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What is syphilis?

Syphilis is a bacterial sexually transmitted infection (STI). Not everyone with syphilis has symptoms, but if you do get them, one of the first ones is a sore (also called a lesion or chancre) on, or in, your genitals, anus, rectum, and/or lips, mouth and throat. Sometimes these sores are noticeable.

If left untreated, syphilis can lead to serious health complications. The only way to know if you have syphilis is to take a syphilis test. Syphilis can be cured, and there are ways to lower your chances of getting and passing on syphilis.

How does a person get syphilis?

Syphilis is typically passed through direct contact with a sore. Direct contact usually happens through:

  • vaginal (frontal) sex
  • anal sex
  • oral sex (including oral-anal)

Syphilis can also be passed to an infant through the placenta during pregnancy or through contact with a sore during delivery.

Less commonly, syphilis may be passed through:

  • sharing sex toys
  • deep kissing
  • sharing equipment to inject drugs

A person with syphilis can pass it on to another person, even if they do not have any symptoms.

All people who are sexually active or use injection drugs can get syphilis. Talk to a healthcare provider about getting tested.

How can I protect myself and others?

To lower the chance of getting or passing on syphilis, you can use:

  • a condom correctly every time you have anal or vaginal sex
  • a condom or oral dam correctly every time you have oral sex
  • condoms on sex toys, if sharing
  • new needles, and other drug use equipment, for every injection

There is no vaccine to protect against syphilis.

What symptoms and health complications can happen?

Many people with syphilis do not have symptoms at all. Untreated syphilis progresses in stages, and potential symptoms look different at each stage.

Primary syphilis: A painless sore may appear on or in the vagina, penis, anus, rectum, and/or lips and mouth two to six weeks after infection. Sometimes the sore is noticeable. The sore may heal with treatment or on its own. Nearby lymph nodes may also become swollen. 

Secondary syphilis: A non-itchy rash may appear, especially on the palms of the hands and soles of the feet. This can happen two to twelve weeks after infection and heals on its own. More sores may appear, and other symptoms may also occur, including fever, headache, muscle ache, lack of appetite, fatigue and hair loss. For those who experience symptoms in the primary or secondary stage, they may be mild and can be confused with other illnesses.

Tertiary (latent) syphilis: Without treatment, secondary syphilis may progress to tertiary syphilis. This can develop anywhere from two to thirty years after infection. Even though there may not be any symptoms, this stage causes the most harm to the body, possibly leading to injury of the brain, eyes, ears, skin, bones, liver, kidneys and heart.

Neurosyphilis: This is when syphilis affects the brain. This may cause changes to personality and problems with memory and thinking clearly. Neurosyphilis can occur at any stage of syphilis.

Can syphilis affect my baby?

Syphilis can be passed to an infant during pregnancy. However, early and effective treatment can help prevent this. Syphilis can cause miscarriage, premature birth, stillbirth or the death of a newborn. Many infants born with syphilis have no symptoms, although some may have a rash. Without treatment, infants born with syphilis may develop serious health issues.

How do I know if I have syphilis?

The only way to know for sure is to get tested. A healthcare provider can do the test. It is usually a blood test, but in some cases a swab is used to get fluids from a sore. Anyone who thinks they may have been exposed to syphilis should get tested. If you think you might be at ongoing risk for syphilis, it is a good idea to get tested regularly.

All pregnant people should be tested for syphilis during pregnancy. People who are at ongoing risk should be tested regularly during pregnancy.

When you take a syphilis test, it is a good idea to get tested at the same time for other sexually transmitted and blood-borne infections (STBBI), including HIV, gonorrhea and chlamydia. Other STBBI can be passed on in the same ways as syphilis. Talk to a healthcare provider about how often you should be tested for syphilis and other STBBI.

What if I have syphilis?

For most people, syphilis can be cured with a single course of treatment. Wait until you finish treatment and until the symptoms disappear before having sex again. If you have a lesion or rash after completing treatment, wait until the symptoms disappear before having sex again.

Can I get syphilis again?

Yes. Having syphilis before does not protect you from getting it again. This is why it is important for all sexually active people, pregnant people, and people who use injection drugs to get tested for syphilis regularly.