Syphilis
What is syphilis?
Syphilis is a sexually transmitted disease.
Is it contagious?
Yes. You can get syphilis by having oral, anal, or vaginal sex. If a woman who is pregnant has syphilis, she can infect her unborn child (fetus).
What is syphilis?
For many years, syphilis was thought to be a disease of the past. Now, it’s making a comeback. In 2018, more people were diagnosed with syphilis than HIV.
The good news is that syphilis is easy to diagnose and cure. Usually, a simple blood test tells you if you have syphilis and an antibiotic medication cures it.
What are the symptoms?
Syphilis can cause problems on the skin and in nearly every organ inside the body. The earliest warning signs are often on the skin.
Why are people getting syphilis?
Many people still think syphilis is a disease of the past. That may lead them to miss the early warning signs. These early warning signs tend to be painless and usually go away within 3 to 6 weeks.
When the early warning signs go away, most people still have syphilis. Without treatment, you can spread syphilis to others. Even when you don’t see signs of syphilis, you can still get and spread it through sexual contact. As more people become infected, the number of people who have syphilis grows.
Testing can find syphilis early
Today, doctors are again encouraging patients to get tested for syphilis. The mention of syphilis can come as a shock to patients, who believe that something else is causing their symptoms. Patients often want to try treatment for another condition first. Doctors discourage this approach.
Waiting to get tested allows syphilis to spread to other parts of your body. When this happens, the disease can cause hearing loss. If it affects your eyes, you may never see as clearly. Some people develop a widespread rash or open sores.
When syphilis affects the skin, many people make an appointment to see a dermatologist. After carefully examining a patient’s skin and asking questions, a dermatologist may recommend a syphilis test.
Getting tested when your dermatologist first recommends it can protect your health. Here’s how:
If you don’t have syphilis: Testing will rule out syphilis, giving you peace of mind and allowing your dermatologist to properly diagnose you. This allows you to get the treatment you need.
If you have syphilis: You can get treatment that cures you.
Testing still saves lives
In mid-century America, posters encouraged people to get tested for syphilis, and the disease almost disappeared. Now it’s back.
Every pregnant woman should get tested for syphilis
In the United States, pregnant women get tested for syphilis. Testing usually happens during the first prenatal visit.
Testing is recommended because a woman who is pregnant can pass syphilis on to her unborn child. Syphilis can cause serious birth defects. It can cause the baby to be born dead (stillborn). Treatment cures the disease so that a mother cannot give syphilis to her unborn child.
Syphilis is caused by a bacterial infection. Most people become infected during sex.
Without treatment, syphilis can progress through stages and can cause serious health problems. Here’s what you may notice during each stage.
Primary stage of syphilis
When it begins: The primary stage of syphilis begins 10 to 90 days after you become infected. Most people develop symptoms about 3 weeks after having sex with someone who has syphilis.
What you may notice: During this stage, you may have:
One or more open sores called chancres, which often feel firm and painless
Swollen lymph nodes
The open sores usually develop on the genitals, inside the mouth, or within the vagina or anus. Because these sores are often painless, many people never notice them.
These open sores usually heal and go away within 3 to 6 weeks. While the sores heal on their own, you still need treatment. Without treatment, syphilis can move to the next stage.
Are you contagious? Yes. Syphilis is very contagious during this stage. If you have sex (oral, anal, or vaginal), you can easily give your partner(s) syphilis.
While less common, you can give someone syphilis through kissing if you have open sores inside your mouth or on your lips.
Open sores
Where the bacteria that cause syphilis work their way into your body, you may develop open sores called chancres.
Secondary stage of syphilis
When it begins: The secondary stage of syphilis begins within 6 months of the syphilis sores going away. Some people enter this stage immediately after (or as) their sores clear.
What you may notice: As the disease spreads throughout your body, many signs and symptoms can develop. The most common are:
Rash (can appear on the skin in many ways and begin before the sores in first stage heal)
Sores on moist areas (genitals, inside the mouth, in the throat or anus)
Fever
Fatigue
Sore throat
Weakness
Hair loss
Weight loss
Swollen lymph nodes
If the disease spreads to your nervous system, you can develop other signs and symptoms, including:
Neck stiffness
Headaches
Hearing loss
Problems with your reflexes
Paralysis
The secondary stage lasts several weeks to several months. Once this stage ends, the signs and symptoms will go away.
While most signs and symptoms go away, this doesn’t mean the syphilis goes away. Without treatment, syphilis often moves to the next stage.
Are you contagious? Yes. Syphilis is very contagious during this stage. If you have sex (oral, anal, or genital), you can easily give your partner(s) syphilis.
While less common, you can give your partner syphilis through kissing if you have syphilis sores inside your mouth or on your lips.
Syphilis rash
A rash can develop anywhere, but it often appears on the palms and soles. It may cause spots, blisters, or many other signs.
