Syphilis

What Is Syphilis?

Syphilis is a sexually transmitted infection that develops in stages — primary, secondary, latent and tertiary — and each stage has different signs and symptoms. Without treatment it can cause serious health problems. Babies can also get syphilis: congenital syphilis is what happens when it passes from a woman to her baby during pregnancy.

Syphilis symptoms

Syphilis moves through four stages. The primary stage brings a single sore — sometimes several — at the spot the infection entered, typically about three weeks after exposure though it can be anywhere from 10 to 90 days. The sore is usually painless and often goes unnoticed when it is inside the mouth, vagina or rectum. It lasts three to six weeks and heals on its own whether or not you are treated, which is why it is so easily missed. The secondary stage usually begins about four to ten weeks after the first sore appears, most often as a rash on the trunk, palms and soles, sometimes with sores in the mouth, vagina or anus, fever and swollen glands. That resolves by itself too. The latent stage has no signs at all and can last years. Most people with untreated syphilis never reach the tertiary stage, but a substantial minority do — published estimates range from about a quarter to a third — typically 10 to 30 years on, when the infection damages the heart and blood vessels, the brain and the nervous system. Syphilis can also affect the eyes, ears and nervous system at any stage. Because every early sign disappears without treatment, the absence of a sore or rash tells you nothing — only a blood test does.

How is syphilis spread?

Syphilis spreads through direct contact with a syphilis sore during vaginal, anal or oral sex. The sores occur in, on or around the penis, vagina, anus, rectum, lips or mouth. Because the first sore is usually painless, you may never notice it — and it heals on its own whether or not you are treated, which is why the infection so often goes unrecognised.

How is syphilis treated?

Syphilis is curable at any stage with antibiotics prescribed by a healthcare provider. Treatment stops the infection progressing, but it does not reverse damage already done, which is why catching it early matters. Avoid sex until treatment is complete and any sores have healed, and make sure partners are tested and treated too.