See how syphilis ravaged a woman’s face 500 years ago, in an artistic interpretation

Before the discovery of penicillin in the 20th century, syphilis was a common bacterial infection during the 16th century.
Before the discovery of penicillin in the 20th century, syphilis was a common bacterial infection during the 16th century. (Image credit: Cícero Moraes)

During the 16th century, a young woman lived with a face covered with sores that hinted that she likely had tertiary syphilis, a late-stage infection that can often lead to death. Her case of the sexually transmitted infection was so severe that centuries later, her skull remains riddled with bone lesions. Now, researchers have created a facial approximation of the woman as part of a new study.

While not much is known about the woman's identity, she lived to be between 25 and 30 years old and her body was excavated from a cemetery at the Skriðuklaustur monastery in Iceland about a decade ago. In addition to having syphilis, her skeleton revealed that she had osteoarthritis and dental enamel hypoplasia, a tooth defect caused by malnutrition in childhood, according to an analysis of a 3D model of the skull provided by the Northern Heritage Network, an online archive of historical skeletons.

Cícero Moraes, a Brazilian graphics expert and one of the study's authors, was struck by the lesions marking her skull and realized that he was looking at his next study subject.

"Tertiary syphilis translated into the approximation in a very impactful way," Moraes told Live Science in an email. "It's disquieting to see a face that looks like that, losing part of its structure, and so severe that an injury reaches the bones."

Although the skull's lower jaw was missing, Moraes was able to use the 3D model as a guide, applying virtual skull and tissue markers to help create the curvature of the deceased woman's face. He also examined other skulls of females of European descent who died around the same age as the woman in the database, as well as the contours of a virtual donor, to create the final facial approximation.

Related: Meet a medieval woman named 'Tora' who lived 800 years ago in Norway

"The cause of death — having only the skull as a reference — is very difficult to stipulate," Moraes said, "but syphilis clearly brought many problems to that individual."

Unlike today, when antibiotics such as penicillin can quickly eliminate the disease, during the 16th century, people of European descent often relied on herbal medicines derived from holywood (Guaiacum sanctum) and skin ointments containing mercury to relieve symptoms. Sweat baths were also popular and were incorrectly thought to help eliminate "the syphilitic poisons," according to a 2021 article in the Journal of Military and Veterans' Health.

The final "didactic work" features swirls of lesions stretching across the woman's right cheek and creeping up to an open gash on her forehead. Researchers opted to give the woman blonde hair to make her more lifelike so that the approximation could provide "an example of the development of the disease in an individual [and shows] how syphilis can become something very serious if not properly treated," according to the study.

"It's evident that today, with the medicines we have at our disposal, a situation like the approximation is very unlikely to happen," Moraes said, "but improbable doesn't mean impossible."

Jennifer Nalewicki
Live Science Staff Writer

Jennifer Nalewicki is a Salt Lake City-based journalist whose work has been featured in The New York Times, Smithsonian Magazine, Scientific American, Popular Mechanics and more. She covers several science topics from planet Earth to paleontology and archaeology to health and culture. Prior to freelancing, Jennifer held an Editor role at Time Inc. Jennifer has a bachelor's degree in Journalism from The University of Texas at Austin.