Hansen’s Disease (Leprosy) – Treatment (For professionals)

• I. Anti-leprosy treatments

1. Modern treatment for leprosy was introduced in 1941 when dapsone and its derivatives were used. Prior to that, the segregation of patients in a leprosarium by law was intended to prevent the spread of leprosy to the community. With effective chemotherapy, leprosy is curable today and treatment is undertaken by the general health services.
2. Rifampicin, clofazamine and dapsone are the most important anti-leprosy drugs used. The World Health Organization Multi-Drug Therapy (WHO-MDT) regime has been successfully used in many countries since 1981. MDT refers to the combination of rifampicin once a month, clofazamine and dapsone daily. Duration of therapy is 6 months for paucibacillary leprosy and 24 months for multibacillary leprosy. Ofloxacin and minocycline are other effective drugs against leprosy.

• II. Anti-reaction treatments

1. Type 1 and Type 2 reactions require additional treatment with prednisolone and other anti-inflammatory agents to minimize tissue and nerve damage. Reactions must be recognized early and treatment initiated without undue delay.
2. Thalidomide is highly effective against Type 2 reactions.

• III. Immunotherapy

1. Persons suffering from leprosy, especially lepromatous leprosy are immunologically deficient towards the leprosy bacilli. Attempts to boost the immune response with vaccines and immunomodulating drugs (e.g. isoprinosine) have not been successful to date.

Adapted from Dr Seow Chew Swee: Update on Leprosy