Doctors often can identify Ramsay Hunt syndrome based on medical history, a physical exam, and the disorder's distinctive signs and symptoms. To confirm the diagnosis, your doctor might take a sample of fluid from one of the rash blisters in your ear for testing.


Prompt treatment of Ramsay Hunt syndrome can ease pain and decrease the risk of long-term complications. Medications may include:

  • Antiviral drugs. Medications such as acyclovir (Zovirax), famciclovir (Famvir) or valacyclovir (Valtrex) often help combat the chickenpox virus.
  • Corticosteroids. A short regimen of high-dose prednisone appears to boost the effect of antiviral drugs in Ramsay Hunt syndrome.
  • Anti-anxiety medications. Drugs such as diazepam (Valium) can help relieve vertigo.
  • Pain relievers. The pain associated with Ramsay Hunt syndrome can be severe. Prescription pain medications may be needed.

Self care

The following can help reduce the discomfort of Ramsay Hunt syndrome:

  • Keep areas affected by the rash clean.
  • Apply cool, wet compresses to the rash to ease pain.
  • Take an over-the-counter pain reliever or anti-inflammatory drug, such as ibuprofen (Advil, Motrin IB, others).

If facial weakness makes it difficult for you to close one of your eyes, take the following steps to protect your vision:

  • Use moisturizing eyedrops throughout the day if your eye becomes dry.
  • At night, apply ointment to the eye and tape your eyelid shut or wear an eye patch.

Preparing for your appointment

You're likely to start by first seeing your family doctor. He or she may refer you to a doctor who specializes in nervous system disorders (neurologist) or to an ear, nose and throat specialist (otolaryngologist).

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

  • What are your symptoms? When did they start?
  • Have you had the sensation that the room is spinning (vertigo)?
  • Has your hearing been affected?
  • Have you noticed a change in your sense of taste?
  • Have you had the chickenpox (varicella) vaccine? When?
  • Have you ever had chickenpox? When?
  • Are you being treated for any chronic health conditions? If so, what treatments are you receiving?
  • Are you pregnant?

What to expect from your doctor

During the physical exam, your doctor will closely examine your face to check for evidence of one-sided paralysis or a shingles rash on, in or around your ear.

Oct 12, 2021

  1. Simon RP, et al. Sensory disorders. In: Clinical Neurology. 10th ed. McGraw-Hill Education; 2018.
  2. Herpes zoster oticus. Merck Manual Professional Version. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/inner-ear-disorders/herpes-zoster-oticus. Accessed August 19, 2019.
  3. Albrecht MA. Treatment of herpes zoster in the immunocompetent host. https://www.uptodate.com/contents/search. Accessed August 25, 2019.
  4. Albrecht MA. Epidemiology, clinical manifestations, and diagnosis of herpes zoster. https://www.uptodate.com/contents/search. Accessed August 25, 2019.
  5. AskMayoExpert. Herpes zoster (shingles). Mayo Foundation for Medical Education and Research; 2019.
  6. Teresa MO. Medical management of acute facial paralysis. Otolaryngology Clinics of North America. 2018; doi.org/10.1016/j.otc.2018.07.004.


We’re transforming healthcare

Make a gift now and help create new and better solutions for more than 1.3 million patients who turn to Mayo Clinic each year.