Can leprosy treatment reverse nerve damage that has already become permanent?

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No, leprosy treatment cannot reverse nerve damage that has already become permanent.

While current multidrug therapy is extremely effective at killing the leprosy bacillus and halting the progression of the disease, it has no effect on body tissues that have already been destroyed. Nerve function can be restored by antileprosy drugs only up to a certain point; once the disease has progressed beyond that threshold, the resulting loss of function—which may include paralysis or loss of sensation—is permanent.1