While rashes, discomfort, and unusual discharge are widely recognized symptoms of sexually transmitted infections (STIs), a lesser-known warning sign could be hiding in plain sight — in your hairline.
Superintendent pharmacist Abbas Kanani, of Online Pharmacy Chemist Click, is raising awareness about an often-overlooked indicator of syphilis: patchy hair loss on the scalp, beard, and even eyebrows. Known medically as syphilitic alopecia (SA), this condition mimics more common forms of hair loss and could easily be mistaken for stress-related shedding or natural ageing.
“Although relatively rare, syphilitic alopecia can result in non-scarring hair loss during the secondary stage of syphilis,” said Kanani. “It tends to resemble other disorders such as alopecia areata, trichotillomania, and telogen effluvium — all of which involve varying degrees of hair thinning or patchy loss.”
SA typically appears in three clinical patterns:
Moth-eaten alopecia: Scattered, small, irregular patches of hair loss resembling fabric damaged by moths — the most common and distinctive form.
Diffuse alopecia: Uniform thinning across the scalp without defined bald patches.
Mixed alopecia: A combination of the above types.
Though the precise mechanisms remain unclear, Kanani suggests the body’s immune response to Treponema pallidum — the bacterium responsible for syphilis — may disrupt the hair growth cycle, leading to follicle dysfunction and hair loss.
More Than Just Hair Loss
Syphilis develops in four stages: primary, secondary, latent, and tertiary. The moth-eaten hair loss most often occurs during the secondary stage, which is also marked by a wider range of symptoms:
Small, painless ulcers on genitals, anus, or mouth
Wart-like growths near the genitals or anus
Rash on the palms and soles, which can spread across the body
White patches in the mouth
Flu-like symptoms including fever, headache, fatigue
Swollen lymph nodes
The challenge? These symptoms may be mild, temporary, or entirely unnoticed — allowing the infection to persist undetected.
“Symptoms can go away on their own, giving a false sense of recovery,” said Kanani. “But without treatment, the infection remains in the body and can progress to cause severe complications later on.”
Rising Cases, Ongoing Risks
Syphilis is primarily transmitted through vaginal, anal, or oral sex via contact with infectious sores. It can also be passed from mother to child during pregnancy.
Globally, an estimated eight million adults were diagnosed with syphilis in 2022. In the UK, recent figures from the UK Health Security Agency show a slight decline in reported syphilis cases, with 2,300 diagnoses between April and June 2024 — down from 2,360 the previous quarter.
Despite this modest drop, public health officials warn against complacency. If untreated, syphilis can lead to serious conditions including:
Heart complications, such as aortic aneurysms and heart failure
Brain and nervous system damage, causing stroke, dementia, or seizures
Sensory impairments, including blindness and deafness
Prevention and Treatment
Fortunately, syphilis is both preventable and curable. Kanani recommends practicing safer sex by consistently using condoms during vaginal, anal, and oral sex. Dental dams or latex covers should also be used for oral contact with genitals.
“If you or your partner are being treated for syphilis, complete the full course of antibiotics — which may be administered via injection, tablets, or capsules — to avoid reinfection,” said Kanani. “And never share sex toys. If you do, clean them thoroughly and use a new condom for each user.”
Anyone experiencing symptoms, or who has had unprotected sex with a new partner, is encouraged to seek medical advice promptly. This includes individuals who are pregnant, planning to conceive, or have shared needles.
“Early detection and proper treatment are key to preventing long-term damage,” Kanani emphasized. “Hair loss in unusual patterns may not just be a cosmetic concern — it could be a sign of something far more serious.”
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