial Palsy Symptoms Bell’s Palsy Symptoms
Bacterial infection—requires antibiotics Viral infection—requires corticosteroids and antivirals
Person has flu-like symptoms Person feels fine
Changes in taste, ear pain, and pain behind ear Changes in taste, ear pain, and pain behind ear
Facial weakness with… Facial weakness
  • Severe headaches
  • Fever or chills
  • Neck stiffness
  • Severe fatigue or lethargy
  • Back or abdominal pain or muscle aches
Can involve one or both sides of face Involves only one side of the face


Spider walking across skin. What is the cause of facial paralysis in your client?

The Borrelia bacteria that causes Lyme disease is transmitted along with the tick’s saliva, and this can damage the facial nerve, resulting in the infected person experiencing weakness or paralysis of the facial muscles.

Determine any medications, contraindications, and cautions before proceeding with any spa treatment.

Treatments that can be offered to the affected side of the face (or both):

  • Microcurrent
  • Skin taping
  • Massage and facial exercises

DISCLAIMER: Work within the scope of your license/certification.


Portrait of Mórag Currin. About the Author

Mórag Currin is a highly sought-after esthetic educator with more than 27 years of spa industry experience and more than twelve years of training and training management experience. She travels around the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people, regardless of skin type or health condition. To learn more about this topic and many other skin challenges, diseases, and symptoms, check out Mórag’s book, Health Challenged Skin: The Estheticians’ Desk Reference.

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