brand-logo

Herpes zoster of the ear - Herpes zoster oticus - Ramsay-Hunt syndrome

Low urgency
--
It is a serious complication of the varicella-zoster virus reactivation (the same virus as herpes zoster or shingles) when it infects the facial nerve, close to the inner ear, that usually affects people over 60 years. It causes severe pain in the ear, blistering of the ear and mouth, facial paralysis on the same side. Vertigo is common. You must consult an otolaryngologist when the pain occurs in order for the diagnosis to be made. The diagnosis is clinical, and the treatment is symptomatic (analgesia and anti-inflammatories), as the benefit of antiviral drugs is uncertain. Delaying the treatment and the severity of the symptoms may worsen the prognosis.
Bibliographic references
  1. Mary A Albrecht. Clinical manifestations of varicella-zoster virus infection: Herpes zoster. UpToDate. Aug 02, 2016.
  2. Adour KK. Otological complications of herpes zoster. Ann Neurol 1994; 35 Suppl:S62.
  3. Uscategui T, Dorée C, Chamberlain IJ, Burton MJ. Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008; :CD006851.
  4. Whitley RJ. infecciones por el virus varicela-zóster. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 1185
  5. Tolosa E. Enfermedades de los pares craneales. Séptimo par: nervio facial. Farreras Rozman. Medicina Interna. Volumen 2. 12º edición: 1503.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Blisters after pain in the ear

    Ear pain

    Blisters in outer ear

    Rash made up of painful blisters

    Swollen lymph node towards the front part of the ear

Symptoms to watch out for

Fever (temperature higher than 100.4 ºF)
Hearing loss
Pain that does not subside with analgesics.

Self-care

Take over-the-counter pain relievers or anti-inflammatories.
Eat a balanced diet: increase consumption of fruits, vegetables, and white meats, and reduce consumption of fatty and fried foods.
Relative rest, rest until symptoms subside.
Consult your family doctor about the prescription for antiviral treatment.
Mediktor logo