Syphilis

Syphilis is spread by unprotected vaginal, anal and oral sex. It can also be spread through intimate or skin to skin contact with an infected person.

An infected mother can pass syphilis on to her baby via the placenta during pregnancy. Read more about syphilis in pregnancy.

The first signs of syphilis don’t last long, so you can have it and pass it on without knowing.

Some people get an ulcer or sore around the genital area or mouth, 3 to 12 weeks after infection. The sore can be any size or shape. It’s usually painless, doesn’t bleed, and feels like a hard button on the skin.

If not treated, the sore heals and disappears after a few weeks. But you are still infected, and the bacteria are in the bloodstream and spreading around the body. This is called the primary stage of the disease.

Two to 6 months after getting infected, you can develop a skin rash (on the face, palms, and soles of the feet), swollen glands, lumps around the moist areas of the body, and hair loss. You can also get headaches, and pains in your bones, muscles and joints. This is the secondary stage, which can last for 6 months or more.

Without treatment, there is a latent stage where there are no visible signs but you are still infectious and can pass on syphilis through sex for up to 2 years. If you have untreated syphilis for over 2 years (called the tertiary stage), the disease can affect the brain, heart, large blood vessels, the spinal cord, skin and bones. This can lead to disability and death.

If a pregnant woman has syphilis, her baby can be born dead or damaged (congenital syphilis). If found early in the pregnancy, syphilis can be treated, lessening damage to the baby. All women should have a syphilis test in the first 12 weeks of pregnancy or at the first antenatal visit.

See your doctor as soon as possible if you think you may have syphilis.

Your doctor will do a blood test for syphilis. However, for a short period just after syphilis enters the body, it can’t be picked up with a test. So if your result is negative, you will need to have the test again after 3 months.

It’s a good idea to get tested for other sexually transmitted infections (STIs) such as chlamydia and HIV at the same time.

Your doctor should also talk to you about contact tracing. Contact tracing involves finding and informing the contacts of a person with an infection so they can get counselling and testing, and treatment if necessary. You can do the contact tracing yourself and/or with help of a health professional. Discuss this with your doctor.

Syphilis is treated with penicillin or other antibiotics. You need to take the full course, and not miss any doctor’s appointments.

After treatment, you’ll need a blood test to make sure you are cured.

If left untreated

In the long term, untreated syphilis can affect the brain, heart, large blood vessels, the spinal cord, skin and bones. This can lead to disability and death.

While you have the infection

Once diagnosis is confirmed, don’t have sex, even with a condom, until after you have completed the full course of treatment. Syphilis is very infectious, particularly during the first and second stages.

You can reduce the risks of getting syphilis, and other STIs, by following this advice:

• Always use condoms or dams and water-based lubricant. Condoms are the best way to protect you both from syphilis and other STIs. Always use condoms during vaginal and anal sex, and dams during oral sex, until you’re totally sure that both you and your partner don’t have an STI.
• Have a long-term relationship where neither of you is already infected, and neither of you has other partners.
• Limit your sex partners. The fewer people you have sex with, the lower the risk of having sex with someone who has syphilis.
• Have regular STI checks.

Talking about STIs can be difficult, but any person you have sex with has a right to know if you have an STI. Discuss it when you are feeling relaxed and confident, not just before you have sex. Your partner will appreciate your honesty and that you don’t want to infect him/her. You have the right to know if they are infected, too.