Key Facts
  • Syphilis is passed through sex or direct skin-to-skin contact.
  • If you have a sore on your genitals, see your health care provider.
  • Syphilis is a sexually transmitted infection that needs to be treated early with antibiotics to avoid serious problems.
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  • Young men's version of this guide

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Syphilis is a sexually transmitted infection caused by a spirochete (a very small organism). It can affect the entire body and needs to be treated with antibiotics early to avoid serious problems.

How common is syphilis?

The rate of syphilis is currently rising. According to the Centers for Disease Control and Prevention, in 2018, there were 115, 045 reported cases of syphilis in the US, as compared to 101,584 cases in 2017.

How is syphilis spread?

Syphilis is passed from person to person through direct contact with the syphilis sore or moist rash. It is usually passed through sexual contact, including vaginal, anal, and oral sex. Pregnant individualswith syphilis can pass it on to their babies before birth.

Am I at risk?

Anyone having unprotected sexual contact with an infected person can get syphilis. Having more than one sexual partner increases your risk.

What are the symptoms of syphilis?

You can have syphilis without any symptoms and still pass it on to others. Early symptoms are very similar to those of many other diseases. Syphilis has 4 stages of symptoms- primary, secondary, latent, and tertiary.

Stage 1 – PrimaryA painless sore (called a chancre- “shan-ker”) may show up at the area where the germ first entered the body, usually on the penis, anus, vulva, mouth, lips, or hand. It is firm and round and usually appears anywhere from 9 to 90 days (average 21 days) after exposure. Sores on the penis or vulva may not be noticed and can disappear on their own within 3-6 weeks. However, even with no sore you can still carry the germ and pass it on to others.

Stage 2 – SecondaryDuring this stage, you may have flu-like symptoms 3 weeks to 6 months after infection. At this time, you can also get a rash (usually brown sores about the size of a penny) on the palms of the hands, soles of the feet, or the groin area. The rash may be over the entire body. Bacteria live in the rash, so any physical contact (sexual and nonsexual) with the rash can spread the infection. The rash usually heals within 2-6 weeks and can go away without treatment. The second stage can also include:

  • Fever
  • Headache
  • