Hair loss on your head and two other body parts ‘could signal an STI’ warns expert

RASHES, soreness and noticeable changes in discharge are usually the first symptoms we think of when it comes to sexually transmitted infections (STIs).

There is however, one lesser-known symptom of a STI that can easily be dismissed as stress or ageing.

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A pharmacist has warned hair loss - particularly patchy hair loss on the head, beard and eyebrows - could be down to an underlying syphilis infection.

Syphilis is a STI that if not treated, can cause serious and potentially life-threatening problems.

Syphilitic Alopecia (SA) is a symptom which mimics other types of alopecia, says superintendent pharmacist Abbas Kanani, superintendent pharmacist of Online Pharmacy Chemist Click.

"Although it is quite rare, it can cause non-scarring hair loss in secondary syphilis," Abbas explains.

"It tends to mimic other hair disorders, such as alopecia areata - which is mostly in small, round patches on the scalp, trichotillomania - a compulsive desire to pull out one's hair, and telogen effluvium - excessive shedding of resting or telogen hair after some metabolic stress, hormonal changes, or medication.

"It can present three clinical patterns that affect not only the scalp region, but also other hair-covered areas; these patterns include moth-eaten, diffuse, and mixed alopecia."

Moth-eaten alopecia looks like multiple, scattered, small patches of hair loss, resembling a moth's damage to fabric.

Diffuse alopecia occurs all over the scalp in a uniform, thinning pattern, rather than in distinct patches.

And mixed alopecia is having two or more different types of hair loss conditions simultaneously.

Because prevalence of the symptom is low the precise mechanisms by which it develops and progresses still has to be ascertained.

However, Abbas added: "The immune response to the bacterium Treponema pallidum, or its presence, could be related to the loss of terminal hairs, hair follicle cycle arrest, and hair bend resulting in empty follicles and broken hairs."

There are four stages of syphilis - primary, secondary, latent, and tertiary.

The “moth-eaten” hair loss pattern is the most common type with SA and is considered to be a characteristic of secondary syphilis.

Other symptoms of syphilis include:

• Small sores (ulcers) on your penis, vagina, or around your bottom (anus) – these are usually painless and you may only have one of them
• Sores in other areas, including in your mouth or on your lips, hands or bottom
• White or grey warty growths most commonly on your penis, vagina or around your anus
• A rash on the palms of your hands and soles of your feet that can sometimes spread all over your body – this is not usually itchy
• White patches in your mouth
• Flu-like symptoms, such as a high temperature, headaches and tiredness
• Swollen glands

Knowing whether you have the STI can be challenging, particularly with syphilis, as it can take three weeks or more for symptoms to appear.

Also, the symptoms of syphilis are often mild and hard to notice, tend to change over time and may come and go.

"Symptoms can improve or go away completely, but if you have not been treated the infection is still in your body which means you can still pass it on and you're at risk of getting serious problems later on," warned Abbas.

Syphilis is transmitted during oral, anal or vaginal sex through contact with infectious lesions, and also during pregnancy through the placenta.

Latest available figures show that globally, eight million adults were diagnosed with syphilis in 2022.

However the UK Health Security Agency (HSA) reports diagnoses of infectious syphilis (primary, secondary and early latent stages) at sexual health services in England decreased slightly in April to June 2024 to an estimated 2,300, down from 2,360 in the previous quarter.

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You should visit your GP or a sexual health clinic if you or a sexual partner have symptoms of syphilis, a sexual partner has told you they have syphilis or another STI or you've recently had sex with a new partner and did not use a condom.

It's also important to book an appointment if you're pregnant or planning to get pregnant and think you might have syphilis or you've injected drugs using a needle that's been used by someone who might have syphilis.

Syphilis is treated with antibiotics, which can come in the form of injections, tablets or capsules.

Abbas explains the duration of the treatment is dependent on the stage of your syphilis.

If it's not treated, syphilis can cause serious and potentially life-threatening problems, some of which may not appear for many years.

According to the NHS, these include heart problems like aortic aneurysms and heart failure, brain damage leading to stroke, dementia, and seizures, and nerve damage causing paralysis, blindness, and deafness.

But syphilis is both a preventable and curable bacterial STI.

Abbas said: "Using condoms consistently and correctly when you have vaginal or anal sex is the best way to prevent syphilis and many other STIs.

"You should also use a condom to cover the penis or a latex or dam to cover the vagina if you have oral sex and make sure you complete treatment if you or your partner have syphilis.

"Avoid sharing sex toys or wash and cover them with a new condom before anyone else uses them."