Syphilis

Resources: Syphilis Symptoms | Stages | Transmission | Risk Factors | Prevention

What Is Syphilis?

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. It can be spread through sexual contact with an infected person, including vaginal, anal, or oral sex. Syphilis has been known for centuries and was once a major public health concern before the discovery of an effective treatment.  If left untreated, syphilis can progress to stages where it can cause serious damage to organs such as the brain and heart.

Is Syphilis Curable

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. It can be spread through sexual contact with an infected person, including vaginal, anal, or oral sex.

One of the most important questions people have about syphilis is whether it is curable. The good news is that yes, syphilis is curable with antibiotics. However, the type and duration of treatment will depend on several factors, including the stage of syphilis and how long a person has had the infection.

The three stages of syphilis are primary, secondary, and tertiary. In the primary stage, a small sore called a chancre appears at the site of infection. This sore is usually painless and can go unnoticed. In the secondary stage, symptoms such as rash, fever, and swollen lymph nodes may appear. These symptoms may also go away on their own but can reappear later during the tertiary stage.

The type of antibiotic used to treat syphilis will depend on which stage of the disease a person has reached. For example, in the primary or secondary stages of syphilis, doctors may prescribe a single injection of penicillin G benzathine or multiple doses of another type of antibiotic such as doxycycline or azithromycin.

In more advanced stages of syphilis where there has been damage to organs such as the brain or heart, treatment may require hospitalization and intravenous (IV) antibiotics for an extended period.

It is important to note that while antibiotics can cure syphilis infections at any stage, they cannot repair any damage already done to organs in advanced stages. That’s why early diagnosis and treatment are so important in preventing serious health complications from developing. It’s also worth noting that even after successful treatment for syphilis infections, it’s still possible to get reinfected if you engage in sexual activity with another infected person without protection.

While having syphilis can be concerning and uncomfortable for those affected by it – especially if left untreated – it’s essential to remember that it’s entirely curable with proper medical care. If you suspect you may have contracted syphilis or have been exposed to someone who does have it – seek medical attention immediately and get tested for all STDs including syphilis.

What Are Syphilis Symptoms?

Syphilis develops in stages, and each stage may come with different symptoms. However, syphilis can be confusing and sneaky. Stages may overlap or may not always happen in the same order. Sores caused by syphilis may be hidden, since they can appear in hard-to-see areas. Syphilis can also go through periods when there are no symptoms for years.¹ Even when signs are apparent, syphilis may still be overlooked. Syphilis has been called “The Great Pretender” because its symptoms in men and women can seem like many other diseases.

At any stage, syphilis can spread and cause damage to the brain and nervous system (neurosyphilis) and the eye (ocular syphilis).

Primary Syphilis

The first sign of syphilis is usually:

• A small painless sore called a chancre
  • Appears at the spot bacteria entered your body (often on, around, or inside the genitals or anus/rectum and sometimes on the lips or mouth)
  • Usually single, but may be multiple

Chancres usually develop within 3 weeks of infection, although symptoms may appear from 10 to 90 days after infection.² Because a chancre is usually painless and may be hidden inside the vagina or rectum, a person may not even know they have primary stage syphilis.

Chancres heal on their own within 3-6 weeks. Even when a chancre disappears, the syphilis bacteria are still in the body unless a person receives treatment.

Secondary Syphilis

While a chancre is healing or several weeks after it has healed, a person with syphilis may progress to the secondary stage.

Secondary syphilis symptoms include: 

• Skin rashes which usually aren’t itchy
• Lesions in the mouth, vagina, or anus
• Fever
• Swollen glands in neck, groin, or armpits
• Weight loss
• Hair loss
• Sore throat
• Headache
• Muscle ache
• Fatigue

Symptoms will go away whether you get treatment or not.  They may come back later or not return at all. But without the right treatment, syphilis stays in the body, and the infection can progress to the latent or even tertiary stage of syphilis.

