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Syphilis symptoms and treatment

Syphilis is a bacterial infection. It is easily spread through unprotected anal, vaginal and oral sex without a condom. It can also be passed on through sharing contaminated needles and injecting equipment. A mother can pass it on to her unborn baby during pregnancy. 

Syphilis is easy to treat and cure with antibiotics. It’s important to get tested and treated early on as without treatment syphilis can seriously damage your heart, brain and nervous system. 

What is syphilis?

Syphilis is a bacterial infection that spreads easily through anal, vaginal and oral sex without a condom. It can also be passed on through sharing contaminated needles and injecting equipment and from mother-to-child during pregnancy. 

It’s not as common as some sexually transmitted infections but if left untreated it can lead to serious health problems. You can catch syphilis more than once, even if you have been treated for it before. 

How do you get syphilis?

Syphilis is mainly spread through contact with an infected sore or rash.  

The infection can be passed on through: 

  • vaginal, anal or oral sex without a condom or dental dam 

  • genital contact 

  • sharing sex toys with someone who has syphilis 

  • sharing contaminated needles and injecting equipment 

  • blood transfusions (this is very rare as most places test blood for infections).  

If you’re worried about a blood transfusion, speak to your healthcare provider. 

Pregnant women can pass the infection on to their unborn baby. This is called congenital syphilis. It’s important that women test for syphilis during pregnancy. For more details on syphilis in pregnancy read our ‘in detail’ tab. 

How do I prevent syphilis?

Syphilis cannot always be prevented, but if you're sexually active you can reduce your risk by practising safer sex. 

Using new condoms and dental dams correctly every time you have sex is the best way to prevent syphilis. Remember that the condom or dental dam must cover any sores or rashes or you won’t be protected. 

You should avoid sharing sex toys and if you do share them, wash them and cover them with a new condom before each use. 

Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it’s even more important to use condoms and get tested regularly even if you don’t have any symptoms.  

It’s also important that you’re able to talk about your sexual health with your partner/s. This way you can let each other know about any symptoms or infections, and discuss how you will have safer sex together.  

Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – doesn’t protect you from syphilis and other STIs. 

If you inject drugs, do not share needles or injecting equipment with other people.  

What are STIs

What are the symptoms of syphilis?

Symptoms of syphilis are often mild and it is easy to pass on the infection without knowing you have it. Many people with syphilis won't notice any symptoms for years. 

Without treatment a syphilis infection develops through different stages. It can become more serious, spreading to other parts of the body.  

Early symptoms 

The first symptoms of syphilis usually develop around 2 or 3 weeks after infection. The first thing a person may notice is a painless sore (called a chancre) - usually around their anus or genitals. Not everyone experiences this symptom. Chancres normally heal by themselves within 2 to 8 weeks, but without treatment the infection may progress to a second stage. 

Later symptoms 

A few weeks after the early symptoms have passed, you might start to feel ill. Later symptoms include a fever, headache or swollen glands. You may also notice weight loss or small skin growths (similar to genital warts) around your anus or genitals. Some people get blotchy red rashes on their body, often on the palms of their hands or soles of their feet. 

Latent stage 

After this, a person may live with syphilis for years without any signs of infection. This is known as ‘latent syphilis’ and can last for decades. If syphilis is left undiagnosed and untreated, the infection will go on to cause serious health problems. 

For more details on the long-term effects of untreated syphilis read our ‘in detail’ tab.

How do I test for syphilis?

To test for syphilis a healthcare professional will do a blood test. The test doesn’t hurt and will only take a small amount of blood. A healthcare professional may also examine your genital area, mouth and throat. This is to check for rashes or growths. If you have sores, a swab will be taken from these.  

If you have syphilis, it’s important that you let any current or recent sexual partners know. They will need to test too. Many people with syphilis do not notice anything wrong. By telling them you can help to stop the infection being passed on. You should also test for other STIs. 

How is syphilis treated?

Syphilis can be cured with antibiotics. However, it’s important that you get tested and treated early on, as some health problems caused by late-stage syphilis can’t be resolved. 

The specific antibiotics used to treat syphilis may vary depending on where you are.  

Don’t have sex or close body contact with other people until you and your current sexual partner(s) have finished your treatment. You will need to be checked by a healthcare professional to make sure the infection has cleared. 

Remember, having been treated for syphilis previously does not make you immune. You can still get syphilis again. 

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What are the long-term effects of untreated syphilis? (Late stage syphilis)

If left untreated, a syphilis infection can last for years or decades without causing any symptoms. Eventually, it can cause irreversible damage to your heart, brain and nervous system and lead to loss of sight, hearing, and other problems. This is known as ‘tertiary syphilis’. Getting tested and treated early means that you can prevent this from happening, and make a full recovery.  

What effects does syphilis have during pregnancy?

Syphilis can be passed from mother to child during pregnancy. This is called congenital syphilis. To avoid passing syphilis on, it’s important that women test for syphilis during pregnancy. Pregnant mothers are advised to test at their first antenatal appointment. They should also test after any incidents they think put them at risk of getting syphilis. 

If you test positive for syphilis, your healthcare worker will offer you antibiotics. This will cure the infection for you and your baby. It’s very important that you take the treatment. Syphilis can be very dangerous for your baby. It increases your risk of miscarriage and stillbirth. Speak to your doctor or healthcare worker for more information and advice. 

What is the link between syphilis and HIV?

If you have been diagnosed with syphilis you should also test for HIV. Having an STI, including syphilis, can increase your risk of getting HIV. This is because having an STI, especially one that causes sores, makes it easier for HIV to get into your body and cause an infection. 

People with HIV can also be more likely to get syphilis. This is especially the case for people who aren’t on treatment or who have a lower CD4 count. You’re more vulnerable to infections, like syphilis, if your immune system is weaker. Syphilis may also progress more quickly in people living with HIV. If you have HIV and think there’s a chance you might have syphilis it’s important to get tested and treated early on. 

Speak to your healthcare provider if you have HIV and are taking treatment for syphilis. It's important to make sure that the syphilis medication won’t affect your antiretroviral treatment (ART). 

How do I tell my recent sexual partner(s) I have syphilis?

If you find out you have syphilis it’s important to tell any recent sexual partner(s). This way they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do. It shows you respect them and want them to stay healthy. 

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  • Last updated: 18 March 2022
  • Last full review: 01 March 2022
  • Next full review: 01 March 2025
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