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Syphilis

Signs, symptoms and treatment

Syphilis is an infection which is relatively harmless if caught and treated early, but potentially fatal if left untreated, leading to stroke, paralysis, and blindness.

Syphilis is one of the less common sexually transmitted infections in the UK, but the number of cases of new diagnoses has risen significantly in the past decade.

There are four stages of syphilis (primary, secondary, tertiary, and latent). The first three carry different sets of symptoms, and in the latent stage, you are carrying the infection but not showing symptoms. In all stages, it is possible that the symptoms will be mild and difficult to recognise.

Primary stage

In the first stage, known as ‘primary syphilis’, symptoms usually develop 2 – 3 weeks after infection. The main symptom is a chancre – a small, painless sore or ulcer that not be noticeable. It typically appears on the penis, vagina, or anal area, though can also develop on or around the mouth, fingers, or buttocks. There may be just one sore, or several. You may also have swollen lymph glands in your neck, underarms, or groin.
This initial stage of infection can last up to 8 weeks. Without treatment, it will progress to the second stage.

Secondary stage

The symptoms of secondary stage syphilis include:

  • A rash – anywhere on the body, but most often on the palms or soles
  • Small skin growths (similar to genital warts) – on the vulva or around the anus
  • White patches inside the mouth
  • Flu-like symptoms (fatigue, headache, joint pain, fever)
  • Swollen glands
  • Patchy hair loss

Tertiary stage

The tertiary stage of syphilis can take years to develop. It is systemic and life-threatening, with symptoms such as:

  • Meningitis
  • Stroke
  • Dementia
  • Loss of co-ordination
  • Numbness
  • Vision problems or loss
  • Heart problems

Treatment for syphilis is usually simple, with a short course of antibiotics, prescribed by a doctor. You will need to get tested in order to receive the prescription. The kind of antibiotics used will depend on how long you’ve had the infection. The same treatment is given for pregnant women who have syphilis, and it is safe for them to use.

For an infection of two years or less, an injection of penicillin into the buttock is given. If you are allergic to penicillin, a 10 – 14 day course of tablets is given.

If you have had the infection for more than two years, you will be given three penicillin injections, at weekly intervals, or a month of tablets.

If the infection is very serious, the penicillin injection schedule is increased to daily for two weeks, or a month of tablets.

A blood test is recommended after treatment in order to ensure that the infection has cleared up.

Will I experience any side effects?

Side effects are a possibility (around 2 in 5 people experience them), but if you do experience them they should clear up in 24 hours. Side effects of syphilis treatment include:

  • Fever
  • Headache
  • Muscle or joint pain

Causes

The infection is caused by the Treponema pallidum bacteria.

Syphilis is most commonly spread through close contact with an infected sore, which usually happens during sexual intercourse (vaginal, anal, or oral). Sharing sex toys or injecting equipment can also lead to infection. Men who have sex with men are thought to be most at risk. It can also be passed on by a pregnant mother to her child, which is why all pregnant women are screened for syphilis as part of routine antenatal blood tests.

What to do next

Our doctors can help you understand any current symptoms and advise on any concerns regarding testing or test results. Please come and see us to discuss any aspect of your sexual health.

FAQ

What is the risk of catching syphilis?

Diagnoses of syphilis increased 61% between 2003 and 2012, with the total number of diagnoses currently being the highest that it’s been since the 1950s. High-risk practices for catching and spreading syphilis include unprotected sex (penetrative and oral), sharing sex toys, and sharing needles. The risks are higher among men who have sex with men.

When was the first known case of syphilis?

The first well-recorded outbreak of the disease we now call syphilis in Europe was in 1495. The disease was much more severe then, with more extreme symptoms and much higher mortality rates. Some blame the European spread of the disease on Christopher Columbus’ voyage to the Americas.

Where does the name ‘syphilis’ come from?

The name was coined by Italian physician and poet Girolamo Fracastoro in a poem dedicated to the disease, in 1530.

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Please note that Walk In Clinic is a private medical centre and not an NHS service.