Ramsay Hunt syndrome


Ramsay Hunt syndrome, also termed herpes zoster oticus, occurs when a shingles outbreak impacts the facial nerve near one of the ears. This can result in a painful rash from shingles, alongside potential facial paralysis and hearing loss in the affected ear.

Caused by the same virus responsible for chickenpox, Ramsay Hunt syndrome occurs when the virus, dormant in nerves following the initial chickenpox infection, reactivates years later, affecting the facial nerves.

Treatment of Ramsay Hunt syndrome is crucial to lower the risk of complications, such as permanent weakness in facial muscles and deafness.


The primary manifestations of Ramsay Hunt syndrome include:

  • A painful red rash with fluid-filled blisters located on, inside, and around one ear.
  • Facial weakness or paralysis on thecorresponding side as the affected ear.

Typically, the rash and facial paralysis in Ramsay Hunt syndrome manifest simultaneously, although occasionally one may precede the other. In some cases, the rash may not develop at all.

Individuals with Ramsay Hunt syndrome may also encounter:

  • Hearing los
  • Ear pain
  • Ringing in the ears
  • Vertigo (a spinning or moving sensation)
  • Difficulty closing one eye
  • Dry mouth and eyes
  • Alteration in taste sense

Facial weakness or paralysis can lead to one corner of your mouth drooping. Additionally, individuals experiencing facial weakness or paralysis may encounter difficulty in closing the eye on the affected side of their face.

If you encounter facial paralysis or develop a shingles rash on your face, contact your doctor promptly. Initiating treatment within three days of the onset of signs and symptoms may aid in averting long-term complications.


Ramsay Hunt syndrome arises in individuals who have previously had chickenpox. Following recovery from chickenpox, the virus remains dormant in the body and may reactivate in later years, resulting in shingles—a painful rash characterized by fluid-filled blisters. Ramsay Hunt syndrome specifically entails a shingles outbreak affecting the facial nerve near one of the ears, often accompanied by one-sided facial paralysis and hearing loss.

Risk factors

Ramsay Hunt syndrome can manifest in individuals who have had chickenpox, with a higher incidence observed in older adults, usually those over 60 years old. This syndrome is rare in children.

It’s important to note that Ramsay Hunt syndrome itself is not contagious. However, the reactivation of the varicella-zoster virus can potentially cause chickenpox in individuals who haven’t been previously infected or vaccinated against it. Such an infection can be particularly severe for individuals with compromised immune systems.

Until the rash blisters scab over, it’s advisable to refrain from physical contact with:

  • Individuals without a history of chickenpox or who have not received the vaccine
  • Those with compromised immune systems
  • Newborns
  • Expectant mothers