The key to recovery from Ramsay Hunt syndrome is the prompt and effective treatment of the varicella zoster virus. Anti-viral medications such as Valtrex, Acyclovir, or Famciclovir are recommended for 7 to 10 days along with strong anti-inflamatory steroids (such as Prednisolone/Prednisone) for 3 to 5 days which are tapered off in about a week or more. Although steroids are usually recommended for the treatment of these acute symptoms and complications, new studies question the effectiveness and viability of this course of action. In patients at risk, blood pressure, blood glucose and electrolytes should be monitored throughout the treatment.
In RHS, the antiviral medication inhibits the replication of viral DNA needed to reproduce itself. Virally infected cells absorb more of the antiviral medication than do normal cells and convert more of it to an active form which prolongs its antiviral activity where it is most needed. Appropriate antiviral medication may reduce the severity and duration of RHS if given soon after the onset of symptoms. Examples of antivirals commonly used in the treatment of RHS include Acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex).
Corticosteroids are often prescribed to reduce inflammation of the facial nerve. Their effectiveness is a matter of contention due to the difficulty of judging how well a patient would have recovered without treatment. This has led to a situation where the decision to prescribe Coritcosteriods has been left to the personal opinions of the Doctor and the patient.
Hospitalisation is not normally called for in cases of Ramsay Hunt Syndrome. However, certain side effects such as encephalitis may make hospitalisation necessary. Also, if the medical team thinks it advisable to administer antiviral medication intravenously, the patient may be hospitalised.