Yaws

What is yaws?

Yaws is a long-lasting and potentially disfiguring skin disease you get from a bacterial infection. A specific type (subspecies pertenue) of the bacteria Treponema pallidum (T. pallidum) causes it. It causes skin growths that start out in one area and then spread to other parts of your body. If left untreated, it can come back months or years later. It can cause permanent damage to your skin, bones and tissues.

Yaws is part of a group of bacterial infections called endemic treponematoses. Other names for it include “pian,” “framboesia” and “bouba.”

Stages of yaws

There are four potential stages of yaws:

• Primary yaws. This is when your first symptoms appear. A growth on your skin starts small, then grows larger and crusts over. This can last three to six months.
• Secondary yaws. Secondary yaws appears a few months after your first symptoms. It causes multiple growths on your skin that can progress to bone infections.
• Latent yaws. In latent yaws, you test positive for T. pallidum but don’t have any symptoms. This could last for years. It’s possible you could still be contagious during this period.
• Tertiary (late) yaws. Without treatment, about 10% of people get tertiary yaws (or “late yaws”) five to 10 years after their first symptoms. Late yaws causes widespread, destructive growths.

What’s the difference between syphilis and yaws?

Yaws is caused by similar bacteria to those that cause syphilis, but it’s not a sexually transmitted infection. It spreads through contact with broken skin.

What are the symptoms of yaws?

Skin cysts, ulcers and sores that spread and change over three different phases are the main symptoms of yaws. Other symptoms can include:

• Swollen lymph nodes.
• Bone pain and swelling.
• Tiredness.
• Generally feeling unwell (malaise).

Primary yaws symptoms

Primary yaws is the first skin growth to appear when you’re infected with Treponema pallidum pertenue. It can appear anywhere on your body, but it most commonly appears on your legs or feet. It’s often called the “mother yaw.” It grows from a cyst to a large, itchy ulcer. It may be pus-filled and crust over. It can heal on its own over a few months and leave a scar.

Secondary yaws symptoms

Secondary yaws symptoms usually start a month or two after the first cyst, but they can start up to two years later. Secondary yaws causes multiple skin growths, often on your hands, arms, legs or feet. They might look or feel:

• Wart-like.
• Ulcer- or wound-like.
• Raised and bumpy (“raspberry-like”).
• Red or yellow.
• Scaly and flat.
• Hard and thick.

Yaws can spread to your bones in this stage, causing pain and swelling in your fingers, toes, arms or legs.

Tertiary yaws symptoms

Without treatment, some people get late yaws five to 10 years after their first symptoms. Yaws growths are spread over many parts of your body in this stage. You might have:

• Large growths near your joints.
• Open wounds that go deep into your skin, cartilage and bones.
• Hard patches (plaques) on your hands and feet.

What causes yaws?

A specific type (subspecies pertenue) of the bacteria Treponema pallidum causes yaws. In the first and second stages of yaws, the skin growths are filled with bacteria. You can get infected from contact with the ulcers or skin growths of someone who has yaws.

Is yaws contagious?

Yes, yaws is contagious. It spreads from person to person through skin-to-skin contact with yaws growths. Yaws is contagious in the first two stages but not the third.

Who is most likely to get yaws?

In parts of the world where it’s common, children under the age of 15 are most likely to get yaws, though adults can get it, too. Experts think adults in these areas may become immune to (protected from) infection over time. Someone traveling to these areas who lives in an area without yaws wouldn’t have immunity.

Where is yaws found?

Yaws is found in (endemic to) humid, tropical areas, including:

• Southeast Asia.
• West and Central Africa.
• The Pacific Islands.

It’s usually found in rural areas, where it spreads more easily.

What are the complications of yaws?

Complications of yaws include:

• Swollen fingers and toes (dactylitis).
• Infection of your bones or their lining (periostitis).
• Tissue death (necrosis).
• Disfigurement.
• Destruction of bone and cartilage in your nose (gangosa).
• Additional bacterial infections.
• Difficulty walking or other physical limitations caused by plaques or other kinds of damage to your body.

How is yaws diagnosed?

A healthcare provider diagnoses yaws by looking at your skin and asking about your health history. They may also test samples of the sores or your blood for T. pallidum. Under a microscope, the bacteria that cause yaws and the bacteria that cause syphilis look the same. The only way to know the difference is by your symptoms.

Is yaws curable?

Yes, a single, high dose of antibiotics almost always cures yaws. Providers treat it with an azithromycin pill or an injection of benzathine penicillin G. Yaws can be treated in any stage, but treatment in earlier stages reduces your risk of serious complications.

Can yaws be prevented?

You can prevent yaws by avoiding skin-to-skin contact with someone who has yaws. Contact with tertiary skin growths doesn’t spread yaws. Healthcare providers can also treat close contacts of people with yaws with antibiotics to prevent infection.

The World Health Organization is also working to eradicate yaws completely. They do this by treating everyone — whether they have symptoms or not — in communities where yaws is common.

What’s the outlook for yaws?

Yaws is generally easy to treat and has a good outcome (prognosis) if you’re treated early in the infection. But it can leave permanent scars and disfiguring damage if it spreads without being treated.

When should I see my healthcare provider?

See your healthcare provider if:

• You’ve traveled to or live in an area with yaws and have symptoms.
• Someone you’ve been in close contact with has been diagnosed with yaws.
• You have a wound that’s not healing or keeps coming back.

Early treatment can cure the infection before it causes permanent damage.

When should I go to the ER?

Go to the emergency room if you have signs of a serious infection, like:

• High fever (over 103 degrees Fahrenheit/40 degrees Celsius).
• Skin around a wound that’s red, hot or painful.
• Dizziness or weakness.
• A fast heart rate.
• Low blood pressure.
• Not peeing or peeing very little.

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• What stage is this?
• Will my skin heal?
• How do I protect my skin while it heals?
• Should my close contacts be treated with antibiotics?
• For how long am I contagious?

A note from Cleveland Clinic

Yaws is a skin disease that starts out small but can become widespread and destructive. It’s found in areas of the world that often don’t have convenient access to healthcare. If you think you have yaws, see a healthcare provider. Yaws is usually easily treatable with a single dose of antibiotics, but the damage caused in later stages can be irreversible.