Syphilis

Topic Overview

What is syphilis?

Syphilis is a sexually transmitted disease (STD). If it’s not treated by a doctor, it can get worse over time and cause serious health problems.

The infection can be active at times and not active at other times. When the infection is active, you have symptoms. When it’s not active, you don't have symptoms, even though you still have syphilis. But even when you don't have symptoms, you can pass it to others.

You don't have to have sexual intercourse to get syphilis. Just being in close contact with an infected person’s genitals, mouth, or rectum is enough to expose you to the disease.

What causes syphilis?

Bacteria cause syphilis. They usually enter the body through the tissues that line the throat, nose, rectum, and vagina. A person with syphilis who has a sore or a rash can pass the disease to others. An infected pregnant woman can also pass syphilis to her baby.

Some things increase your chance of getting syphilis. They include:

  • Having unprotected sex (such as not using condoms or not using them correctly). This risk is high among men who have unsafe sex with other men.
  • Having more than one sex partner and living in an area where syphilis is common.
  • Having a sex partner who has syphilis.
  • Having sex with a partner who has many sex partners.
  • Trading sex for drugs or money.
  • Having HIV.

What are the symptoms?

You may not notice symptoms of syphilis. Sometimes they are the same as symptoms for other diseases. This can cause someone with the disease to put off seeing a doctor. And it can make it harder for a doctor to tell if you have syphilis.

The four stages of syphilis have different symptoms.

  • Primary stage: One of the first signs is a painless open sore called a chancre (say "SHANK-er"). Because syphilis is usually spread when people have sexual contact, chancres are often found in the mouth, the anus, or the genital area. They may also be found wherever the bacteria entered the body.
  • Secondary stage: A skin rash and other symptoms may show up 4 to 10 weeks after a person is infected. At this stage, it is very easy to spread the disease through contact with the mouth, the anus, the genitals, or any area where there is a skin rash.
  • Latent stage: After the rash clears, a person may have a period with no symptoms. This is often called the “hidden stage.” Even though symptoms go away, the bacteria that cause syphilis are still in the body and begin to damage the internal organs. This stage may be as short as 1 year or last from 5 to 20 years. Often, a woman with latent-stage syphilis doesn't find out that she has the disease until she gives birth to a child with syphilis.
  • Late (tertiary) stage: If syphilis is not found and treated in the early stages, it can cause other serious health problems. These can include blindness, problems with the nervous system and the heart, and mental disorders. It can also cause death.

How is syphilis diagnosed?

If you have sores, bumps, a rash, blisters, or warts on or around your genital or anal area, or if you think you were exposed to an STD, see your doctor.

He or she will do a physical exam and will ask you about your symptoms and your sexual history. You will probably have one or more blood tests to check for the disease. Because the open sores from syphilis make HIV infection more likely, you may also be tested for HIV.

To prevent babies from getting syphilis, experts recommend that all pregnant women have a syphilis blood test.

How is it treated?

Syphilis can be cured with antibiotics. Both you and any sex partners that you may have exposed to the disease will need to be treated.

It is important to know that syphilis is not a disease that you can treat on your own. It must be treated with medicine that only your doctor can give you. With treatment, you avoid other serious health problems, and you keep from spreading syphilis to others.

If a woman is pregnant and has untreated syphilis, it can cause miscarriage or stillbirth. It can also cause the baby to be born with the disease. This is called congenital syphilis.

At any stage of the disease, antibiotics work well to cure syphilis. They can't undo the damage already caused by late-stage syphilis. But they can help you avoid further problems from the disease.

How can you prevent syphilis?

There are some things you can do to prevent syphilis. Whether you have never had the disease or you have had it before and are trying to keep from getting it again, you can use these tips:

  • Limit how many sex partners you have, and be aware of any risky behaviors.
  • Always use condoms, and use them correctly. Be aware of the condom’s expiration date.
  • Buy condoms made in the United States, where strict safety standards are met.
  • Keep the condom in the wrapper until you are ready to use it.
  • Women can use a female condom.

Frequently Asked Questions

Learning about syphilis:

Being diagnosed:

Getting treatment:

Ongoing concerns:


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Author: Kathe Gallagher, MSW Last Updated: October 2, 2007
Medical Review: Kathleen Romito, MD - Family Medicine
Jeanne Marrazzo, MD, MPH - Infectious Disease

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