Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women. You usually get syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.

The early stage of syphilis usually causes a single, small, painless sore. Sometimes it causes swelling in nearby lymph nodes. If you do not treat it, syphilis usually causes a non-itchy skin rash, often on your hands and feet. Many people do not notice symptoms for years. Symptoms can go away and come back.

The sores caused by syphilis make it easier to get or give someone HIV during sex. If you are pregnant, syphilis can cause complications, or you could lose your baby. In rare cases, syphilis causes serious health problems and even death.

Syphilis is easy to cure with antibiotics if you catch it early. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading syphilis. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It is transmitted from person to person via direct contact with a syphilitic sore, known as a chancre. These sores can be found on the genitals, vagina, anus, rectum, lips and mouth. Pregnant women can transmit the disease to their unborn child. Syphilis can cause long-term health complications if left untreated.

How is syphilis spread?

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can spread from an infected mother to her unborn baby.

How can I reduce my risk of getting syphilis?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis;
• Using latex condoms the right way every time you have sex. Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Am I at risk for syphilis?

Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs.

• All pregnant women should be tested for syphilis at their first prenatal visit.
• You should get tested regularly for syphilis if you are sexually active and
  • are a man who has sex with men;
  • are living with HIV; or
  • have partner(s) who have tested positive for syphilis.

What does syphilis look like?

Syphilis is divided into stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage. A person with primary syphilis generally has a sore or sores at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless. Symptoms of secondary syphilis include skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed. During the latent stage, there are no signs or symptoms. Tertiary syphilis is associated with severe medical problems. A doctor can usually diagnose tertiary syphilis with the help of multiple tests. It can affect the heart, brain, and other organs of the body.

Symptoms of syphilis in adults vary by stage:

Primary Stage

During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. Sores are usually (but not always) firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore usually lasts 3 to 6 weeks and heals regardless of whether or not you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

Secondary Stage

During the secondary stage, you may have skin rashes and/or mucous membrane lesions. Mucous membrane lesions are sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet. The rash usually won’t itch and it is sometimes so faint that you won’t notice it. Other symptoms you may have can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms from this stage will go away whether or not you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

Latent Stage

The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. If you do not receive treatment, you can continue to have syphilis in your body for years without any signs or symptoms.

Tertiary Stage

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death.

Neurosyphilis and Ocular Syphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (ocular syphilis). This can happen during any of the stages described above.

Symptoms of neurosyphilis include

• severe headache;
• difficulty coordinating muscle movements;
• paralysis (not able to move certain parts of your body);
• numbness; and
• dementia (mental disorder).

Symptoms of ocular syphilis include changes in your vision and even blindness.

Syphilis is an STD (sexually transmitted disease) that you can get during vaginal, anal, or oral sex. If you're pregnant and have syphilis, you can pass it to your baby.

Get tested for syphilis if you:

• Are pregnant
• Are a man who has sex with men
• Are living with HIV (also called being HIV-positive)

Some people who get syphilis don't notice any symptoms. The only way to know if you have syphilis is to get tested.

If it's not treated, syphilis can lead to serious health problems — and even death. Medicine can cure syphilis, but it can't undo any damage that syphilis has already caused. That's why it's important to get tested regularly if you're at risk.

What if I've had syphilis before?

Being treated for syphilis once doesn't protect you from getting it again. It's possible to get syphilis again after you've been cured, so ask your doctor if you need to be tested again.

What about cost?

Insurance plans must cover syphilis testing for adults at higher risk for syphilis and all pregnant women. That means you may be able to get tested at no cost to you. Talk to your insurance company to find out more.

What do I ask the doctor?

When you visit the doctor, it helps to have questions for the doctor or nurse written down ahead of time. You may also want to ask a family or friend to go with you to take notes.

Print this list of questions and take it with you to your appointment.

• Am I at risk for syphilis?
• Do I need to get tested for syphilis?
• How often do you recommend I get tested for syphilis?
• What happens during the test?
• How will I find out my test results?
• When will I get my test results?
• If I have syphilis, what will happen next?
• Can you give me some information about syphilis to take home with me?

Syphilis can be cured with the right antibiotics. However, treatment will not undo any damage that the infection has already caused.

What is the treatment for syphilis?

There are no home remedies or over-the-counter drugs that will cure syphilis, but syphilis is easy to cure in its early stages. A single intramuscular injection of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) will cure a person who has primary, secondary or early latent syphilis. Three doses of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) at weekly intervals is recommended for individuals with late latent syphilis or latent syphilis of unknown duration. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations (e.g., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate treatments for syphilis, as these combinations provide inadequate doses of penicillin.

Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, ceftriaxone. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

And Syphilis Is…?

Syphilis is a sexually transmitted disease that doesn’t get a whole lot of media attention. But that doesn’t mean you shouldn’t have it on your radar. Even though it’s simple to prevent and can be cured with the right treatment, it can cause very serious health problems if not treated. Untreated syphilis can eventually spread to the brain and nervous system or to the eye. This can cause problems like hearing loss, stroke, and blindness. And there’s another big concern: Having syphilis can increase a person’s risk for getting HIV or giving it to others.

Here’s Why You’ll Be Hearing More About Syphilis

Syphilis awareness efforts around the country have been ramping up because recent data show that syphilis rates are on the rise. Rates of primary and secondary (P&S) syphilis—the most infectious stages of the disease—increased a troubling 11% between 2018 and 2019.

Even though men who have sex with men (MSM) account for only 4% of the U.S. male population, they account for nearly half of reported P&S syphilis cases. The current situation is stark— reported syphilis among MSM increased 31% from 2015 to 2019.

What is the link between syphilis and HIV?

In the United States, approximately half of MSM with P&S syphilis are also reported to have HIV. The troubling reality is that if you are a gay man who does not have HIV, but who is diagnosed with P&S syphilis, you are more likely to be infected with HIV in the future. Having a sore or break in the skin from an STD like syphilis may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STDs can also put you at greater risk for getting HIV.

WHAT CAN I DO TO MAKE SURE I DON’T GET SYPHILIS?

If you are a sexually active gay or bisexual man, here’s what you can do:

• Talk to Your Doctor. Have an honest and open talk with your health care provider about your sexual history and ask to be tested for syphilis and other STDs at anatomic sites of exposure. Many men don’t have symptoms so testing is the only way to be sure that you do not have syphilis. If you are HIV negative and have syphilis, ask your health care provider about PrEP.
• Protect Yourself and Your Partner. If you are sexually active, doing the following can lower your chances of getting syphilis: (1) being in a long-term, mutually monogamous relationship with a partner who has been tested and has negative STD test results, and (2) using latex condoms the right way every time you have sex. If you have sex with more than one partner, don’t use condoms, or engage in risky sex behaviors, then you should get tested more frequently (e.g., every 3 to 6 months).