Does Syphilis Destroy the Nose?

February 8, 2024
Avatar for Jyoti KinghornJyoti Kinghorn
Syphilis can destroy the nose

Syphilis infection can have symptoms in the nose such as the formation of blisters or sores in the nose, and the destruction of nasal cartilage.

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. The infection is spread when someone has sexual contact with an infected person. Syphilis can also be transmitted from a pregnant person to their fetus (congenital syphilis).

Syphilis can be readily treated by antibiotics. However, when left untreated the disease progresses in distinct stages.

Stages of syphilis

Stage 1. The first stage of syphilis, called primary syphilis, is characterized by a round painless sore called a chancre. It usually appears in 3 weeks after exposure but can take as long as 3 months. A chancre generally forms around the genitals and less frequently around the mouth or the anus. In very rare cases, it has also been found in the throat. A chancre is infectious and contact with it transmits syphilis.

Stage 2. The second stage is syphilis, called secondary syphilis is observed about 2-12 weeks after the formation of the chancre and is characterized by a wide range of symptoms. There is often a rash that spreads throughout the body including the palms of the hand and the soles of the feet. People feel fatigued and may have muscle aches or headaches. They may have swollen lymph glands, lose weight without trying, or experience patchy loss of hair. They may also develop ulceration in their noses.

Stage 3. The chancre as well as the symptoms of secondary syphilis can resolve on their own in about 2 months. However, without treatment, the infection stays active but can go into an asymptomatic hidden stage called latent syphilis.

Stage 4. The final stage of syphilis is called tertiary syphilis. In this stage, syphilis causes damage to the internal organs. The infection reaches this stage in 3-30 years and at this time can damage organs such as the eyes, ears, heart, and brain. It can also severely affect the nose.

Effect of syphilis on the nose

Untreated syphilis can have a rare effect- deformity of the nose. The worst effects of syphilis on the nose are seen during the tertiary stage, although some nasal symptoms can be seen in the secondary stage as well.

Symptoms of syphilis in the nose include:

  1. Superficial or deep ulcerations in the nose
  2. Gumma (a soft mass that grows in tissues, like a tumor) in the nose
  3. Perforation in the cartilage causing the destruction of the nasal septum
  4. Formation of a saddle nose due to shrinkage of fibroid tissue, destruction of the nasal cartilage, and collapse of the nasal bridge.

Before the discovery of penicillin, syphilis was a dreaded disease that was lethal to those who contracted it. It was more common at that time to see people who were missing noses as a result of syphilis infection. Deformities were also seen in the faces and noses of children who contracted syphilis as fetuses from their infected mothers.

Due to the widespread use of penicillin, most people who contract syphilis never reach the tertiary stage and the worst nasal symptoms are of mostly historical relevance. However, syphilis has been re-emerging as a threat in recent years as the number of infections has been steadily rising.

Saddle nose repair

Syphilis treatment and saddle nose repair

Syphilis in the nose is treated by killing the bacteria by topical application of chemicals such as yellow mercury oxide and removing the crusts. The nasal passages are regularly cleaned with alkaline douches. This is done in combination with curing syphilis with antibiotics.

The typical treatment of syphilis is intramuscular administration of benzathine penicillin. Other antibiotics such as doxycycline and azithromycin may be prescribed as well. The antibiotic type, dose, and duration of treatment may vary based on the patient’s symptoms and the stage of the infection. After the treatment, patients are asked to return for serological work to confirm that they are free of infection.

Having a deformed nose because of syphilis can cause discomfort and loss of confidence. Once the infection has been treated, patients may seek plastic surgery to reconstruct the nose. Modern plastic surgery can be successful at restoring the structure and function of the nose.

Syphilis prevention

When having oral, anal, or vaginal sex with someone of unknown STI status, syphilis can be prevented by using protection such as condoms and dental dams.
Congenital syphilis can be prevented by pregnant individuals getting tested for STIs before they get pregnant, or as soon as they find out that they are pregnant. Early treatment can protect their growing baby from getting the infection.

Getting tested

The first step to maintaining sexual health is to regularly get tested for STIs including syphilis. Antibiotics can cure syphilis. But they cannot undo the harm the infection has done to someone’s body. Therefore, the sooner the infection is detected and treated, the lesser the long-lasting impact.
To find a testing location near you, visit

The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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