Sexual Health

STI & STD Lowdown: What Is Syphilis?

Syphilis is an STD caused by the bacterium Treponema pallidum; when left untreated, it can cause serious health risks.

Is Syphilis very common?

In recent years there has been a rise in the disease in Europe and the US. In 2016 alone, there were 88,042 newly reported diagnoses of syphilis in all stages in the US. In England, cases rose by 20% in 2014 to 2015, particularly among men who make up 94% of all diagnoses, the Daily Mail reported in early March.

How can you get Syphilis?

It is transmitted from person to person via direct contact with a syphilitic sore, also know as a chancre. They occur on or around the external genitals, such as in the vagina, around the anus, in the rectum or even around or in the mouth. The transmission can also occur during vaginal, anal, or oral sex.

More so, pregnant women who have syphilis can transmit the infection onto their unborn child.

What are the symptoms in adults?

The average time between receiving syphilis and the start of the symptoms is about 21 days, however it can also range from 10 to 90 days. Syphilis has been called ‘The Great Pretender’, as its symptoms can look like many other diseases. But the disease follows typically a range of stages, which can last for weeks, months or even years.

Primary stage

The primary stage is when a single or multiple chancres appear. They are usually, but not always, firm, round and painless and will appear around the location where the disease has entered the body. What is important to note, is that they will heal after about 3-6 weeks no matter if the person has been treated or not. However, if the infected person does not receive adequate treatment at this stage, they will progress into the secondary stage of the infection.

Secondary stage

This stage includes mainly skin rashes and/or sores in the mouth, vagina or anus. It typically starts with the development of a rash on one or more areas of the body 0 tthis can happen when the primary chancre is still healing or has healed completely. The rashes are usually not itching and may appear to be rough and red or reddish brown spots on both the palms of the hands and the bottoms of the feet. However, there are also rashes with a different appearance on different parts of the body, which may resemble rashes of an other disease. Sometimes the rashes associated with the secondary stage are very faint, which makes it hard to notice them.

Another symptom are large, raised, grey or white lesions known as condyloma lata which may develop in warm and moist areas such as the mouth, underarm or groin region.

In addition to rashes, symptoms of the secondary stage may include: fever, swollen lymph glands, a sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue.

Also these symptoms will go away with or without any treatment. But without the adequate treatment, the infection will progress to the latent or tertiary stage of the disease.

Latent stage

The latent stage of syphilis is also called the ‘hidden’ stage, as it is a period of time where there are no visible signs or symptoms of the disease. This stage can go on for years.

Tertiary Syphilis

This is very rare and develops in a subset of untreated syphilis infections. It can appear 10-30 years after the infection was first inquired and can be fatal. Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. The symptoms depend on the organ that is affected.


The problem with syphilis is that it can invade the nervous system at any stage of the infection and cause symptoms like headaches, altered behaviour, difficulty in coordinating muscular movements, paralysis, sensory deficits and dementia.

Ocular Syphilis

Can also occur at any stage of the infection and affects the eyes. It can cause vision changes and even permanent blindness.

How can syphilis be diagnosed?

A specific blood test is required for testing.

What is the treatment? 

Antibiotics are recommended, depending on the stage of the infection, the type of antibiotics can vary. The treatment will prevent the disease from progressing but it might not repair any damage already done. People who receive treatment must abstain from any sexual contact with their partners and must wait until the syphilis sores are completely healed. It is also important to notify the previous sex partners so that they can get tested themselves and receive treatment if necessary.

How can syphilis be prevented?

* Correct and consistent use of condoms can reduce the risk, however a syphilis sore outside the area that is covered can still allow a transmission.
* Only having sex with people who got tested and are ‘all clear’.

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