Syphilis, a sexually transmitted infection, can indeed lead to hair loss, a condition known as syphilitic alopecia. This manifestation typically signals the progression of the infection to its secondary stage. While concerning, the hair loss associated with syphilis is generally reversible with appropriate medical intervention.
How Syphilis Affects Hair
The hair loss observed in syphilis results from the body’s response to the Treponema pallidum bacterium. During the secondary stage, the bacteria disseminate, triggering a systemic inflammatory response. This inflammation can directly impact hair follicles.
The inflammatory process disrupts the normal hair growth cycle, affecting the anagen (growth) phase. This interference can lead to premature entry of hair follicles into the telogen (resting) and exogen (shedding) phases. The Treponema pallidum bacterium may also directly invade and damage the hair follicles, contributing to hair shedding.
Patterns of Hair Loss
Hair loss due to syphilis, often termed alopecia syphilitica, presents with distinctive patterns. The most recognized appearance is a “moth-eaten” or patchy alopecia, characterized by small, irregular bald spots across the scalp. This pattern is a notable indicator of secondary syphilis. These patches are typically non-scarring with poorly defined edges.
Beyond the scalp, hair loss can extend to other areas of the body, including the eyebrows, eyelashes, beard, and occasionally other body hair. In addition to patchy hair loss, some individuals may experience diffuse thinning across the scalp, which can resemble other common forms of hair loss. A combination of both patchy and diffuse hair loss can also occur.
Addressing Syphilis and Hair Loss
Addressing syphilis-related hair loss begins with an accurate diagnosis of the underlying infection. Healthcare providers typically diagnose syphilis through blood tests, such as rapid plasma reagin (RPR) and venereal disease research laboratory (VDRL) tests. If these are positive, confirmatory tests like the fluorescent treponemal antibody absorption (FTA-ABS) test are often used to confirm the presence of specific antibodies to Treponema pallidum. A physical examination of hair loss patterns and other symptoms also aid in diagnosis.
Treatment for syphilis, and consequently for the associated hair loss, primarily involves antibiotics. Penicillin is the most common and effective treatment for all stages of syphilis. For individuals with a penicillin allergy, alternative antibiotics like doxycycline or tetracycline may be prescribed. Once the underlying syphilis infection is successfully treated, the hair loss is generally reversible, with hair regrowth typically beginning within weeks to a few months. Full hair recovery is common, as the hair follicles are usually not permanently damaged.