Leprosy treatment: clear steps, medicines and what to expect

Leprosy is curable and treatment usually stops spread of the disease fast. If you or someone close has signs—skin patches with loss of feeling, or numb hands and feet—seek a clinic or dermatologist. Early treatment lowers the risk of nerve damage and long-term problems.

Main medicines used

The standard approach is WHO’s multidrug therapy (MDT). For most people this means a combination of rifampicin, dapsone and, in some cases, clofazimine. Short version: paucibacillary (PB) leprosy usually needs 6 months of therapy; multibacillary (MB) leprosy about 12 months. Health workers decide which course fits you.

Each medicine has a job: rifampicin is the most powerful and given under supervision; dapsone acts daily to kill bacteria; clofazimine helps clear skin lesions and reduces inflammation during some reactions. Many national programs provide MDT free through WHO supplies, so check your local health center.

What to watch for and how to manage

Side effects and reactions are common but manageable. Dapsone can cause anemia—people with G6PD deficiency need testing before dapsone. Rifampicin may upset the liver and turns body fluids orange-red (harmless but surprising). Clofazimine can darken skin and fat-colored spots can appear; that fades slowly after treatment ends.

Two main immune reactions can happen during or after treatment. Type 1 (reversal) gives swelling and worsening nerve pain; Type 2 (erythema nodosum leprosum, ENL) brings painful lumps, fever and general illness. Doctors often use short courses of corticosteroids (like prednisone) to protect nerves. Severe ENL may need thalidomide in non-pregnant adults—but thalidomide is strictly controlled because it causes birth defects.

Protecting nerves is a priority. If you notice new numbness, tingling, muscle wasting or pain, call your clinic right away—early steroid treatment can save function. Physiotherapy, protective footwear, wound care and sometimes surgery help when nerves are damaged.

Public health steps matter. Household contacts may be offered single-dose rifampicin as post-exposure prophylaxis (ask your clinic if it’s available). Regular follow-up is standard: monthly during treatment, then periodic checkups—many programs follow patients for at least two years to watch for late reactions.

Practical checklist: get a clinical exam, ask for MDT through your health service, test for G6PD if possible, keep appointments, report new nerve symptoms fast, and get rehab support for hands and feet. If cost or access is a worry, national leprosy programs and some NGOs can help.

Treatment works. With the right medicines, monitoring and simple self-care, most people recover without major disability. Talk to a qualified clinician for a clear plan tailored to you.