A Narrative Review on the Management of Ramsay-Hunt Syndrome Through Acupuncture: Mechanisms and Clinical Perspectives

Ramsay-Hunt Syndrome (RHS) is a neurological disorder caused by the reactivation of the varicella-zoster virus, resulting in facial paralysis, otalgia, and vesicular rashes. Even after treatment with antivirals and corticosteroids, long-term complications like postherpetic neuralgia can persist, prompting interest in complementary therapies such as acupuncture. This narrative review aimed to assess the efficacy of acupuncture in the management of RHS, emphasizing its mechanisms and clinical outcomes. A literature search in PubMed, Web of Science, and China National Knowledge Infrastructure was conducted up to August 15, 2025. After screening, 11 clinical studies on acupuncture treatment for RHS were included in the final analysis. The included clinical studies suggest that acupuncture may improve facial nerve function, relieve pain, and promote recovery, particularly when initiated early. Mechanistically, it improves peripheral nerve repair through increased neurotrophic factors, better circulation, and reduced neuroinflammation. Early acupuncture intervention within 7–10 days of onset is associated with a faster recovery and fewer complications. Despite the promising results, limitations such as small sample sizes and methodological inconsistencies should be addressed. Thus, further rigorous studies are needed to confirm efficacy and standardize treatment protocols. Overall, acupuncture is considered a valuable adjunctive therapy for RHS, complementing conventional medical approaches.