Concerning the contribution of valacyclovir to the recovery of the patient, it has been repeatedly reported that this antiviral agent is effective in RHS if given within three days after onset of symptoms in combination with prednisolone [ 3 ]. Despite the frequent application of valacyclovir in RHS, however, it is under debate to which degree the agent contributes to the outcome of RHS patients. No studies are available which compared valacyclovir and steroids, each in monotherapy, concerning their effect in RHS. In a study on 196 patients with Bell’s palsy or RHS the outcome was mainly predicted by the initial degree of denervation [ 20 ]. In this study recovery was incomplete after one year if initial denervation was >90%, irrespective of the drugs applied [ 20 ]. As long as open questions concerning the antiviral treatment of RHS are unsolved, however, RHS patients should receive antiviral agents in addition to dexamethasone or prednisolone.