No matter what, there’s nothing more daunting than the aspect of continuously losing your hair. It’s doesn’t matter that you have a lot of bad hair days; it’s your hair, and you love it even if it doesn’t exactly behave the way you want.
Now, if it isn’t anything serious, you’ll only lose a few hair strands temporarily. The damage will be reversible, and you’ll be as good as new in no time.
However, sometimes, the problem can lie deeper, and you might not even notice that it may be causing hair loss in the first place. Syphilitic alopecia or syphilis hair loss is very much real, and the prospect is worrisome.
The thing about syphilitic alopecia is that many people are hesitant to talk about it. That’s because of the stigma associated with sexually transmitted diseases.
According to the Centre for Disease Control, there were 129,813 cases of syphilis in 2019, of which 38,992 cases had primary and secondary syphilis. After reaching a historic low in 2000, according to the CDC, over the years, the number of cases of syphilis reported has increased. And more men are affected by it than women.
What Is Syphilis?
Syphilis is a highly contagious bacterial infection caused by Treponema pallidum. Contact with a sore on the infected person’s body can pass it onto another person. Although commonly spread through sexual intercourse, including vaginal, oral, and anal sex, it can also penetrate the body through cuts on the skin or by infecting the mucous membrane.
Syphilitic sores, also known as chancres, are painless at first and can begin to develop on different areas of the body, such as genitals, rectum (around or inside it), and mouth (around or inside it). It usually happens that the person who has syphilis isn’t aware of the infection.
So, they may unknowingly spread the infection. It is also possible for the bacteria to stay dormant inside the body of the infected person without them experiencing any signs and symptoms. It can become active after years have passed.
The earlier the treatment for syphilis, the better. If left untreated, syphilis can cause damage to the heart, brain, eyes, bones, joints, muscles, blood vessels, digestive tract and liver, among other organs. An infected mother can also pass on syphilis to the unborn child.
How Contagious Is Syphilis?
The disease is highly contagious and commonly spreads through sexual activities. The risk of passing syphilis onto another person increases if they have unprotected sex or are HIV positive. Other risk factors include having multiple sexual partners and a man having sexual intercourse with a man.
It is not possible for a person to get infected with syphilis by coming in contact with doorknobs, common utensils, and sharing toilet and bathtub, clothes and swimming pool with the infected person.
There are different stages of syphilis. It is contagious during the primary and secondary stages but not the tertiary stage. A person can pass syphilis onto another in the latent stage.
What Are the Symptoms and Stages of Syphilis?
Let’s take a look at the symptoms of syphilis at different stages.
Primary Syphilis Stage
At this stage of syphilis, a painless sore appears on the body at the site where the bacteria entered it. Such a sore is known as a chancre.
Some people may develop more than one sore on their body. Usually, it appears around the anus, genitals, or mouth. These sores may appear after 3 weeks of the infection and go away after 6 weeks.
It is important to treat syphilis in the first stage; otherwise, it will progress to the secondary stage.
Secondary Syphilis Stage
Secondary syphilis can last for as long as a year, with its symptoms coming and going away. Patients with secondary syphilis can develop a non-itching rash on the body that can even extend to the palms and the soles of the feet. Manifestations of secondary syphilis can take more than a month to half a year.
Wart-like lesions are another manifestation of secondary syphilis. It can also result in the appearance of mucous patches in the mouth. Other symptoms of secondary syphilis include swollen lymph nodes, fatigue, fever, joint ache, headache and hair loss. The symptoms of secondary syphilis can improve on their own without you needing any treatment for them.
Tertiary Syphilis Stage
Left untreated, syphilis can progress to the tertiary stage. It can cause damage to the eyes, heart, brain, and nerves, among other organs.
Neurosyphilis can also occur at this stage when the nervous system, brain or spinal cord incur damage. It can also cause blindness, deafness, mental illness, paralysis, heart disease, and impotence, among other problems.
Latent Syphilis Stage
It is when the infection stays dormant in the body and shows no signs and symptoms. This happens when syphilis is not treated. The symptoms of infection may never show up. This stage can precede the tertiary syphilis stage.
