What is Syphilis?

Syphilis is a bacterial infection caused by a bacterium called Treponema Pallidum. It is transmitted via unprotected sexual contact with an infected partner (through intercourse, oral or anal sex, shared sex toys, and drug needles). It is referred to as a "silent" STI because its symptoms are quite common, and can come and go. A person can live with syphilis for years and be unaware of it. Syphilis is curable, and should be treated immediately to prevent complications.

Recent news reports of an outbreak of syphilis in China have linked it to a growth in the economy, the influx of migrant workers, and increased prostitution and unprotected sex. Congenital syphilis (passed from mother to baby during pregnancy) is common, and health reports show that one infected baby is born every hour in China. Rates have also increased over the last decade in the UK and US.


While syphilis can be passed from mother to infant during vaginal delivery, the most common way to contract the disease is by sexual activity:

  • Anal Sex
  • Oral Sex
  • Vaginal Sex

What Are the Signs and Symptoms of Syphilis in Men and Women?

Syphilis can be very secretive and go unnoticed for a very long time. Frequently, people that has the disease do not even realize they have it and this is part of the reason that syphilis is a common sexually transmitted disease.

Signs and symptoms can be so light that the patient do not even notice them until they are more visible. At first, people can confuse the symptoms with other more common diseases, such as a rash, an ingrown hair or a pimple. Also, the syphilis symptomatology comes and goes over time, but that does not mean the disease has disappeared. Remember that the only way of getting rid of it is by taking medicine for it.

Syphilis can lead to serious complications if not treated, but the positive side is that with proper antibiotics, the disease will disappear.

This disease has different stages of signs and symptoms, and it can be very confusing due the overlapping that happens. You may pass times with no symptoms at all, but with the infection very active inside you. The clinical manifestations can vary with each stage.

Primary Syphilis:

Appearing 10 to 90 days after the infection, the typical primary lesion is the chancre (where the infection entered into your body), which usually starts as a single and painless papule that becomes eroded and indurated. Usually there is a single lesion, but a minority of patients can develop multiple ones. In men, is more frequently seen on the penis, but it can also be found in the anal region, mouth or external genitalia. In women, is common seeing the primary lesion on the cervix and labia.

Atypical primary lesions are common. This has clinical relevance especially regarding the amount of infectious Treponema pallidum (bacteria producing the disease) that the patient has and his immunologic status. The genital lesions must be differentiated from those appearing in herpes simplex virus infection, chancroid, donovanosis and traumatic injury.

Regional lymphatic lesions (usually inguinal) can accompany the primary lesion, appearing after 1 week of lesion onset. These nodes are firm, painless and nonsuppurative. Usually is bilateral and may appear with every regional chancres. The primary lesion generally heals after 4 to 6 weeks of appearing with or without treatment, although lymphadenopathy may last for months.

Secondary Syphilis:

This stage usually appears 2 to 8 weeks after the first chancre and, includes mucous and cutaneous lesions, as well as generalized indurated lymph nodes. In the 15% of patients, the primary lesion may still be present. Generalized skin rash (especially on the trunk and proximal extremities) not itchy and with multiple lesions is common, but in some cases it can be very mild to the point that the patients do not notice it. Spots can become papules and/or pustules, and frequently involve the palms of hands and soles of feet.

Patchy alopecia of the scalp hair, beard or eyebrows appears in 5% of cases if there is hair follicles involvement. In warm and moist regions, lesions can progress to highly infectious gray-white lesions called condylomata lata in 10% of patients with this stage. There can be silver mucosal erosions, usually on the mouth or genitalia, with a red ring.

Systematic symptomatology include fever, sore throat, weight loss, anorexia, muscle aches, headache and meningismus. Less common complications of this stage include hepatitis (most common), nephropathy, gastrointestinal disorders, ocular issues, arthritis and periostitis. As the first stage, clinical manifestations of secondary syphilis resolve spontaneously after 1 to 6 months.

Latent Syphilis:

In an untreated person, positive serologic tests for syphilis and absence of clinical manifestations indicates the diagnosis of latent syphilis. Is suspected based on history of syphilis lesions. Early latent syphilis goes until the first year after infection, while late latent syphilis goes after that first year after infection. This does not mean that treatment is not necessary, is just a stage were the pathogens are at sleep or hidden. If not treated, syphilis can progress to the third and final stage.

