Leprosy: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Leprosy?
An infectious disease doctor, who treats infections, usually treats leprosy. A dermatologist, a skin doctor, may also help. In the United States, people may be treated at special clinics run by the National Hansen's Disease Program. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is leprosy?
Leprosy, also called Hansen's disease, is an infection caused by slow-growing bacteria called Mycobacterium leprae. It can affect the nerves, skin, eyes, and lining of the nose. Leprosy is hard to spread and completely curable. People with leprosy can live an active life during and after treatment.
Leprosy occurs on a spectrum. The mildest form, called tuberculoid or paucibacillary, usually has a small number of skin lesions. The most severe form, called lepromatous or multibacillary, usually has many skin lesions and lumps under the skin called nodules. Forms in between are called borderline.
Symptoms
The bacteria grow very slowly. Signs can take anywhere from several months to 20 years to appear.
- Skin patches that are lighter than your normal skin color. Patches can also look darker or redder.
- Patches with less feeling when touched, or less sense of heat or pain.
- Skin patches that do not heal after several weeks to months.
- Muscle weakness.
- Numbness or lack of feeling in the hands, arms, feet, and legs.
In severe leprosy, the lining of the eyelids and the inside of the nose and mouth can be affected. This can lead to vision loss or damage to nasal tissue. Numb hands and feet are easy to injure without noticing. Fingers and toes do not just fall off. Repeated unnoticed injuries can cause the body to reabsorb them, so they look shorter. Some people have episodes called reactions, which can cause more nerve damage. Signs include pain and swelling of skin patches and nerves. In severe forms, signs can include fever and painful skin lumps.
Causes and who gets it
Leprosy likely spreads when a person with the disease coughs or sneezes and others breathe in the droplets again and again over a long time. You must have close contact with someone with untreated leprosy over many months to catch it. You cannot get it through casual contact such as shaking hands or sitting next to someone with the disease. It is not spread through sex or passed to a baby during pregnancy. Around 95 percent of people cannot get leprosy because their immune system fights off the bacteria.
In the southern United States, some armadillos carry the bacteria, but the risk to people is very low. Each year, up to 225 people in the U.S. and 250,000 people around the world are diagnosed. Most people with leprosy in the United States became infected in a country where it is more common.
How doctors diagnose it
A doctor examines the skin and checks for patches with loss of feeling. To confirm leprosy, the doctor takes a skin or nerve sample and looks for the bacteria under a microscope. Tests may also be done to rule out other skin diseases.
Treatment
Leprosy is treated with a combination of antibiotics. Treatment usually lasts between one to two years. The illness can be cured if treatment is completed as prescribed. Antibiotics used include dapsone and rifampin. People on long-term medicine become noninfectious, which means they do not pass the germ to others. Medicines may also be used to control inflammation. Nerve and tissue damage that happened before treatment is generally permanent. Early treatment helps limit the damage and lowers the chance of long-term problems.
When to see a doctor
Contact your health care provider if you have symptoms of leprosy, especially if you have had contact with someone who has the disease. In more severe forms, fever with painful skin lumps can be a type of reaction that can lead to further nerve damage. Cuts and burns on numb hands and feet can go unnoticed, which may lead to permanent damage or infection.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can look at a suspicious skin patch and help arrange care with a specialist or a Hansen's disease clinic.
Common questions
Is leprosy curable?
Yes, leprosy is curable. Treatment must be completed as prescribed. Nerve and tissue damage that occurred before treatment is generally permanent, so early treatment matters.
Is leprosy very contagious?
No, leprosy does not spread easily from person to person. You cannot get it through casual contact such as shaking hands.
Does leprosy still exist?
Yes, leprosy still exists. Up to 225 people in the U.S. and 250,000 around the world are diagnosed each year. It is rare in the United States.
Do fingers and toes fall off from leprosy?
No, they do not just fall off. The bacteria attack the nerves and make fingers and toes numb. Injuries on numb parts can go unnoticed and lead to permanent damage or infection.
Can you get leprosy from armadillos?
It may be possible, but the risk is very low. Some armadillos in the southern United States are naturally infected with the bacteria.
Sources
- Centers for Disease Control and Prevention - About Leprosy (Hansen's Disease)
- MedlinePlus - Leprosy
- MedlinePlus Genetics - Leprosy
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
