- Syphilis is a sexually transmitted disease (STD) that can have very serious complications when left untreated, but is simple to cure with the right treatment.
- The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.
What is syphilis?
Syphilis is a bacterial STD that can cause long-term complications if not treated correctly. In 2015, the United States experienced the highest number and rate of reported syphilis cases in more than 20 years. During 2014-2015, syphilis rates increased in every region, a majority of age groups, and across almost every race/ethnicity.
How is syphilis spread?
Syphilis can be spread by direct contact with a syphilis sore during vaginal, anal, or oral sex. Sores can be found on the penis, vagina, anus, in the rectum, or on the lips and in the mouth. Syphilis can be spread during the infection's primary, secondary, and early latent stages. Syphilis can also be spread from an infected mother to her unborn baby.
What are the symptoms of syphilis?
Syphilis is divided into stages (primary, secondary, latent, and late syphilis) and there are different signs and symptoms associated with each stage. A person with primary syphilis generally has a painless sore or sores at the site of the infection. In the secondary stage, a person may develop a non-itchy body rash that can show up on the palms of the hands and soles of the feet, all over the body, or in just a few places. In the latent/late stage, syphilis can cause severe medical problems affecting the heart, brain, eyes, and other organs. In the latent stage, sometimes also known as the "hidden" stage, there are usually no visible signs or symptoms of syphilis.
Symptoms of syphilis in adults can be divided into stages:
During the first (primary) stage of syphilis, there may be a single sore or multiple sores. The sore is the location where syphilis entered the body. The sore is usually firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore lasts three to six weeks and heals regardless of whether or not you receive treatment. Even though the sore goes away, a person must still receive treatment so the infection does not move to the secondary stage.
During the secondary stage, skin rashes and/or sores in the mouth, vagina, or anus (also called mucous membrane lesions) may occur. This stage usually starts with a rash on one or more areas of the body. The rash can show up when a primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of the hands and/or the bottoms of the feet. The rash usually will not itch and it is sometimes so faint that it will not be noticed. Other symptoms may include fever, swollen lymph glands (also called lymph nodes, groups of cells that help to fight infection), sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms from this stage will go away whether or not a person receives treatment. Without the right treatment, the infection will move to the latent and possibly late stages of syphilis.
Latent and Late Stages
The latent stage of syphilis begins when all of the earlier symptoms disappear. Without treatment, a person can continue to have syphilis in their body for years without any signs or symptoms. Most people with untreated syphilis do not develop late-stage syphilis. However, when it does happen, it is very serious and occurs roughly 10-30 years after the infection begins. Symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis (not able to move certain parts of your body), numbness, blindness, and dementia (mental disorder). In the late stages of syphilis, the disease damages internal organs and can result in death.
A syphilis infection is called an "early" case if a patient has been infected for a year or less, such as during the primary or secondary stages of syphilis. People who have early syphilis infections can more easily spread the infection to their sex partners. The majority of early syphilis cases are currently found among men who have sex with men, but women and unborn children are also at risk of infection.
What are the risk factors for syphilis?
A risk factor is the chance that something will harm or otherwise affect a person's health.
Risk factors for syphilis include:
- Engaging in unprotected vaginal, anal, or oral sex.
- Having sex with multiple partners.
- Being a man who has sex with men.
- Having HIV.
- Having a sexual partner who has tested positive for syphilis.
Have an honest and open talk with your healthcare provider and ask whether you should be tested for syphilis or other STDs.
How can I reduce my risk of getting syphilis?
The only way to avoid syphilis completely is to not have vaginal, anal, or oral sex.
If you are sexually active, the following can lower your chances of getting syphilis:
- Being in a long-term, mutually monogamous relationship with a partner who has been tested and has negative STD test results.
- Using latex condoms correctly every time you have sex. Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.
Are there tests for syphilis?
Most of the time, a blood test can be used to test for syphilis. Some healthcare providers will diagnose syphilis by testing fluid from a syphilis sore.
You should get tested regularly for syphilis if you are pregnant, are a man who has sex with men, have HIV infection, and/or have partner(s) who have tested positive for syphilis.
How is syphilis treated?
When treated in the early stages, syphilis is easy to cure. The preferred treatment is penicillin, an antibiotic medication. If you are allergic to penicillin, your healthcare provider will suggest another antibiotic. However, treatment will not undo any damage that the infection has already caused.
I was treated for syphilis. When can I have sex again?
Avoid sexual contact until you have completed the treatment and blood tests indicate the infection is cured.
I was treated for syphilis. Can I get it again?
Having syphilis once does not protect you from getting it again. Even after you have been successfully treated, you can still be re-infected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is recommended to make sure that your treatment was successful.
Even if you do not have any symptoms, you can still infect your sex partners. Using condoms may help lower this risk but it will not get rid of the risk completely.
Because syphilis sores can be hidden in the vagina, anus, under the foreskin of the penis, or in the mouth, it may not be obvious that a sex partner has syphilis. Unless you know that your sex partner(s) has been tested and treated, you may be at risk of getting syphilis again from an untreated sex partner.
If you have syphilis, you should tell your sex partner(s) and let them know so they can get tested and treated, if necessary.
What happens if I don't get treated?
Without treatment, syphilis can spread to the brain and nervous system, or the eyes, even causing blindness. Syphilis is serious and should be treated as soon as it is diagnosed.
What are the implications of syphilis on pregnancy?
Syphilis has increased among women in recent years. Disturbingly, it has also increased among pregnant women and newborns. If you are pregnant and have syphilis, you can give the infection to your unborn baby. This is called congenital syphilis. Having syphilis can lead to a low birth-weight baby. It can also make it more likely to deliver a baby too early or stillborn (a baby born dead). To protect your baby, you should be tested for syphilis at least once during your pregnancy and at delivery and receive immediate treatment if you test positive.
An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies can have health problems such as cataracts, deafness, or seizures, and can die.
Did you know? (Learn more about male condoms)
Content last reviewed on March 29, 2019