Syphilis

What are the symptoms?

Primary Stage: The first stage happens within 10 days to 3 months of getting syphilis. During this first stage, there is usually one sore (called a chancre) on the penis, anus, or in the throat, but there can also be many. A chancre is small, round, and painless, so people don’t usually even know it is there, especially if it is on the anus. After about 3-6 weeks the sore heals by itself, but syphilis is still present in the body unless the person is treated with antibiotics.

Secondary Stage: The second stage of syphilis happens one week to six months after the chancre appears, though sometimes this stage occurs before the first stage is resolved, especially in people living with HIV. In this second stage, there is a rash that usually doesn’t itch that can appear on many different parts of your body, including the palms of the hands and soles of the feet. A person with the second stage of syphilis may also feel tired, have patchy hair loss, sore throat, and head and muscle aches. These symptoms will also go away by themselves, but if you are not treated, you will still have syphilis.

Latent Syphilis: This stage begins after the secondary stage if the syphilis hasn’t been treated. A person can have no symptoms for many years while remaining infected and can develop severe complications later in life. Latent syphilis means that a person still has syphilis but that they don’t have any physical symptoms; the only way this is diagnosed is by a blood test.

Tertiary Syphilis: In the later stage of syphilis major parts of the body may be affected, such as the liver, heart, blood vessels, bones, and nerves. Brain damage, loss of balance, and severe shooting pains in the legs can result.

Neurosyphilis (syphilis involving the brain and central nervous system): Persons with syphilis can suffer damage to the brain, spinal cord, and key nerves at any stage of syphilis infection. If you have syphilis, your medical provider will examine your nervous system to ensure there are no signs of neurosyphilis. If any symptoms or signs are found, further testing can be performed to check for this condition. Neurosyphilis requires a more intensive course of medication to ensure effective treatment.

How do I know if I have it?

If you think you may have been exposed to syphilis, see your medical provider. He or she can do a test to see if you have it or not.

Can I cure it?

Yes. Syphilis can be cured with antibiotics. If you test and treat in time, you can avoid later complications of the infection.

Why should I care?

Syphilis is easy to miss, and it can do serious damage to the whole body. But even if you don’t see any symptoms, having it can still make it easier to catch HIV (or to transmit if you are HIV-positive). Getting tested and treated can literally save your life.

Are there any long-term effects?

If a person doesn’t get antibiotics until the late stage of syphilis, they could suffer permanent damage, including brain damage. While late-stage syphilis can still be cured with antibiotics, the damage cannot always be undone.

When a person has HIV and syphilis together, the syphilis can be more harmful to them than if they did not have HIV; it can also make their HIV disease worse. That is why it is especially important to be tested regularly for syphilis if you have HIV and are having sex.

How do I prevent it?

Syphilis can be transmitted by skin contact with the sores, which are usually found on the genitals or rectum. This means it can be transmitted during anal and oral sex, as well as by genital rubbing. Latex condoms help prevent the transmission of syphilis, but don’t completely prevent it because the sores could be in places the condom doesn’t cover.

Syphilis can also be transmitted by skin contact with the second stage rash, which is often found on the hands or feet, but can appear anywhere on the body.

I was recently told I have syphilis and I was treated with antibiotics. Is there anything else I should do?

Syphilis infection can last for years if untreated. If you’re not sure exactly when you got infected, it is a good idea to tell all your current and former sex partners from the last three months (if you had primary syphilis), six months (if you had secondary syphilis), or one year (if you had early latent syphilis) to get tested or treated. You can send an anonymous message to tell your partners they need to be tested by visiting here: www.inspot.org.

You will also be contacted by a public health worker who will work with you to make sure you and your partners receive proper antibiotic treatment. Cooperating with the health worker will prevent many other people from getting syphilis. Please do your part.

For more information or to find an STD clinic near you go to www.hivtest.org or www.inspot.org.

More information, including symptom images (graphic) are available at STD Checkup.