Reviewed by Physician Tjai Kang Jie and Dr Eki Wari on January 3, 2023

What Is Ramsay Hunt Syndrome And Why Did It Give Justin Bieber Facial Paralysis?

Published March 22, 2023| 7 min read

Ramsay hunt syndrome is the health condition that gave Justin Bieber partial facial paralysis. It can happen to anyone who has had chickenpox. Here's how to protect yourself.

Ramsay hunt syndrome is the mysterious disease that made headlines when singer Justin Bieber announced he had it. It causes facial paralysis and can happen to anyone who has had chickenpox.

As a result, many people were left wondering if they, too, can suffer similar symptoms.

Read on to learn what causes Ramsay hunt syndrome, how to identify its symptoms and treatment options that can help.

What Is Ramsay Hunt Syndrome?

A young man with partial facial paralysis — Facial paralysis is one of the symptoms of Ramsay hunt syndrome.

Ramsay hunt syndrome is the condition that paralyzed half of singer Justin Bieber’s face in 2022. It’s also called herpes zoster oticus and is a complication of chickenpox.

How does it happen?

After you’ve recovered from chickenpox, the virus lies dormant in your body. It may reactivate years later and attack the nerves, causing shingles.

When the shingles attack involves the facial nerves, it can cause facial paralysis. Thankfully, the condition is usually reversible, though the recovery can take a long time. Early diagnosis and treatment help improve the chances of a full recovery.

Who is prone to getting it?

Ramsay hunt syndrome occurs only in people who have had chickenpox in the past and is more common in older adults aged 60 and above.

The condition isn’t contagious, but reactivation of the varicella-zoster virus can cause chickenpox in people who have not had it or have not been vaccinated for it.

This happens if you come into contact with the fluid from blisters that form on an affected person.

Serious complications can arise in people with weak immune systems. If you suffer from Ramsay Hunt syndrome, stay away from newborns, pregnant women, and people with vulnerable immune systems until your rash blisters scab over.

Symptoms Of Ramsay Hunt Syndrome

A woman in a red coat rubbing her watery eyes — Watery eyes may be a sign of Ramsay hunt syndrome.

The three main symptoms of Ramsay hunt syndrome include paralysis of half of the face, pain in the ear, and blisters in the ear canal. Rashes and facial paralysis usually appear simultaneously. However, at times a rash may not appear at all.

Other symptoms to note include changes in sensation of taste, dry eyes, watering of the eyes, sensitivity to sounds, a blocked nose, and difficulty speaking.

If other nerves are involved, you may also get associated symptoms. For example, if the vestibulocochlear nerve is affected, it may cause hearing loss, ringing in the ears, and dizziness.

Though the symptoms of Ramsay hunt syndrome are usually temporary, some people may develop complications. These include permanent hearing loss and facial weakness, eye damage, and pain.

Contact your doctor immediately if you experience facial paralysis or a shingles-like rash on your face. Beginning treatment within three days from the first sign of symptoms improves the chances of a full recovery and prevents long-term complications.

Ramsay Hunt Syndrome Treatments

Being a viral illness, the treatment of Ramsay hunt syndrome in Western medicine involves using antiviral drugs. Other medications are also given to reduce pain and other symptoms.

According to Traditional Chinese Medicine (TCM) Physician Tjai Kang Jie, the internal basis of the syndrome is a weak body constitution and insufficient essence in the brain.

“Strong pathogenic qi (vital energy) can seize on the weakness of the body and invade the ear, face, and brain, disrupting the flow of qi and blood, injuring the tendons and vessels, and weakening the muscles.”

Physician Tjai

Physician Tjai explains that the TCM treatment of Ramsay hunt syndrome involves a combination of acupuncture and herbal medication. The aim of this treatment is to dispel pathogenic qi and strengthen the body to improve the ear, face, and brain systems.

Acupuncture

In TCM, the condition leads to exogenous pathogenic factors that invade the Yang Ming, Shao Yang, and Tai Yang channels. This results in the blocking of facial meridians, disorders of qi and blood activity, and loss of nourishment of facial muscles and tendons.

