What Is Herpes Zoster Oticus?

Herpes zoster oticus, also known as Ramsay Hunt syndrome (RHS), is a rare type of shingles -- a viral infection that gives you a painful rash. It's caused by the varicella-zoster virus, the same virus that causes chickenpox.

With RHS, the virus attacks nerves in your face near your ear. Anyone who's had chickenpox can get it, but it usually affects people over 60.


RHS often causes a painful rash of blisters filled with fluid in or around one ear. In some cases, blisters also can show up in your mouth and throat. Regular shingles also cause a blistery rash, but the bumps usually break out on a smallish strip of your torso instead of on your face.

Because of the nerves that are affected, RHS also usually causes some weakness in the muscles in your face. You might find it hard to smile or completely close one eye. In rare cases, you might not be able to move the muscles at all

Other common symptoms include:



The virus that causes chickenpox (varicella-zoster) moves into your bloodstream then hibernates inside groups of nerves. It can stay there forever and never cause trouble again -- or it can "wake up" and create a new infection in one of the nerves in your body. When it affects the nerve in your face that goes to your ear, it's called herpes zoster oticus.

In most cases, there doesn't seem to be a reason for the "reactivation" of the virus. Most people are usually immune to RHS after one outbreak, though people with weak immune systems can get shingles -- including the herpes zoster oticus type -- more than once.

Is It Contagious?

You can't get RHS from someone who has it. But the blisters have the live varicella zoster virus in them. So newborns and people who haven't had chickenpox or been vaccinated against it can get chickenpox from someone with RHS.

People who have had chickenpox or the chickenpox vaccine can't get herpes zoster oticus from being around someone with RHS because their immune systems have learned how to fight the virus. They also won't develop chickenpox again for the same reason.


Diagnosis and Treatment

If you think you may have RHS, you should see a doctor right away so you can begin treatment quickly. Your doctor can usually diagnose it with an exam. But she may want to test a bit of fluid from a blister to confirm it.

Antiviral drugs, like acyclovir, may help you get better faster. Your doctor also may give you a prescription for pain medication or a corticosteroid to help make you more comfortable and get rid of some of the inflammation.

Infections usually clear up within a couple of weeks. Some people have nerve pain from RHS after the rash is gone. In rare cases, surgery is needed to ease pressure on the nerve in your face.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on August 18, 2016


Cleveland Clinic: "Herpes Zoster Oticus."

Facial Palsy UK: "Ramsay Hunt Syndrome."

Mayo Clinic: "Ramsay Hunt syndrome," "Shingles."

Merck Manual: "Herpes Zoster Oticus," "Shingles."

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