Tertiary (Late) Syphilis:

Generally occurs 10 to 30 years after the initial infection. At this time, the patient can have serious health problems involving brain (neurosyphilis), heart, eyes, kidneys, liver, bones, joints, among others. Loss of motor skills and paralysis, numbness, blindness and dementia are the most common complications. In the majority of cases, this stage is known for the progress into mental illness, continued by death.

This disease can be easily treated in time, but the damage produced by the infection in the tertiary stage cannot be changed or healed.

Get tested for Syphilis

Syphilis is treated with antibiotics. Later stages of the illness could require more aggressive treatment, possibly in a hospital. Act immediately and get tested today!

Get tested for STDs today

What Are the Complications and Risks of Syphilis?

Syphilis can cause many types of complications if left untreated:

Congenital Syphilis:

  • Anemia
  • Deformities
  • Developmental delays
  • Jaundice
  • Seizures
  • Development of tertiary syphilis and associated conditions


  • Fetal death
  • Infant death
  • Miscarriage
  • Passing syphilis to the baby during delivery
  • Premature birth

Tertiary Syphilis

Partners and Re-infection

You should refrain from all forms of sexual activity until your body is free from the infection. If you have tested positive for gonorrhea, all your sexual partners should be notified so they can be tested and treated. It is possible to be re-infected, so be sure to use all possible precautionary measures.

How is Syphilis Treated?

Syphilis is treated with antibiotics. In early stages, a single injection of penicillin may be all that is necessary (other antibiotics are available in oral form for those allergic to penicillin). Later stages of the illness could require more aggressive treatment, possibly in a hospital. If syphilis is diagnosed during latent stages, increased injections of penicillin will be required to clear it up.

Blood tests will detect the presence of antibodies, which the body produces in large quantities, to help fight the bacteria.

Recovery Time

You are not considered fully recovered from syphilis until all of the sores are entirely healed. In addition, if the disease had progressed to the point of organ damage, this damage is irreversible.

Sexual Activity

Sexual activity should be avoided until all sores are healed completely. Having sex prior to this could cause the infection to spread to your partner. Additionally, it is imperative that your sexual partners be informed of your condition, as they should be tested and, if needed, treated. It is possible to be re-infected with syphilis, so you should avoid sex with any partner who has not been tested and/or treated.

How is Syphilis Prevented?

Always practice safe sex, particularly with a new partner. Use condoms for intercourse and a dental dam (or condom cut in half) for oral/anal sex. Syphilis can be spread by skin-to-skin contact and a small sore may not be noticed by the carrier. Never share sex toys, and be vigilant about any skin rashes or unusual sores on the body, particularly after unprotected sexual contact.

Syphilis has been around for generations. It was eradicated in China and has only recently resurfaced due to cultural changes and the economic climate. The World Health Organisation (WHO) estimates current rates of syphilis at 12 million worldwide. Sexual health researchers are looking for more efficient ways to diagnose it – for example, via saliva tests, which are less invasive, and don’t have to be done in a clinic.

Regular STI testing is important throughout life. Don’t feel embarrassed to get tested, or to ask a new partner if they have the all clear. It’s safe sex and common sense. STIs can be treated if they are picked up in the early stages.

Mark Riegel, MD

Quick Snapshot

Can it be cured?

Yes. Early stage syphilis is easily curable; Treatment is more difficult at later stages.

Type of Infection

Bacterial. Syphilis is caused by the bacterium ema pallidum.

How is it treated?

Antibiotics. A single injection of penicillin at early stage; Later stage treatment may require hospitilzation.

Recovery Time

Varies. Recovery from syphilis is not complete until all the sores are healed; Damage from the disease may be permanent.

Can I have sex?

No. Avoid sexual activity until the disease is fully cured.

Can I get re-infected?

Yes. Sexual intercourse with an infected partner can lead to re-infection.

Do I Have Syphilis?

Find out whether or not you have Syphilis and what STD test is recommended using our anonymous symptom checker. Get you personalized results and recommendations!

Syphilis Symptom Checker