When I meet patients with facial palsy in the treatment room, there are things I hear first most often: “I woke up and one side of my face felt strange,” or “My mouth does not close well, and my eye feels dry and gritty.” Facial palsy, also called Guanwasa, appears when there is a problem with the nerve function that moves the facial muscles. Because the change is sudden, it can be alarming, but it is important to calmly assess the range of symptoms and the overall condition of the body and respond early.
Cold wind is not the only cause
Facial palsy is often thought of as an illness caused by exposure to cold, but in reality, several factors often act together. It may occur when the body’s recovery capacity has declined due to overwork, lack of sleep, severe stress, after respiratory infections such as the common cold, shingles, reduced strength around childbirth, diabetes, and other factors.
In Korean medicine, we look at the circulation of qi and blood in the face, tension and weakness in the meridians, and overall fatigue together. This is why we view it not simply as a facial problem, but as a sign that the balance of the whole body has been disturbed.
Symptoms to check in the early stage
When facial palsy occurs, wrinkles on one side of the forehead may not form well, or the eye may not close completely. The corner of the mouth may droop, water may leak when drinking, or food may feel stuck on one side. Some people also have discomfort outside the face, such as dry eyes, changes in taste, pain around the ear, sensitivity to sound, or tinnitus.
- If weakness in one arm or leg, slurred speech, severe dizziness, or decreased consciousness occurs together, please call 119 or go to the emergency room first.
- If the eye does not close well, the cornea may dry out, so artificial tears and eye protection may be needed.
- If shingles is suspected, with ear pain, blisters, or severe pain, we recommend seeking prompt care.
What does Korean medicine treatment aim for?
In the early stage, acupuncture, moxibustion, pharmacopuncture, and herbal medicine prescriptions may be considered with the goal of reducing tension around the facial nerve and supporting the circulation of qi and blood. Even with the same facial palsy, the treatment plan may differ for people with marked reduced strength, changes around pregnancy or childbirth, diabetes, or chronic fatigue.
If symptoms have lasted a long time, or if there is contracture with facial tightness, synkinesis in which the eye closes when smiling, or persistent left-right asymmetry, management of sequelae is needed. Depending on the condition, acupuncture treatments such as thread embedding may be used to stimulate acupuncture points and soft tissue, with an approach focused on easing tension in hardened areas. All treatment should be decided according to the degree of palsy, time of onset, and accompanying symptoms.
Lifestyle management to support recovery
- Secure enough sleep, and avoid strenuous exercise, late-night work, and alcohol for a few days.
- Avoid self-exercises that rub the face strongly or force large movements, and receive guidance after a consultation for any exercises that are needed.
- If your condition has declined after a common cold or shingles, prioritize keeping warm and resting.
- If your eyes are dry, avoid direct wind and reduce long periods of screen use.
- Do not stop medications you are taking for diabetes, high blood pressure, or other conditions on your own.
Facial palsy may appear to be only a problem of facial expression, but it can affect eating, sleep, and relationships as well. I determine the treatment direction by looking together at when the symptoms began, how quickly they changed, accompanying eye and ear symptoms, and overall fatigue. If you notice a sudden change in your face, I recommend seeking care to check your current condition rather than waiting.