Pop singer Justin Bieber announced he is canceling upcoming concerts and taking a break from performing because he is suffering from Ramsay Hunt syndrome, a rare viral condition that has caused paralysis in his face.
Bieber shared his diagnosis with his fans in an Instagram video posted on June 10. “Obviously, as you can probably see from my face, I have this syndrome called Ramsay Hunt syndrome and it is from this virus that attacks the nerve in my ear, my facial nerves, and has caused my face to have paralysis,” the star explained.
The condition has left Bieber unable to blink or smile on the affected side of his face, which he demonstrated in the video.
What Is Ramsey Hunt Syndrome?
Ramsey Hunt syndrome is a late complication of the varicella-zoster virus (VZV) infection, the same virus that causes chickenpox in kids and shingles in adults, says Patrick Byrne, MD, chair of the Head and Neck Institute at Cleveland Clinic in Ohio.
“We believe that the virus lies dormant after a previous exposure. Then, for reasons that are not well understood, in some cases it will ‘reawaken’ and affect the facial and hearing nerves. It can affect the skin around the ear as well,” says Dr. byrne
The condition can affect people of any age, but it’s more common in adults over the age of 60, according to the National Library of Medicine (NIH). Factors that increase the risk of herpes zoster also increase the incidence of Ramsay Hunt syndrome, including stress, chemotherapy, immunocompromise, infection, and malnutrition.
In rare cases, the virus is reactivated and infects a nerve in the head near the inner ear, causing irritation and swelling and resulting in Ramsay Hunt syndrome, according to the Ichan School of Medicine at Mount Sinai in New York City.
In addition to the facial paralysis that Bieber described, symptoms can include severe pain in the ear, painful rash on the eardrum, ear canal, earlobe, tongue, and roof of the mouth on the affected side of the face. Hearing loss, tinnitus, and vertigo may also occur in people who have Ramsey Hunt syndrome.
Treatment and Outlook for Ramsey Hunt Syndrome
The treatment options for Ramsey Hunt syndrome include acute and chronic management, says Byrne. “In the short term we use steroids and antiviral medication,” he says.
If the pain continues, painkillers may also be prescribed, according to Mount Sinai. A special eye lubricant and artificial tears can be used because the affected eye can get dry from lack of blinking.
The chances of a full recovery are improved if treatment is started within three days after the symptoms begin. If there isn’t much damage to the nerve, most people get better within a few weeks. However, if the nerve is severely damaged, full recovery may not be possible.
Complications of the syndrome may include changes in the appearance of the face, loss of vision, persistent pain, and changes in facial movements due to nerve damage. “Many patients end up without any sequela (long-term effects). However, in comparison to Bell’s palsy, Ramsey Hunt patients are more likely to end up with some facial dysfunction that persists,” says Byrne. In those cases, patients are treated with a combination of facial retraining, chemo denervation (using Botox to block signals to prevent abnormal facial muscle activity), and sometimes surgical interventions, he says.
Bieber Cancels Shows, Asks Fans for Understanding While He Rests and Relaxes
“For those who are frustrated by my cancellations of the next shows, I’m just physically obviously not capable of doing them,” said Bieber.
Bieber’s Justice World Tour was originally planned for summer 2020, but then postponed to 2021 and then again to 2022 due to the pandemic, according to billboard. Earlier this year, shows in Las Vegas were canceled after the singer tested positive for COVID-19.
In the video, the singer explained his decision. “This is pretty serious you can see. I wish this wasn’t the case but, obviously, my body’s telling me I got to slow down. And I hope you guys understand and I’ll be using this time to just rest and relax and get back to 100 percent so that I can do what I was born to do. But in the meantime, this ain’t it. I gotta go get my rest on so that I can get my face back to where it’s supposed to be.”
Bieber expressed optimism for his recovery at the end of the message, and said he is doing facial exercises to get his face back to normal. Massage and physical therapy can be part of the treatment to prevent long term effects that may result from facial paralysis.