What is leprosy?

Hansen’s disease, or leprosy, is a disease that affects the nerves and skin. It’s one of the oldest infectious diseases in human history, and is caused by a slow-growing bacteria called Mycobacterium leprae. About 95% of people are naturally immune against the bacteria that causes leprosy, according to the Florida Department of Health.

▪ Symptoms: Leprosy causes discolored patches of skin, lumps and ulcers, and numbness in affected areas. If left untreated, leprosy can lead to paralysis, crippling of hands and feet, disfigurement and blindness.

▪ What to look for: Dunn says leprosy can appear as patches or plaques that are well marked. “I can take a pen and I can draw a circle around them perfectly,” he said. These skin patches or plaques tend to be lighter in color, but not always. And if you rub your finger over that area it tends to have less sensation than the surrounding skin, Dunn noted. “One mimicker of this is actually psoriasis. So it can look a little like a psoriatic plaque,” Dunn said. Other presenting signs to look for include a loss of the eyebrows and eyelashes and a kind of thickening or furrowing of the facial features. “The ear lobes can start to elongate a little bit as the nerves and the connective tissue kind of gets softer,” Dunn said.

▪ Treatment: Leprosy is typically treated with two or three antibiotics simultaneously for one to two years to help prevent the bacteria from developing resistance against the drugs, the U.S. Centers for Disease Control and Prevention says. While treatment can cure the disease and prevent the illness from getting worse, it cannot reverse nerve damage or physical disfiguration from the illness.

▪ The bottom line: “In the past, Hansen’s disease was feared as a highly contagious, devastating disease, but now we know that it’s hard to spread and it’s easily treatable once recognized,” according to the CDC. “Still, a lot of stigma and prejudice remains about the disease, and those suffering from it are isolated and discriminated against in many places where the disease is seen.”

How does leprosy spread?

Even though leprosy has ancient roots, doctors still don’t know how leprosy spreads between people. What they do know is that leprosy doesn’t spread easily and is easy to treat if detected early, according to the CDC.

Scientists believe leprosy can spread by inhaling infected respiratory droplets that are released when an infected person coughs or sneezes, similar to how flu and COVID spread. However, unlike with flu and COVID, you need to inhale these infected respiratory droplets over a long period.

“Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease,” which means you cannot get leprosy through “casual contact,” such as by shaking hands, sitting next to each other on the bus or sitting together for a meal, according to the CDC. Leprosy is also not spread by sex nor can it be passed on to an unborn child during pregnancy.

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