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Syphilis symptoms & treatment

Syphilis bacteria

FAST FACTS

  • Syphilis is a sexually transmitted infection (STI) that causes infected sores, blisters or ulcers on your genitals, anus (bottom) or mouth.
  • It’s normally passed on through sex without a condom or by sharing sex toys with someone who has the infection.
  • Using condoms, dental dams and latex gloves during vaginal, anal and oral sex can protect you from getting syphilis. To be effective any sores or rashes must be covered.
  • You can test for syphilis with a simple physical examination and a blood test.
  • It’s recommended that mothers test for syphilis during pregnancy, as the infection can be passed on from mother to child, and be very dangerous for unborn babies.
  • Syphilis can be cured with antibiotics, however for full recovery it’s important to catch the infection early.

If you have had sex without a condom, or you are worried about syphilis or other STIs, get tested as soon as possible – even if you don’t have symptoms.

What is syphilis?

Syphilis is caused by a bacteria called Treponema pallidum.

How serious is syphilis?

Syphilis is easy to treat and curable in the early stages, but if you don’t get treatment it can cause serious health problems, including damage to the heart and brain, which can be irreversible (permanent).

A woman with the infection can pass it on to her unborn baby (congenital syphilis) increasing the risk of miscarriage, stillbirth or newborn death within a few days after birth.

How do you get syphilis?

Syphilis can be passed on easily and you can get it from:

  • vaginal, anal or oral sex without a condom or dental dam, with someone who has syphilis (even if they don’t have symptoms)
  • sharing sex toys without washing or covering them with a new condom each time they are used
  • direct contact with an infected sore or rash - this means you can get syphilis from touching someone’s sore or rash, even if you don’t have sex and there’s no penetration, orgasm or ejaculation
  • sharing needles with someone who has syphilis, or having a blood transfusion from someone with the infection. However, in most places blood is tested for syphilis before transfusions, so it’s rare to get syphilis this way.

It’s possible for syphilis to be passed from mother to child during pregnancy, if the infection is left untreated.

Syphilis, HIV and sexual health

  • Having an STI, including syphilis, increases your risk of getting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter your bloodstream during sex.
  • If someone living with HIV also has syphilis, their viral load will increase, which will make them more likely to pass on HIV, even if they are taking HIV drugs (antiretrovirals).
  • People living with HIV are more likely to get syphilis and it can progress more quickly and severely in people living with HIV.
  • If you are taking antiretrovirals it is important to discuss with your doctor how treatment for syphilis may interact with your HIV drugs.

If you are worried about getting HIV, find out everything you need to know in our HIV Transmission and Prevention section.

How do you protect yourself and others from syphilis?

  • Use a new male or female condom or dental dam every time you have vaginal, anal or oral sex – remember that these must cover sores or rashes or you will not be protected.
  • Use a new dental dam or latex gloves for rimming and fingering (exploring your partner’s anus with your fingers, mouth or tongue) and use latex gloves for fisting.
  • Cover sex toys with a new condom and wash them after use.
  • Having multiple sexual partners can also increase your risk of getting syphilis. If you are having sex with multiple partners, it’s even more important to use condoms and have regular STI tests.
  • Discuss your sexual health with your partner. Knowing each other’s sexual health status can help you decide together how to have safer sex.
  • Test for syphilis during pregnancy.

Note condoms are the best protection against sexually transmitted infections and pregnancy. PrEP doesn’t prevent syphilis or pregnancy.

Ask your doctor or healthcare worker if you want more advice.

What are the symptoms of syphilis?

Many people with syphilis won't have any symptoms for years.

Syphilis has three stages, each with distinct symptoms:

  1. First stage (primary syphilis) - about 10 days to three months after infection you may find a painless sore (chancre) - usually on the penis or vagina, in the mouth or around the bottom. This usually heals within two to six weeks. Glands near the sore (in the neck, groin or armpit) may get bigger. If the infection is not treated, it will move to the second stage.
  2. Second stage (secondary syphilis) - a few weeks after the sore disappears you may get a rash on your body, often on the palms of your hands or soles of your feet. You might feel ill, with a fever or headache; have hair loss, weight loss or skin growths around the vulva (area around the vagina) in women and around the anus (bottom) in both men and women.

Between the second and third stage people with syphilis normally won’t experience any symptoms (this is known as the ‘latent stage’).

  1. Third or late stage (tertiary syphilis) - years later, syphilis can seriously damage your heart, brain and nervous system. The infection is usually detected by this point.

Can I get tested for syphilis?

Yes - a healthcare professional can examine your genital area, mouth and throat, and check for rashes or growths. There’s also a blood test and, if you have sores, a swab will be taken.

If you have syphilis you should be tested for other STIs. It’s very important that you tell your recent sexual partner/s if you have syphilis, so they can also get tested and treated. Many people who have the infection will not notice anything wrong, and by telling them you can help to stop syphilis from being passed on; and it can also stop you from getting it again.

How is syphilis treated?

Syphilis can be cured with antibiotics. However, it’s important that you get tested and treated early on, as damage caused by late-stage syphilis infection is often irreversible (permanent).

You will need to have regular blood tests for at least a year after treatment, to ensure that the infection has cleared.

Treatment for syphilis does not make you immune – meaning that you can get syphilis more than once. If you test positive, any current or recent sexual partners should also be tested and treated.

Avoid having sex until you have finished your treatment, the sores have healed and your healthcare professional says you can.

What happens if I don't get treatment for syphilis?

If it is not treated, syphilis can spread to other areas of the body and cause serious health problems and even death.

  • It can damage the brain, leading to loss of sight, hearing, sensation, as well as dementia and other problems. Many of these results are irreversible.
  • It can also cause serious damage to the heart.
  • Small bumps or tumours can develop on your skin, bones, liver and other organs. These can be treated with antibiotics.
  • As with most STIs, syphilis puts you at risk of other STIs, including HIV – a syphilis sore can bleed easily, providing an easy way for HIV to enter your bloodstream during sex.
  • Syphilis during pregnancy can be passed on to the baby if left untreated. It can also lead to serious complications with the pregnancy, including increasing the risk of miscarriage, stillbirth, or the newborn dying within a few days after birth.

Photo credit: ©iStock.com/iLexx

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Last full review: 
01 July 2018
Next full review: 
01 July 2021
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Last updated:
16 October 2018
Last full review:
01 July 2018
Next full review:
01 July 2021