Bejel: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Bejel?
A primary care doctor usually manages the first steps, ordering blood tests and starting antibiotics. An infectious disease specialist may be consulted for unusual cases, and an orthopedic doctor if bones are affected. 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 bejel?
Bejel is a long-lasting bacterial infection affecting the skin, bones, and lining of the mouth. It is caused by a germ related to the one that causes syphilis but is not spread through sex. Doctors also call it endemic syphilis.
Bejel is caused by a bacterium called Treponema pallidum subspecies endemicum. Unlike syphilis, it does not spread through sex. It passes through mouth-to-mouth contact, shared utensils, or skin contact among people living close together. It is rare in the United States, found mainly in dry, rural parts of Africa, the Middle East, and Central Asia.
Symptoms
Bejel develops in stages. Early signs can include small sores or patches inside the mouth, a sore throat, and moist patches on the skin. Later, it can affect bones and skin, causing bone pain, skin growths, and, in severe untreated cases, nasal cartilage damage.
Causes and who gets it
The germ passes through direct contact with sores or saliva, or through shared household items. It is not passed from mother to baby during pregnancy. It usually affects children where the infection is common; crowded housing and limited access to water make spread more likely.
How doctors diagnose it
Doctors ask about symptoms, travel history, and living conditions, and examine the mouth, skin, and bones. Blood tests detect antibodies; these are the same tests used for syphilis, so results need careful interpretation.
Treatment
Bejel is treated with antibiotics. Penicillin given as an injection is the standard treatment worldwide; other pills may be used for people allergic to penicillin. After treatment, sores usually heal and the person is no longer contagious. Early treatment works best, though bone or cartilage damage may not reverse.
When to see a doctor
Anyone with mouth sores, skin patches, or bone pain after living in or traveling to an area where bejel occurs should see a doctor. Early treatment prevents lasting damage.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance; a concierge doctor usually charges more and often works alongside insurance. Either can evaluate and treat bejel, and longer appointments allow time to discuss history and follow-up.
Common questions
Is bejel the same as syphilis?
No. They are caused by closely related bacteria, and blood tests cannot always tell them apart. But bejel is not spread through sex. It also does not affect the brain and heart the way untreated syphilis can.
Can I catch bejel in the United States?
It is very unlikely. Bejel is not common in the United States. The risk comes from close, ongoing contact with people in communities where the disease still exists.
Is bejel contagious?
Yes, but only through close personal contact such as sharing utensils or mouth-to-mouth contact. Casual contact like a handshake does not spread it. After antibiotic treatment, a person is no longer contagious.
Can bejel come back after treatment?
Reinfection is possible if a person returns to an environment where the disease spreads. Doctors usually recheck blood tests after treatment to confirm the infection is gone.
Sources
- NIH Genetic and Rare Diseases Information Center - Bejel
- MedlinePlus - Sexually Transmitted Infections
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.
