This Common STD Can Cause Hair Loss for Men and Women

Sexually transmitted diseases - commonly known as STDs or STIs (sexually transmitted infections) - are on the rise - especially among young women and middle-aged men - with the main offenders being chlamydia, gonorrhoea and syphilis.

Whilst advice regarding the sexual health benefits of barrier contraception seem to be increasingly falling on deaf ears, perhaps appealing to people's vanity may be a way to get the message across - after all, one of these common STDs can cause diffuse hair loss in both men and women.

Syphilitic alopecia - hair loss from syphilis

Syphilitic alopecia is a syphilis-related hair loss condition that can cause diffusely thinning hair across the entire scalp, or give the hair a patchy, 'moth-eaten' appearance.

It is a form of secondary syphilis that is uncommon but - as with cases of syphilis itself - is becoming more routine. When it does present, may be misdiagnosed as Telogen Effluvium or Chronic Telogen Effluvium where there is hair thinning across the entire scalp, or Alopecia Areata, Trichotillomania, Lichen Planopilaris or Tinea Capitis, where the hairloss presents in patches. Because of this, it is known as 'the great imitator'.

A 2017 case study noted that dermoscopy - the use of a trichoscope - is advised in order to establish a confirmed diagnosis. That way, features that may otherwise be missed by the human eye alone - such as 'tapered bended hairs, erythematous background, diffuse scaling and perifollicular hyperkeratosis' - should be more easily spotted.

Once diagnosed, syphilitic hairloss will usually start to clear up after approximately three months of on-going treatment of the underlying syphilis. This usually involves a course of one or more types of prescription-only oral antibiotic medications.

What is syphilis?

Syphilis is a sexually-transmitted bacterial infection that can be caught by both men and women, multiple times. It does not go away without prescription treatment.

Although it may present with no symptoms at all - which is why regular sexual health screenings are important for everyone who is sexually active - there are a number of signs to look out for. These include small ulcers or sores on the genitals, anus or mouth, a blotchy red rash on the palms or soles of the feet, white patches in the mouth, tiredness, headaches, joint pains, a fever and swollen glands in the neck, groin or armpits.

Mild cases can be treated with antibiotics whilst other bouts may require hospitalisation. If left untreated for a number of years, the NHS advises that syphilis can spread to the brain or other parts of the body, leading to long-term consequences.

Diagnosis is fairly straightforward and syphilis testing can be carried out at any sexual health or genitourinary (GUM) clinic. It involves a blood test and, where appropriate, taking swabs of fluid from any sores.

Barrier contraception, such as condoms, are recommended to protect against and to help prevent syphilis and other STDs.

Increasing STI diagnoses for young women, middle-aged men and over 65s

The American Centers for Disease Control and Prevention published a report in October 2019 detailing health officials' concerns over rising cases of these three STIs, of which 2.4 million cases were diagnosed in just the past year. Previously syphilis in particular had been almost eliminated.

In the UK STDs are now thought to be more commonly found in middle-aged men than in teenage boys; the latest Public Heath England research, also published in October 2019 with figures providing an overview for 2018, shows 23,943 cases of STIs diagnosed in men aged 45 to 64 years, versus 21,438 in male adolescents between 13 and 19 years of age.

However, the British Association for Sexual Health and HIV advises that syphilis is on the rise among young women.

Factors from 'hook-up culture' to a lack of awareness of the symptoms are being blamed for their prevalence among young people - though cases in teenagers do appear to be waning.

The surge in numbers of people aged 45 to 64 years old being diagnosed with an STD - as well as the rising levels of over 65s - is thought to be due to lessened concerns about pregnancy leading to unprotected sex, and apps such as Tinder and Grindr making dating later in life easier.

Whilst some people seem happy to ignore the potential health consequences associated with sexually transmitted diseases, including infertility, maybe the message that contracting syphilis could potentially cause them to lose their hair may succeed where health education has failed.