Acupuncture can recuperate qi activity, eliminate exogenous pathogenic factors, and activate blood circulation to clear collaterals.

An acupuncturist will focus on the following acupoints:

Directly above the pupils when the eyes are looking straight ahead, 1 finger width superior to the eyebrow.

On the face, on the lower border of the zygomatic bone, inferior to the outer canthus of the eye.

Located on the cheek, in the depression one finger-width anterior and superior to the lower angle of the mandible where m. masseter attaches.

Located directly below the pupil, lateral to the corner of the mouth.

Posterior to the lobule of the ear in the depression between the mandible and the mastoid process.

You can find this on the back of the hand, between the thumb and index finger bones.

On the dorsum of the foot, in the depression proximal to the 1st metatarsal space.

This point is located on the shin, four fingers-breadth below the knee joint.

Fengchi (GB20): in the depression created between the Sternocleidomastoid and Trapezius muscles, at the connection of the occipital and nuchal areas.

Located where the base of your skull meets the top of your neck.

On the midline of the lateral aspect of the thigh, 7 finger widths above the transverse popliteal crease

Yang Bai (GB14)
Quan Liao (SI18)
Jia Che (ST06)
Di Cang (ST04)
Yi Feng (TE17)
He Gu (LI04)
Tai Chong (LR03)
Zu San Li (ST36)
Feng Chi (GB20)
Feng Fu (DU16)
Feng Shi (GB31)

Home remedies

Keep the areas affected by rashes clean at all times. You may apply cool, wet compresses to the rash to reduce the pain. If your eyes become dry, use moisturizing eye drops throughout the day. An eye ointment can help combat dryness at night.

Western medicine

Your doctor will prescribe antiviral medicines such as acyclovir, famciclovir, or valacyclovir, which act against the chickenpox virus. A short course of steroids may also be prescribed to augment the effect of antiviral therapy. Painkillers may be given to tackle pain caused by the condition. Certain anti-anxiety medications like diazepam help to relieve vertigo.

Herbal remedies

Herbs that can help with treating symptoms are:

Mulberry leaf (sang ye), chrysanthemum flower (Ju Hua), Cicada Slough (Chan Tui), and peppermint (Bo He), which expel Wind-Heat and clear the head and the eyes.

Bombyx batryticatus (Jiang Can) and earthworm (Di Long) expel Wind and eliminate Phlegm and Dampness.
Buthus martensii Karsch (Quan Xie) and Ptyas dhumnades (Wu Shao She) clear blockages in the meridians and expel Wind.

To clear Heat from the body, TCM recommends Chinese herbs honeysuckle flower (Jin Yin Hua), and Weeping forsythia (Lian Qiao). Herbs like Rehmannia root (Sheng Di Huang) and figwort root (Xuan Shen) can be used if your symptoms are more severe.

“TCM remedies are generally safe as long as they are administered by licensed TCM practitioners. Those experiencing sudden facial paralysis or hearing loss, immense vertigo, or difficulty breathing or swallowing should seek immediate help from the nearest hospital instead.”

Physician Tjai

Some herbal remedies that are used to treat chickenpox symptoms can be used on symptoms of Ramsay Hunt syndrome too.

You can also take TCM ingredients with anti-viral properties, such as edible bird’s nest, Cordyceps, and Lingzhi, to boost your body’s immune defense system, making you less likely to experience severe symptoms.

Seek Help As Soon As Possible

Certain cases of Ramsay hunt syndrome that don’t respond to conventional medical treatment have at times responded to TCM. However, as treatment is highly individualized, it is advisable to consult a TCM practitioner for the most appropriate therapy for you.

Justin Bieber recovered from Ramsay hunt syndrome and resumed his world tour in Europe. However, as he has experienced, the condition can throw your life off balance. So, if you notice any of the symptoms, don’t hesitate. Quick treatment leads to a speedy recovery.