Latent stage of syphilis
When it begins: The latent stage of syphilis begins after the rash and other signs and symptoms clear.
What you may notice: This stage is also called the “hidden stage” because you will not have any signs and symptoms.
Even without signs or symptoms, you can still have syphilis.
Without treatment, you may stay in the latent stage for the rest of your life. Some people relapse and go through the secondary stage again. If this happens, you’ll develop signs and symptoms again. You can go through the secondary stage two or more times.
Each time the secondary stage ends, you return to the latent stage.
Are you contagious? Yes. Even when you don’t have signs or symptoms, you can still give someone syphilis by having sex (oral, anal, or genital).
Symptoms disappear
In this stage, you don’t have signs or symptoms, but a blood test can still diagnose syphilis.
Tertiary stage
When it begins: Reaching the tertiary stage of syphilis usually takes many years. However, syphilis can progress quickly. Without treatment, some people reach this last stage within 1 year of getting syphilis.
What you may notice: This stage is also called the “destructive” stage because it can damage your organs. In this stage, you may develop:
Gummas, which are sores that can grow deep and eat away at the area (skin, lungs, liver, or bone) where they develop.
A condition called cardiovascular syphilis, which attacks your heart and blood vessels.
A condition called neurosyphilis, which attacks your nerves, spinal cord, and brain.
In this stage, syphilis becomes so destructive that it can cause death.
Even in this stage, treatment can stop the syphilis from getting worse. However, treatment cannot undo damage caused by syphilis.
Are you contagious? No
Gummas
The sores on this patient’s scalp are called gummas. This type of sore can grow deep, destroying even the bone beneath.
Syphilis can affect your eyes or nervous system at any stage
If the bacteria that cause syphilis get into your central nervous system, you can develop a condition called neurosyphilis.
Symptoms of neurosyphilis can include:
Headaches
Neck stiffness
Confusion
Ringing in the ears or hearing loss
Red, irritated eyes, blurry vision, or blindness
Stroke
Weakness
Dementia
Loss of balance
It is important to tell your doctor if you have any of these symptoms. Neurosyphilis requires special treatment to cure it. You may need tests like an eye exam or other tests to tell if you have neurosyphilis.
Syphilis can also affect your eyes at any stage. Signs that this has happened include having red, irritated eyes and problems seeing clearly. Some people go blind.
Who gets syphilis?
Anyone can get syphilis. This disease spreads mainly through sexual contact, so you have a greater risk of getting syphilis if you are sexually active and:
Have unprotected sex with multiple sex partners
Are HIV-positive
Are a man who has sex with other men
Have sexual partners who test positive for syphilis
If you take antiretroviral treatment (ART) for HIV, you still have a higher risk of developing syphilis if you are sexually active. ART helps to slow down HIV. ART cannot reduce your risk of developing other sexually transmitted diseases, such as syphilis.
You can reduce your risk of developing an STD by either: 1) not having sex at all, or 2) using condoms (or dental dams) if you do have sex.
What causes syphilis?
This disease is caused by bacteria. To survive, these bacteria need to live on or inside the human body. They cannot survive on a toilet seat, towel, or bedding.
Syphilis spreads through intimate contact
You cannot get syphilis from a toilet seat, towel, or bedding.
How do you get syphilis?
Syphilis is a contagious disease. Most people catch it during sex.
When your sex partner has syphilis, the bacteria that cause the disease create open sores. These sores may appear on the genitals, where you might see them. The sores can also develop inside the mouth, anus, or vagina. These sores tend to be painless, so many people don’t know they have syphilis sores.
When you touch these sores during sex, the bacteria spread from your partner to you. Once the bacteria attach to your body, they start multiplying. This can happen quickly, within hours.
Syphilis can spread from one person to another through:
Oral, anal, or vaginal sex
Genital-to-genital contact
An open wound in your skin
Kissing (if syphilis has caused mouth sores)
A woman who is pregnant can give syphilis to her unborn baby: Syphilis can spread from mother to baby before (or during) birth. The medical term for this type of syphilis is “congenital syphilis.”
Testing can tell whether a woman who is pregnant has syphilis. If a pregnant woman is not tested, she may be unaware that she has syphilis and pass the disease to her unborn child. Babies who are infected in the womb might die before they are born. Some might be born with serious birth defects.
Most pregnant women in the United States get tested for syphilis during a prenatal checkup. When the disease is caught early, syphilis can be treated before it affects the baby.
With the right antibiotic, syphilis can be cured.
The antibiotic works by killing the corkscrew-shaped bacteria in your body that cause syphilis.
How is syphilis diagnosed and treated?
If your doctor recommends that you get tested for syphilis, knowing what to expect can help put your mind at ease. Here’s what happens from getting tested to treated.
