What is it?
Syphilis is not as common as some sexually transmitted infections but if it's not treated it can cause very serious health problems. Syphilis is caused by bacteria known as Treponema pallidum. It's easily passed from one person to another through sex. Anyone who's having sex can get it and pass it on.
How do I get it?
Syphilis is easily passed from one person to another through sex. You can pass syphilis on without knowing you have it because symptoms can be mild and you may not notice or recognise them. It can also be passed on before symptoms are noticeable, or after they’ve disappeared.
- Syphilis can be passed from one person to another during sex and by contact with the ulcers of someone who has syphilis.
- It can be passed on through vaginal, anal or oral sex, or by sharing sex toys. Using a condom correctly can reduce your chance of getting or passing on syphilis.
- Syphilis can also be passed on by blood transfusion and injecting drug use (sharing needles) but this is very rare. In the UK, all blood donations are screened for syphilis before the blood is used.
- If you’re pregnant, it’s possible to pass the infection to the baby before birth. This is known as congenital syphilis.
- You can’t get syphilis from hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.
Signs and Symptoms
The signs and symptoms can be difficult to recognise and you might not notice them.
Syphilis can develop in stages:
- the early stage (primary and secondary syphilis)
- the latent stage
- the late stage (also called tertiary syphilis).
Early and late syphilis may cause symptoms, while in latent syphilis there are no symptoms. If you do get symptoms, you might notice the following:
- One or more ulcers can appear, where syphilis entered the body. These ulcers are called chancres (pronounced ‘shankers’) and are often painless.and may appear anywhere on the body. They may appear between 2 weeks and 3 months after coming into contact with syphilis but it can be sooner or later.
- Ulcers may appear on the vulva (the opening to the vagina and urethra, the labia - vaginal lips - and the clitoris), or the cervix.
- Ulcers may appear on the penis or foreskin.
- They may be around the opening of the urethra or around the anus.
- Less commonly, ulcers may appear in the mouth, and on the lips, tonsils, fingers or buttocks.
- The ulcers of primary syphilis are very infectious and may take 2–6 weeks to heal. By this time, if syphilis hasn’t been treated, it will spread to other parts of the body. It’ll then be known as secondary syphilis.
If syphilis isn’t treated, the secondary stage usually occurs around 4-10 weeks after any ulcers have appeared. Syphilis is still infectious at this stage and can be passed on to someone else. Symptoms might include:
- a painless rash that’s not normally itchy; it can spread all over the body, or appear in patches and is often seen on the palms of the hands and soles of the feet
- flat, warty-looking growths on the vulva or around the anus (often mistaken for genital warts)
- a flu-like illness, tiredness, and loss of appetite, with swollen glands (this can last for weeks or months)
- white patches on the tongue, cheeks, or roof of the mouth
- patchy hair loss.
When syphilis remains untreated, without any signs or symptoms of infection, it’s known as latent syphilis. Diagnosis is made by a positive blood test. People with latent syphilis may still be infectious.
Tertiary or late syphilis
Untreated syphilis may, after many years, start to cause serious damage to the heart, brain, bones and nervous system. Late syphilis is rare in the UK.
You can only be certain you have syphilis if you have a test. If you think you might have syphilis, it’s important not to delay getting a test so you can start treatment, if needed, and don’t pass the infection on to anyone else.
Syphilis is tested usually from a blood sample. The Doctor or Nurse may do a genital examination. This may include an internal examination of the vagina, or an examination of the penis, foreskin and opening of the urethra (where urine comes out). They may also examine your anus, internally and externally. The doctor or nurse will also check the body for any rashes, ulcers or warty growths. They may check the mouth and throat area.
Have a test if:
- you, or a sexual partner, have or think you might have symptoms
- you’ve recently had unprotected sex with a new partner
- you, or a partner, have had unprotected sex with other partners
- a sexual partner tells you they have syphilis or a sexually transmitted infection
- you have another sexually transmitted infection
- you’re pregnant or planning a pregnancy.
You could still have syphilis even if a partner has tested negative. The only way to make sure you don’t have syphilis is to get tested yourself. If you’ve had syphilis before, you can still get it again, even if you’ve been treated. If you have syphilis, you’ll be advised to get tested for other sexually transmitted infections (STIs). It’s possible to have more than one STI at the same time.
Syphilis is treated with antibiotics. This may be a single injection, a course of injections or tablets or capsules. Penicillin is the most common treatment for syphilis, but there are several different antibiotics that can be used. Let the doctor or nurse know if you’re allergic to penicillin.
Further Guidance: Syphilis