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Syphilis

Syphilis can be hard to spot and is one of the most easily caught sexually transmitted infections. If untreated it can cause serious health problems in both men and women.

How it's caught

Syphilis can cause serious health problems in both men and women.

Although syphilis can be hard to spot without the right blood test, it's one of the easiest sexually transmitted infections to catch and pass on.

Syphilis spreads best by contact between moist skin areas anywhere on or in the body. People remain infectious to others for about two years from initial infection if they are not treated.

Some of the ways you can catch it include:

Syphilis makes HIV easier to pass on and catch, and HIV can make syphilis harder to treat.

Symptoms

Early syphilis is easy to miss. Many people show no sign that they're infected.

Syphilis can make some people feel very ill, especially the 'secondary stage' with a rash and fever.

You may see three stages:

The first stage (primary syphilis)

10 days to three months after you have been exposed a small, painless sore or ulcer (called a chancre). The sore will appear on the part of your body where the infection was transmitted, typically the penis, vagina, anus, rectum, tongue or lips. Most people only have one sore, but some people have more.

You may also experience swelling in your lymph glands (such as in the neck, groin or armpit).

The sore will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its second stage.

The second stage (secondary syphilis)

The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore. At this stage common symptoms include:

  • a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet
  • tiredness
  • headaches
  • swollen lymph glands

Less common symptoms include:

  • fever
  • weight loss
  • patchy hair loss
  • joint pains

These symptoms may disappear within a few weeks, or come and go over a period of months.

Syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called ‘latent syphilis’. You can still pass it on during the first year of this stage. However, after a couple of years, you cannot pass the infection to others, even though you remain infected.

The latent stage can continue for many years (even decades) after you first become infected. Without treatment, there is a risk that latent syphilis will move on to the most dangerous stage – tertiary syphilis.

The third stage (tertiary syphilis)

The symptoms of tertiary syphilis can begin years or even decades after initial infection. Around one in three people who are not treated for syphilis develop serious symptoms eventually.

The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms:

At this stage, syphilis can be dangerous enough to cause death.

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Syphilis and pregnancy

Syphilis can be passed from a mother to her unborn baby. This is why all women are offered syphilis testing in pregnancy.

It can be successfully treated during pregnancy with a course of antibiotics. The treatment does not harm the unborn baby.

If syphilis is left untreated during pregnancy it causes serious birth defects, miscarriages or stillbirths.

Testing

If you think you may have syphilis, visit your GP or your local sexual health service. Syphilis testing involves giving a sample of blood or a sample from an ulcer and the test result is highly accurate. Getting tested is the only reliable way of knowing if you have syphilis or not. If you develop any of the symptoms of syphilis then get help quickly, especially if you notice a sore on your genitals.

The earlier syphilis is treated the better. If you are generally unwell and think you are at higher risk of syphilis then get tested.

You could be at higher risk because you are a man who has sex with men, have recently had sex overseas or have had multiple sexual partners - especially at the same time.

What's involved in syphilis testing?

The only reliable way to tell if you have syphilis or not, is to have a blood test. In the very early stage of the infection, syphilis in an ulcer can be seen if a swab is taken from the ulcer and looked at under a special microscope or sent to the laboratory for syphilis detection. These tests are only available in some sexual health services.

If you or your partner are worried that you may have syphilis, see a doctor straight away.

You can visit your GP or a sexual health service.

Treatment

Early syphilis infections can be easily treated with antibiotics, even during pregnancy.

Late stage syphilis infections and those in people with HIV are more complicated to treat. Treatment at any time can stop further illness and cure the infection itself, though it does not repair any damaged organs.

Partners need to take care not to re-infect each other until both have been given the all clear.

Syphilis is treated with antibiotics (usually Penicillin). Treatment is usually given by injection and may involve one or more doses, depending on the stage of the infection.

Once the treatment has finished, further blood tests are carried out to make sure the infection has gone. These tests may be required at intervals for up to a year.

Your partner should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They will generally be offered treatment regardless.

While you are being treated and until you get a clear test result:

  • Do not have any kind of sex
  • Avoid intimate contact with your partner and others

This will stop you from infecting your partner if they are clear, and stop you being re-infected if they also have syphilis.

A small number of people experience a reaction to the initial treatment with antibiotics known as the Jarisch-Herxheimer reaction. It is thought that the reaction is triggered by a large amount of bacteria dying at the same time due to antibiotic treatment.

This causes flu-like symptoms such as fever, headaches, and muscle and joint pain. The reaction normally only lasts 24 hours, and causes no serious problems.

Prevention

To reduce the risk of getting syphilis:

  • Use condoms for anal and vaginal sex
  • Use a condom or dental dam for oral sex
  • Reduce the number of partners you have sex with
  • Be extra careful if having sex in places where syphilis is more common.

Remember - you can have syphilis for many years without any obvious symptoms that might make you or your GP think you have it. To keep yourself safe, regularly get tested for syphilis if you have been at risk.

 

For more information call  0800 22 44 88 or use our sexual health service finder to look for help in your area.