Syphilis is a bacterial infection caused by Treponema pallidum, primarily transmitted through sexual contact. Historically, severe physical deformities were associated with its later stages. However, modern medical advancements and effective treatments have profoundly altered the infection’s impact and progression.
Syphilis and Facial Disfigurement
Severe facial disfigurement can occur in very rare, untreated cases of advanced syphilis. This complication is linked to tertiary syphilis, the infection’s latest stage. Tertiary syphilis is characterized by gummas, which are soft, tumor-like lesions that can develop on various body parts, including bones and cartilage.
When gummas form in the facial region, particularly around nasal structures like the septum or bridge, they can cause extensive tissue destruction. This erosion of bone and cartilage can lead to the collapse or severe deformity of the nasal structure, resulting in a “saddle nose” deformity. While historically documented, this outcome is exceedingly rare today due to effective treatments.
The Progression of Untreated Syphilis
If untreated, syphilis progresses through distinct stages, each with different characteristics. Primary syphilis, the initial stage, typically appears as a single, painless sore (chancre) at the infection site. This sore usually emerges 10 to 90 days after exposure and often heals on its own within weeks.
Secondary syphilis can follow, marked by a non-itchy skin rash that may appear anywhere, including palms and soles. Other symptoms can include fever, swollen lymph nodes, and fatigue. These symptoms may also resolve without intervention, leading to the latent stage.
During the latent stage, the infection remains in the body without outward signs or symptoms, potentially lasting years or decades. If untreated through these earlier stages, it can advance to tertiary syphilis. This late stage can emerge years or decades after initial infection, causing severe complications like gummas, cardiovascular problems, and neurosyphilis. Early detection and treatment prevent progression to these severe, potentially irreversible stages.
Diagnosis, Treatment, and Prevention
Syphilis diagnosis primarily uses blood tests, which detect antibodies to Treponema pallidum, indicating current or past infection. Fluid from a suspected sore can also be examined microscopically for direct bacterial detection.
Penicillin is the preferred and highly effective antibiotic for all stages of syphilis. Early stages often require a single intramuscular injection, while later stages may need multiple doses over several weeks. Penicillin cures the infection and halts its progression, though it cannot reverse damage from late-stage complications like gummas or organ damage. Individuals with a penicillin allergy can often undergo desensitization to safely receive the medication.
Prevention involves practicing safer sex with consistent condom use during vaginal, anal, and oral sex. Regular testing for syphilis and other STIs is important, especially for those with multiple partners or higher risk. Early diagnosis and prompt treatment prevent severe outcomes and further transmission.