Leprosy (Hansen’s Disease)

Leprosy is a bacterial infection that damages your nerves, muscles, skin, eyes and respiratory tract. It can cause patches of pale or discolored skin, loss of sensation (numbness) and permanent disabilities.

Leprosy was once a mysterious disease that created a lot of fear. People with leprosy were often treated unfairly and isolated from others. We now know the cause and that it’s a treatable disease. It doesn’t spread easily from person to person.

Leprosy is also called Hansen’s disease. Some people prefer that name because of the stigma associated with the word “leprosy.”

Does leprosy still exist?

Yes, leprosy still exists today. About 200,000 people are diagnosed around the world each year. It’s rare in the U.S.

Symptoms of leprosy (Hansen’s disease)

Symptoms of leprosy include:

• Patches of skin, often with raised edges, that are different from areas around them — they might be discolored, pale, red, thick, stiff, swollen or numb
• Red or purple nodules or lumps
• Painless ulcers or sores on the bottom of your feet
• Enlarged nerves
• Weakness or paralysis
• Loss of eyebrows or eyelashes
• Vision loss or other eye issues

Leprosy develops slowly. It takes several years — sometimes, decades — to develop symptoms after exposure.

Leprosy causes

Mycobacterium leprae bacteria cause leprosy. Experts don’t fully understand how the disease spreads, but they think it’s transmitted through airborne droplets when an infected person coughs or sneezes.

Is leprosy contagious?

Yes, leprosy is contagious (spreads from person to person). But it’s not easy to get. You have to spend a long time — many months — in close contact with someone to get leprosy. Most people’s immune systems fight it off. You’re not contagious if you’re receiving treatment.

Risk factors

You’re at higher risk for leprosy if you live in areas where it spreads. This includes parts of Asia, Africa and South America.

Leprosy complications

Complications of leprosy include:

• Permanent paralysis
• Permanent damage to your hands and feet that makes them difficult to use
• Permanent change to your appearance
• Shortening of your toes and fingers
• Ulcers that won’t heal
• Blindness
• Chronic pain

How doctors diagnose leprosy

A healthcare provider diagnoses leprosy by doing a physical exam, looking at your skin and getting a nerve or skin biopsy. They may also get blood tests or perform tests of your nerves or muscles (like nerve conduction tests).

Depending on your symptoms, a provider might diagnose you with:

• Tuberculoid (paucibacillary) leprosy. This type usually has mild symptoms. You may have only a few areas of pale or reddish skin, mild muscle weakness or areas that feel numb.
• Lepromatous (multibacillary) leprosy. This type of leprosy causes widespread sores and lesions affecting your nerves, skin and organs.
• Borderline (dimorphus) leprosy. Symptoms of this type of leprosy fall somewhere in between tuberculoid and lepromatous leprosy symptoms.

How is leprosy treated?

Leprosy is curable. Healthcare providers use a combination of three antibiotics, known as multidrug therapy (MDT), to kill the bacteria. Antibiotics to treat leprosy include:

• Dapsone
• Rifampin
• Clofazimine

You’ll have to take these medications for six to 12 months. Take all medications as prescribed, even when your symptoms start to improve. There’s no need to isolate from others while in treatment.

A provider might also recommend surgery to remove nodules and help with nerve damage.

When should I see my healthcare provider?

Any time you develop skin sores, numbness or muscle weakness, it’s important to schedule an appointment with a healthcare provider. They can determine if your symptoms are due to leprosy or another health condition.

Can leprosy be prevented?

It’s not easy to contract leprosy. If you’re in close contact with someone who has it, your provider may recommend getting tested yearly to make sure you can treat an infection early, before you have any symptoms.

What can I expect if I have leprosy?

If you’ve been diagnosed with leprosy, get treatment right away. The sooner you begin treatment, the less likely it is that you’ll have severe or lasting symptoms. Your provider will continue to monitor you over the next couple of years.

Antibiotics can cure the infection, but nerve damage and disabilities caused by leprosy can be permanent. They may get worse even years after treatment.

What is the life expectancy of a person with leprosy?

When treated, someone with a mild form of leprosy can expect to live about as long as someone without it. If left untreated for too long, leprosy can lead to severe complications and death.

Do leprosy colonies still exist?

Yes, some leprosy communities still exist. In the past, misunderstanding and fear around the disease led to the belief that people with leprosy needed to be isolated from others. Now, we know that that isn’t true. Most people are treated on an outpatient (at home) basis. But some people still live in the communities, either due to stigma or because they’ve made it their home over many years.

Is leprosy an STD?

No, leprosy isn’t a sexually transmitted infection (STI). It’s thought to infect your respiratory tract.

Do armadillos carry leprosy?

Yes, some do. A species of armadillo native to the southern U.S. and Mexico can carry leprosy and spread it to humans.