Syphilis can be hard to spot and is one of the most easily caught sexually transmitted infections. If untreated it can cause serious health problems.
Although syphilis can be hard to spot without the right blood test, it's one of the easiest sexually transmitted infections to catch and pass on.
Syphilis spreads best by contact between moist skin areas anywhere on or in the body. People remain infectious to others for about two years from initial infection if they are not treated.
Some of the ways you can catch it include:
- Oral sex without a condom or dental dam
- Mutual masturbation
- Anal sex without a condom
- Vaginal sex without a condom
- Mouth contact with the anal area
Syphilis increases the risk of catching HIV, and HIV can make syphilis harder to treat.
Early syphilis is easy to miss. Many people show no signs that they have it.
Syphilis can make some people feel very ill, especially the 'secondary stage' with a rash and fever.
You may see three stages:
The first stage (primary syphilis)
10 days to three months after you have been exposed, a small, painless sore or ulcer (called a chancre) may apeaar.. The sore will appear on the part of your body where the infection was transmitted, typically the penis, vagina, anus, rectum, tongue or lips. Most people only have one sore, but some people have more.
You may also experience swelling in your lymph glands (such as in the neck, groin or armpit).
The sore will then disappear within two to six weeks and, if the condition is not treated, syphilis will move into its second stage.
The second stage (secondary syphilis)
The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore. At this stage common symptoms include:
- a non-itchy skin rash appearing anywhere on the body, but commonly on the palms
- swollen lymph glands
Less common symptoms include:
- weight loss
- patchy hair loss
- joint pains
These symptoms may disappear within a few weeks, or come and go over a period of months.
If untreated syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called ‘latent syphilis’. You can still pass it on during the first year of this stage. However, after a couple of years, you cannot pass the infection to others, even though the infection is still there.
of the hands or soles of the feet The latent stage can continue for many years (even decades) from first infection. Without treatment, there is a risk that latent syphilis will move on to the most dangerous stage – tertiary syphilis.
The third stage (tertiary syphilis)
The symptoms of tertiary syphilis can begin years or even decades after initial infection. Around one in three people who are not treated for syphilis develop serious symptoms eventually.
The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms:
- Loss of co-ordination
- Heart disease
- Skin rashes
At this stage, syphilis can be dangerous enough to cause death. This is rarely seen in the UK now.
Syphilis can be passed from a mother to her unborn baby. This is why all women are offered syphilis testing in pregnancy.
It can be successfully treated during pregnancy with a course of antibiotics. The treatment does not harm the unborn baby. It treats the mother and baby at the same time.
If syphilis is left untreated during pregnancy it causes serious birth defects, miscarriages or stillbirths.
If you think you may have syphilis, visit your local sexual health service. Syphilis testing involves giving a sample of blood and a sample from an ulcer (if present) and the test result is highly accurate. Getting tested is the only reliable way of knowing if you have syphilis or not.
If you develop any of the symptoms of syphilis then get help quickly, especially if you notice a sore on your genitals.
The earlier syphilis is treated the better. If you are generally unwell and think you are at higher risk of syphilis then get tested.
You could be at higher risk because you are a man who has sex with men, have recently had sex overseas or have had multiple sexual partners – especially group sex.
Early syphilis infections can be easily treated with antibiotics, even during pregnancy. It normally involves 1 or more injections with large doses of a form of penicillin. The number of injections depend on the stage of infection. If you are penicillin allergic you can still be treated with alternative antibiotics.
Late stage syphilis infections and those in people with HIV can be more complicated to treat. Treatment at any time can stop further illness and cure the infection itself, though it does not repair any damaged organs.
Partners need to take care not to re-infect each other until both have been given the all clear.
Once the treatment has finished, further blood tests are carried out to make sure the infection has gone. These tests may be required at intervals for up to a year.
Your partner should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They will generally be offered treatment regardless.
While you are being treated and until you get a clear test result:
- Do not have any kind of sex
- Avoid intimate contact with your partner and others
This will stop you from infecting your partner if they are clear, and stop you being re-infected if they also have syphilis.
A small number of people experience a reaction to the initial treatment with antibiotics known as the Jarisch-Herxheimer reaction. It is thought that the reaction is triggered by a large amount of bacteria dying at the same time due to antibiotic treatment.
This causes flu-like symptoms such as fever, headaches, and muscle and joint pain. The reaction normally lasts 24 hours, and causes no serious problems.
To reduce the risk of getting syphilis:
- Use condoms for anal and vaginal sex
- Use a condom or dental dam for oral sex
- Reduce the number of partners you have sex with
Be extra careful if having sex in parts of the world where syphilis is more common
Remember - you can have syphilis for many years without any obvious symptoms.. To keep yourself safe, regularly get tested for syphilis if you have been at risk. It is possible to get syphilis more than once.