Latent Syphilis

Latent syphilis symptoms include: 

• No symptoms– even for years

Although latent syphilis is silent with no visible signs or symptoms of syphilis present, the infection isn’t gone. During the early part of the latent stage, a person is contagious, even when no signs are present.

Tertiary Syphilis

Many people with untreated syphilis don’t develop tertiary syphilis. However, when it happens, it’s very destructive. Tertiary syphilis can impact many different organ systems and cause serious problems and even death.

Tertiary syphilis symptoms may include:³

• Large sores called gummata, which appear inside the body or on the skin
• Strokes
• Numbness
• Deep, boring bone pain
• Heart problems
• Vision problems or blindness

While syphilis can be treated at any stage, treatment does not reverse the damage that has already been done.

Learn more about syphilis symptoms.  

How Do You Get Syphilis?

Syphilis is most commonly spread through skin-to-skin or mucous membrane contact with someone’s syphilitic sore, also known as a chancre. This contact most commonly happens during vaginal, anal, and oral sex or sexual contact. Syphilis is contagious during its primary and secondary stages, and it can sometimes be spread during the early latent period (when symptoms stop showing).

Syphilis can also be transmitted from pregnant women to their baby, which is called congenital syphilis (CS). Congenital syphilis can be dangerous. The Centers for Disease Control and Prevention (CDC) reports that up to 40% of babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn.⁴

Who Is At Risk?

Anybody who is sexually active can get syphilis during vaginal, anal, or oral sex.

You may have an increased risk of getting syphilis if you:

• Have unprotected sex
• Have partner(s) who have tested positive for syphilis
• Have multiple sex partners
• Are a man who has sex with men (MSM)⁵
• Have HIV

The CDC also recommends all pregnant women get tested for syphilis during their first prenatal visit.⁶

How Do You Prevent Syphilis?

The best way to prevent syphilis is to not have sex, but having safer sex helps reduce your risk. Using a latex condom or dental dam every time you have sex provides a barrier against direct contact with a sore. However, sometimes sores pop up in areas that aren’t covered, and contact with these sores can spread syphilis.

Limiting your sexual partners or having a mutually monogamous relationship with a sex partner who has tested negative for syphilis can help you prevent infection. If you think you or your sexual partner(s) has syphilis, get tested. Regular STD testing keeps you informed about your sexual health status and empowers early detection and treatment.

Syphilis in the US

Syphilis has been on the rise in the United States in recent years. According to data from the Centers for Disease Control and Prevention (CDC), there were over 115,000 cases of syphilis reported in 2018, representing a 14% increase from the previous year.

Syphilis can be spread through sexual contact with an infected person. Syphilis can cause serious health complications if left untreated, including damage to the heart, brain, and nervous system.  Syphilis is most commonly diagnosed among men who have sex with men (MSM) and young adults aged 20-29 years old. However, it is important to note that anyone who engages in unprotected sexual activity with an infected person can contract syphilis.

The reasons for the increase in syphilis cases in recent years are complex but may be due to factors such as changes in sexual behavior patterns (such as increased use of dating apps), decreased condom use among certain populations, lack of access to healthcare services for testing and treatment, stigma associated with getting tested for STIs or seeking treatment for them, and inadequate public health funding for prevention efforts.

To address this issue effectively will require ongoing efforts on multiple fronts including improving access to testing and treatment services; promoting safe sexual behaviors; reducing the stigma associated with STIs; increasing public awareness about the risks associated with unprotected sex; and advocating for increased public health funding for prevention efforts.

Syphilis remains a significant public health concern in the United States that requires urgent attention from policymakers and healthcare professionals alike.  STDcheck.com is here to help people get tested, and take control of their sexual and physical health. By working together to promote safe sexual practices and improve access to testing and treatment services we can help reduce rates of syphilis infections across all populations.

Medically Reviewed by Julie Hutchinson, MD on February 2, 2022