If damage to the nerve is minimal, then a good recovery is usually expected. If damage is more severe, there may not be full recovery even after several months. Overall, chances of recovery are better if treatment is started within 3 days of onset of symptoms. It is very important that the appropriate dosage of medications are issued to assure that the virus becomes dormant. The Physicians Desk Reference ® calls for a significantly stronger dosage of antivirals for the zoster virus that causes RHS than that prescribed for Bell's Palsy, the most common misdiagnosis.

Children are more likely to have a complete recovery than adults. Older adults are less likely to achieve full recovery than younger adults.

Recovery may be complicated if the nerve grows back to the wrong areas (synkinesis) which may cause inappropriate responses, such as tears when laughing or chewing (croc´s tears). Some may experience involuntary closing of the eye when talking or eating food.

There may also be long term damage in hearing as full recovery only occurs in 50% of patients and residual tinnitus is commonplace.

Vertigo can continue for several months after onset of Ramsay Hunt syndrome but often leaves after only a few weeks. The initial onset of vertigo can produce severe nausea and vomiting in cases but prolonged effects are rare. Somewhat more common is residual disequilibrium due to severe damage to the vestibular nerve.