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What Is Syphilis?

Syphilis is a sexually transmitted disease (STD). STDs (also called sexually transmitted infections or STIs) are infections that spread from person to person during sex or close sexual contact.

Early treatment can cure syphilis (SIF-eh-lis) and prevent long-term problems.

What Causes Syphilis?

A type of bacteria called Treponema pallidum causes syphilis.

How Do People Get Syphilis?

In a syphilis infection, sores called chancres (SHANK-ers) or wart-like sores called condyloma lata (kon-duh-LOW-muh LAH-tuh) form. Usually, the infection spreads when someone touches the sores. This can happen through vaginal, oral, or anal sex; using fingers ("fingering"); or any other sexual contact.

A chancre or condyloma lata may be hard to see, so someone might touch it on another person’s skin and not know it’s there.

An infection during pregnancy can spread to the baby before birth or during delivery.

What Are the Signs & Symptoms of Syphilis?

Signs and symptoms of syphilis depend on which of the four stages someone is in.

Primary Syphilis

About 3 weeks after someone is infected, one or more chancres (sores) show up where the sexual contact happened (genitals, mouth, or rectal area). They’re usually painless.

The chancres go away in about 3–6 weeks, even without treatment. But if someone isn’t treated, primary syphilis will become secondary syphilis.

Secondary Syphilis

A few weeks to months after the chancres appear, people may develop:

  • a rash, often on the palms of the hands and soles of feet
  • flu-like symptoms (for example, fever, headache, tiredness, loss of appetite, muscle aches, joint pain, and sore throat)
  • swollen glands (lymph nodes)
  • wart-like sores (condyloma lata) in areas like the mouth and around the genitals and anus
  • hair loss

Over time, secondary syphilis can cause liver, kidney, and digestive tract problems.

The symptoms of secondary syphilis will go away, but without treatment the infection will become latent syphilis.

Latent Syphilis

Someone with latent syphilis is infected but doesn’t have any symptoms. Syphilis can stay latent (not obvious or causing symptoms) for life or it may become late syphilis.

Late Syphilis

Late syphilis can cause serious damage to the blood vessels, heart, and other organs. This stage may happen 1–30 years after someone is infected. Even a person who hasn’t had symptoms of primary or secondary syphilis can develop late syphilis.

What Is Neurosyphilis?

Neurosyphilis (nor-oh-SIF-eh-lis) is syphilis that has spread to the brain and rest of the nervous system. It can happen during any of the stages of syphilis. People with neurosyphilis can have:

  • syphilitic meningitis (swelling of the tissues around the brain and spinal cord)
  • damage to spinal cord
  • seizures
  • dementia (affecting things like thinking and memory)
  • eye problems that can lead to blindness

How Is Syphilis Diagnosed?

To find out if someone has syphilis, health care providers usually do a blood test. Fluid from the chancre also can be tested. Someone who has symptoms of neurosyphilis will get a spinal tap (lumbar puncture). This test collects some fluid from around the brain and spinal cord for testing in a lab.

How Is Syphilis Treated?

Health care providers treat syphilis with antibiotics . These medicines are given as a shot or through an IV (a tiny tube that goes into a vein). Syphilis is easier to treat when it’s found in the earlier stages. How long treatment lasts depends on the stage of syphilis someone has.

Syphilis can be cured. But the medical problems it can lead to — like dementia, artery damage, or blindness — usually don’t go away.

After treatment, doctors will do follow-up testing to see if the infection is gone.

If someone has syphilis, all sexual partners should get tested (and treated, if needed):

  • For primary syphilis: partners from the last 3 months
  • For secondary syphilis: partners from the last 6 months
  • For latent syphilis: partners from the last year (because there could have been a chancre or condyloma lata that wasn't noticed)

Can Someone Get Syphilis More Than Once?

People can get syphilis again if their partners aren’t treated, or if they're treated but then have sex with someone else who has syphilis.

Can Syphilis Be Prevented?

The only way to prevent syphilis and other STDs is not to have any type of sex. To lower their risk of getting an STD, people who decide to have sex can:

  • Use a condom, finger condom, or dental dam every time they have sex (vaginal, oral, or anal sex; or using fingers).
  • Get tested with any new partners before having sex.
  • Have sex with only one partner (who doesn’t have sex with other people).

Anyone who is sexually active should get tested for STDs every year, or more often if recommended by their health care provider.

Reviewed by: Lonna P. Gordon, MD
Date Reviewed: Oct 1, 2023

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