Step 1: Take a blood test
If you might have syphilis, your doctor will order a blood test. If this blood test is positive, the lab typically performs a second test on your blood to confirm that you have syphilis. If you have syphilis, you need treatment.
Step 2: Determine stage
Your doctor will determine the stage of infection by reviewing information from your exam and asking you questions.
Step 3: Treat and cure
To cure syphilis, you need to receive the right antibiotic. Here’s how you may get the antibiotic:
Early stage: One shot of penicillin
Late stage: Three shots of penicillin, with one shot given each week for three weeks
Syphilis affects your nervous system: Penicillin given through an IV (intravenous) infusion, with treatment given once a week for two weeks.
To treat syphilis with penicillin, you need a shot or IV infusion. Taking penicillin pills cannot cure you.
You should not have sex for at least 1 week after treatment and until all symptoms have gone away.
Step 4: Follow-up with your doctor
While treatment can cure you, follow-up appointments are necessary. Some people need more than one shot of penicillin. Others get re-infected. During your follow-up appointments, you’ll have:
A blood test to make sure you no longer have syphilis
Other medical tests if the disease was caught late
Step 5: Partner notification
You should tell your partner(s) that you were diagnosed with syphilis. This is important so that they can be tested and, if necessary, treated. It will also prevent them from giving the infection back to you or to other people.
Your doctor is required by law to report all syphilis infections to the local health department. If you prefer, the health department can help notify your partner(s) that they need to be tested.
Step 6: Prevent repeat infections
When you start having sex again, use latex condoms and/or dental dams to prevent getting syphilis again or other sexually transmitted diseases.
While the right antibiotic can cure syphilis, it cannot undo damage already done. If syphilis caused hearing loss, you’ll continue to have hearing loss after being treated. If the syphilis has damaged your heart, you may need surgery to repair the damage.
How is syphilis treated if you are allergic to penicillin?
If you are allergic to penicillin, tell your doctor before you get your first shot or IV of penicillin.
Some people can be treated with another antibiotic, such as doxycycline or tetracycline. If your doctor decides to treat you with one of these antibiotics, you will need several follow-up appointments. These antibiotics can be less effective at treating syphilis.
If you are pregnant and allergic to penicillin, you must treat with penicillin. It’s the only antibiotic that can treat both mother and baby. A method called “desensitization” is used so that you can be safely treated with penicillin.
Treatment for syphilis is essential if you are pregnant. Treatment could save your baby’s life and prevent birth defects.
Some people feel sick within hours of syphilis treatment
About 10% of people treated for syphilis feel sick within a few hours. They may develop one or more of the following:
Fever
Chills
Flushing
Achy muscles
Racing heart
Headache
Rash
Many people fear these signs and symptoms signal a serious allergic reaction to the penicillin. Research shows this isn’t an allergic reaction. However, it’s unclear why some people develop this reaction. It’s possible that the person’s immune system is reacting to the dying bacteria.
The reaction clears quickly on its own, usually disappearing completely within 24 hours.
While you feel sick, it can help to drink lots of water and take medicine to reduce the fever.
Keep all follow-up appointments with your doctor
By keeping all of your follow-up appointments, you will get the care you need. That care may include an HIV test. People who have had syphilis have a higher risk of developing an HIV infection.
If the syphilis was caught in a late stage, it may have affected your body in other ways. You may need other medical tests. People also need follow-up syphilis blood tests to make sure the syphilis treatment worked.
5 things to do if you’re diagnosed with syphilis
This disease is common, and it can be cured. If you find out that you have syphilis, dermatologists recommend that you:
Get treated. With the right antibiotic, syphilis can be cured. Without treatment, syphilis can spread to other parts of your body, and eventually cause permanent damage. Having syphilis for a long time can cause hearing loss, heart damage, and many other health problems.
Tell your sex partner(s) that you were diagnosed with syphilis. Some people find this difficult to do. Telling your sex partner(s) is important. It allows them to get tested and receive treatment, if necessary. Treatment also prevents your partner(s) from infecting you again or infecting other people.
If you prefer, your local health department can work with you to tell your partners they need to be tested. Ask your doctor about this option. According to the Centers for Disease Control (CDC), most partners don’t know that they have been exposed until notified by their partner, a doctor, or the health department.Tell your partner(s)
If you’re diagnosed with syphilis, tell your partner(s) so that they can get tested.
Stop having sex for at least one week and until:
You finish your treatment for syphilis.
Your symptoms go away.
Use condoms and/or dental dams when you start having sex again. These help to prevent the spread of syphilis and other STDs.
Keep your follow-up medical appointments. After you get treated for syphilis, you need blood tests to make sure you no longer have the disease. Some people need more than one shot of penicillin to cure syphilis. It’s also possible to get re-infected.
By following this self-care advice, you can make sure that you get cured and prevent spreading syphilis to others. That can help dramatically reduce the number of people who have syphilis.