Bieber tried to smile, blink, and move his face during the video to the fans, but it was clear that one side of his face remained still as he continued to speak.
“So for those who are frustrated by my cancellations of upcoming shows, I’m just physically, obviously, I can’t do them,” he said. “This is pretty serious as you can see.”
Bieber said he has been doing facial exercises to try to regain movement, but that he will need time to recover.
“I wish it wasn’t like that, but obviously my body tells me I have to slow down,” he said. “I hope you understand, and I’m taking this time to rest and relax and go back to 100% to be able to do what I was born to do. But in the meantime, that’s not it.”
The virus that causes Ramsay Hunt Syndrome is called chickenpox virus, which belongs to the family of herpes viruses; is the same pathogen behind chickenpox in children and chickenpox in adults, according to the National Organization for Rare Disorders.
It is unclear how Bieber contracted the virus, but he may have contracted the germ a few years ago during a fight with chickenpox. The virus, which is not contagious, can remain dormant in your body for years before reactivating and spreading to a facial nerve near your ear, becoming shingles or, in some cases, Ramsay Hunt, for unknown reasons.
As in the case of Bieber, people with RHS often experience some degree of facial paralysis or weakness on one side of the face and a rash on the outside of the ear, although both symptoms are not guaranteed.
Other symptoms that may accompany RHS include noise in the ear, temporary hearing loss, nausea, vomiting, dry eyes, earache, and loss of taste.
The syndrome occurs in about 5 out of every 100,000 people in the United States each year, says the National Rare Disorders Organization, although its prevalence can be underestimated because cases are often misdiagnosed.
Anyone who has had chickenpox can develop RHS at some point, most likely during adulthood. Most cases occur among the elderly; children are rarely affected.
Antiviral drugs such as acyclovir or famciclovir, both used to treat herpes virus infections, along with corticosteroids can treat RHS. However, some symptoms may become permanent, such as facial paralysis and hearing loss. Eye drops can help protect the cornea from drying out if people can’t blink, as is the case with Bieber. In his message, he said it was unclear how long it could be before he got better.
“She’ll be fine,” Bieber said. “I hope, and I trust God and I trust that all this will go, it’s all for a reason.”