Jun 28, 2022 9:00 AM

Author: University of Utah Health Communications


Approximately one in three people in the United States will get shingles—the same virus that causes chickenpox. The varicella-zoster virus can reactivate at any time, although your risk increases as you age. When it does reactivate, it can appear on several parts of the body. In rare cases, a shingles outbreak can affect a nerve near one of your ears. This is called Ramsay Hunt Syndrome.

What triggers Ramsay Hunt Syndrome?

Anyone who has recovered from chickenpox can get shingles. Once infected by chickenpox, the virus stays inactive in your system. For unknown reasons, the virus can reactivate. Research has connected high stress and lowered immunity as possible triggers for shingles.

The reactivation of shingles can cause a rash of blisters on your face or body. In rare cases, blisters can form in the ear and cause hypersensitivity in the facial nerves. This can cause facial paralysis and hearing loss, also known as Ramsay Hunt Syndrome (RHS).

What are the symptoms of Ramsay Hunt Syndrome?

The two main symptoms include a rash with blisters in and around the ear and facial weakness or paralysis on the same side as the affected ear. Other symptoms include:

  • Ear pain
  • Hearing loss
  • Ringing in the ears
  • Difficulty closing one eye
  • Vertigo
  • Body aches

“Patients with Ramsay Hunt Syndrome tend to feel very ill,” says David Renner, MD, a neurologist at University of Utah Health. “Patients may also have difficulty with eye closure, wrinkling their forehead, and puckering their lips, along with hypersensitivity to light touch on the same side of the affected face.” Symptoms can last for a few weeks or could even become permanent. If you develop any symptoms, see a doctor right away.

Who is most at risk of shingles or Ramsay Hunt Syndrome?

Shingles is more common after age 55 and increases with age in people who had prior chickenpox. Anyone with a weakened immune system also has an increased risk of getting shingles.

It’s uncommon for people younger than 55 to get shingles. Anyone under age 55 who is infected with shingles should see a doctor. It’s important for a doctor to evaluate a patient to determine whether there are any underlying medical conditions or circumstances.

Is Ramsay Hunt Syndrome common?

RHS is a rare neurological disorder. According to the National Organization for Rare Disease (NORD), 5 out of every 100,000 people develop RHS each year in the United States.

Is shingles or Ramsay Hunt Syndrome contagious?

Shingles or RHS aren’t contagious unless a person has lesions that are open and weeping and a person has direct contact with those lesions. The risk is lower when the lesions are crusted over. Those experiencing shingles should not be around immunosuppressant individuals.

Can Ramsay Hunt Syndrome be treated?

Treatments such as antiviral medicines are available to help treat shingles or RHS. To better improve recovery, patients may be given steroids in addition to an antiviral medication. A shingles vaccine could also help prevent the disease and complications. Often, shingles goes away on its own.

Who is eligible to receive a shingles vaccine?

People aged 50 and older are eligible to get a shingles vaccine—also known as Shingrix. The two-dose shingles vaccine can be provided to adults 19 years and older who have a weakened immune system.

It’s also important to be vaccinated against chickenpox. Chickenpox vaccinations can start as young as 12 months. Anyone who is 13 years or older and has not received a chickenpox vaccine should get one. If you’ve never had chickenpox, you should get vaccinated.

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