Is Syphilis Curable?
The right antibiotic can treat syphilis. A single injection of penicillin might even treat syphilis if it is still in its early stages.
If it has progressed, you can still get treatment for it, but it might not be possible to reverse the damage caused by it at different stages. You may end up with permanent damage to your brain and heart, for instance.
What is Syphilitic Alopecia?
Alopecia from sexually transmitted diseases (like syphilis) occurs at a frequency of 2.9 to 7%. Hair loss due to syphilis may result from syphilitic alopecia, and they can have different causes.
Lesions on the Scalp
Sometimes, hair loss because of syphilis occurs due to the formation of lesions on the scalp. It is extremely rare and is a manifestation of secondary syphilis.
The other type of syphilis hair loss is diffuse. It may give the appearance that the person is suffering from telogen effluvium or alopecia areata. This is essential syphilitic alopecia and is also quite rare. It is of the non-scarring type and also occurs at the secondary syphilis stage.
Cases of people experiencing moth-eaten alopecia as a result of syphilis have been reported. It is a type of essential syphilitic alopecia and occurs most commonly. It gets its name for presenting hair loss due to syphilis in a moth-eaten appearance. It may occur in combination with diffuse hair loss.
The person with moth-eaten alopecia may seem to have a scalp hair appearance that is similar to other hair loss conditions such as trichotillomania and tinea capitis (fungal infection). That means moth-eaten alopecia can mimic other hair loss conditions.
It is also possible that the patient experiences non-scarring hair loss from alopecia in other areas of the body, such as eyebrows and public areas. Alopecia syphilitica can damage the hair follicles and affect the hair growth cycle.
The stress from syphilis can push the hair into the resting phase of the growth cycle. And that can result in excessive shedding a few months later. This kind of hair loss also occurs if the body’s “balance” is upset due to a disease, which in this case is syphilis.
Is Syphilis Hair Loss Permanent?
The good news is that this kind of hair loss isn’t permanent. Once the infection is treated, the regrowth can resume. The hair follicles will start giving rise to new hairs. Eventually, your hair should regain its old strength and density. However, getting treatment as soon as possible is important for treating hair loss due to syphilis.
What Is The Treatment For Hair Loss Due To Syphilis?
One study on a person with moth-eaten pattern hair loss showed that the administration of “benzathine penicillin G” resulted in the regrowth of hair 5 weeks after.
Antibiotics offer the best treatment for syphilis. After the treatment, hair grows in approximately 3 months. The hair growth cycle is of 3 months when new hair forms and starts to grow under the skin. Syphilis hair loss is not permanent unless it’s understood that syphilis is causing hair loss and it’s treated.
Can Hair Transplant Treat Syphilis Hair Loss?
Syphilis affects the donor area of the scalp (back and sides). This means that the surgeon cannot take hair follicles from there as there will be less hair in the donor area. This, unfortunately, makes the patient unsuitable for a hair transplant.
With the hair transplant, we use the hair on the backside, so we need a strong donor area to extract hairs from. However, since moth-eaten alopecia, the most common syphilitic alopecia, affects the whole scalp, it makes hair transplant impossible.
If you’re experiencing permanent hair loss due to androgenetic alopecia or any other types of alopecia, you can get restoration surgery after syphilis has been treated.
Hair loss is secondary syphilis presenting itself. It can occur due to skin lesions or moth-eaten, diffuse, non-scarring hair loss.
Getting early treatment for syphilis stops the progress of the infection into more advanced stages, where it can cause permanent damage to your body.
As long as you’re experiencing hair loss due to syphilis, you are not suitable for hair transplant surgery. Also, you don’t need surgery for this type of hair loss since it’s only temporary. However, if it’s for permanent conditions (scarring alopecia, pattern baldness or traction alopecia), you first need to get the infection treated.
If you’re experiencing any symptoms of the disease, get yourself checked and treated. For more information, you can contact us anytime.
Reviewed and Approved by Dr. Hassan Soueid.