Justin Bieber made a surprising comeback to music with his album, S.W.A.G., in July 2025.
However, before the surprise launch of his album in June of the same year, the star suffered from facial paralysis due to Ramsay Hunt Syndrome, which he revealed via Instagram.
Dr. Matthew Miller, director of the UNC Facial Nerve Center, spoke about facial paralysis and what it means for Bieber and others who suffer from it.
Ramsay Hunt syndrome is a reactivation of the varicella-zoster virus that affects the facial nerve, resulting in facial paralysis.
Most often, Ramsay Hunt syndrome is seen in individuals who have had chickenpox, caused by a primary varicella-zoster virus infection.
After a person recovers from chickenpox, the virus can remain dormant in the nerves and reactivate years later, affecting the facial nerve near the ear. This leads to a combination of facial paralysis and a painful rash.
“Think of it like shingles of the facial nerve. One in three people get shingles, while Ramsay Hunt syndrome is much less common: it affects about one in three hundred people,” said Dr. Miller.
Why does it happen?
The condition occurs when the virus reactivates in the geniculate ganglion, a collection of nerve cells that control facial movements and sensations. Factors such as stress, weakened immunity or aging can increase the risk of viral reactivation.
Symptoms
Ramsay Hunt syndrome can manifest itself in a series of symptoms, which often occur suddenly:
- Painful rash around or in the ear, sometimes on the mouth or tongue
- Facial paralysis on one side of the face, causing the eye to droop or become difficult to close
- Ear pain, which can be severe
- Hearing loss or ringing in the ears (tinnitus)
- Vertigo (dizziness) and balance problems
- Loss of taste or dry mouth and eyes
Complications
If Ramsay Hunt syndrome is not treated promptly, it can lead to complications such as permanent facial weakness, persistent pain (postherpetic neuralgia), or long-term hearing loss. Early treatment significantly improves recovery outcomes.
Treatment
Treatment is aimed at reducing the severity of symptoms and preventing complications:
- Antiviral medications (such as acyclovir) to fight the virus
- Corticosteroids to reduce inflammation and swelling of the nerve
- Pain relief, including painkillers
- Eye care, such as lubricating drops, to prevent dehydration if the eye cannot close properly
- Physiotherapy, which can help restore facial movement
Treatment is most effective when started within 72 hours of the onset of symptoms.
Ramsay Hunt syndrome is a serious but treatable condition associated with the reactivation of the chickenpox virus.
Like Justin Bieber, recognizing symptoms early, especially facial paralysis and ear rashes, is crucial. With timely medical care, many patients can make a significant recovery and avoid long-term complications.
