On June 10, 2022, Justin Bieber announced that he is taking a break from his tour after being diagnosed with Ramsay Hunt Syndrome, leaving half of his face paralyzed. This left many people, especially his fans, frustrated because of the postponed Justice Tour. While others were asking, “What is Ramsay Hunt Syndrome?”
What is Ramsay Hunt Syndrome?
Ramsay Hunt Syndrome (aka RHS or herpes zoster oticus) is a rare neurological disorder when shingles caused by the Varicella-Zoster virus infect a nerve near the inner ear, causing rashes and facial paralysis.
The virus that is known as varicella-zoster virus (VZV), the virus that causes chickenpox, is the main cause of RHS. Anyone who had chickenpox is susceptible to getting infected with RHS.
The dormant VZV inside your body will reactivate after some years and will give you a shingles outbreak that affects one side of your face.
The Ramsay Hunt Syndrome itself is not contagious. However, the reactivated varicella-zoster virus in the body can cause chickenpox in unvaccinated people or those who never had chickenpox before. This could be more dangerous for people with weak or compromised immune systems.
2 main symptoms mainly characterize Ramsay Hunt Syndrome:
- A painful red rash with fluid-filled blisters on, in the ear canal, and around the ear
- Facial paralysis on the side of the affected ear
- Sometimes painful rashes can attack the tongue and roof of the mouth according to the Icahn School of Medicine at Mount Sinai
According to the Mayo Clinic, facial paralysis and rash usually occur at the same time. Although there are cases when one would appear before the other or the rash would never occur at all.
In an Instagram video posted last June 10, 2022, Justin Bieber explained his symptoms with the following quote:
"It is from this virus that attacks the nerve in my ear and my facial nerves and has caused my face to have paralysis. As you can see, this eye is not blinking, I can't smile with this side of my face, this nostril will not move, so there is full paralysis in this side of my face."
Other symptoms people infected by RHS may include:
- Ear pain
- Loss of hearing
- Tinnitus or ringing inside the ear
- Difficulty in closing the eye on the affected side of the face,
- Loss of taste
- Dry mouth and eyes
If not treated immediately and without proper care, the infected person may receive the following complications:
The facial paralysis will make closing the eye of the affected area difficult and will make your eyes dry. When this happens, the cornea of that eye will be damaged. Once damaged, the infected person will experience pain and blurry vision.
Permanent Hearing Loss and Facial Paralysis
If treated with care, the person will experience temporary hearing loss and facial paralysis. If otherwise, they could become permanent.
This is a painful condition that leaves a lasting pain in the areas of the skin that are affected by shingles. With RHS, the shingles damage the nerve fibers on the affected area of the face causing messages sent by these nerves confusing, exaggerated, and painful. This complication may last up to a year even after getting cured of RHS.
Immediate and prompt treatment of RHS can manage symptoms and decrease the risk of severe complications. Doctors may prescribe the following medications:
- Antiviral drugs like acyclovir, Famvir, or valacyclovir for combating the varicella-zoster virus
- A short regimen of high dose of Corticosteroids prednisone can boost the effectiveness of the antiviral medication
- Anti-anxiety medications like diazepam can relieve vertigo
- Pain relievers to relieve the patient of severe pain
Home remedies can also help alleviate the pain and discomfort experienced by the infected person.
- Clean the areas affected by rash and shingles regularly
- Use over-the-counter pain relievers
- Apply a warm or cool compress to the rash to ease the pain
For the affected eye, you can do:
- Use moisturizing eye drops to prevent the affected eye from drying up
- To close the eyes at night, apply ointment to the affected eye and wear an eyepatch or tape the eyelids
Fortunately, people who were vaccinated against chickenpox have a strong chance of not contracting RHS. Once receiving two shots of the vaccine, the vaccinated person may enjoy a 90% immunity against the Varicella-Zoster virus which causes RHS.
People in their 50s are advised to take the shingles vaccine.
Developing Ramsay Hunt Syndrome is a bad experience, especially for artists like Justin Bieber, whom many people are looking forward to watching his performance. But we should understand that he, like any artist or celebrity, is a human who has limits like any of us.
Because of this setback, Justin Bieber was “physically obviously not capable” to perform. But he assured his fans that everything will be back to normal.
Gabinete, J. (2022, June 11). Justin Bieber reveals facial paralysis, cancels Justice concert tour. PEP.Ph. https://www.pep.ph/news/foreign/166247/justin-bieber-facial-paralysis-a734-20220611
Blum, D. (2022, June 11). What Is Ramsay Hunt Syndrome? Justin Bieber’s Diagnosis, Explained. The New York Times. https://www.nytimes.com/2022/06/10/well/live/ramsay-hunt-syndrome-facial-paralysis.html
NHS website. (2021, November 18). Post-herpetic neuralgia. Nhs.Uk. https://www.nhs.uk/conditions/post-herpetic-neuralgia/#:%7E:text=Post%2Dherpetic%20neuralgia%20is%20a,full%20recovery%20within%20a%20year.
NORD - National Organization for Rare Disorders. (2015, February 11). Ramsay Hunt Syndrome. https://rarediseases.org/rare-diseases/ramsay-hunt-syndrome/#:%7E:text=Ramsay%20Hunt%20syndrome%20(RHS)%20is,loss%20may%20also%20be%20present.
Mayo Clinic. (2021b, October 12). Ramsay Hunt syndrome - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783
Mount Sinai Health System. (n.d.). Ramsay Hunt syndrome. Retrieved June 15, 2022, from https://www.mountsinai.org/health-library/diseases-conditions/ramsay-hunt-syndrome
LaMotte, S. C. (2022, June 13). What is Ramsay Hunt syndrome, the virus attacking Justin Bieber’s face? CNN. https://edition.cnn.com/2022/06/11/health/ramsay-hunt-syndrome-explainer-wellness/index.html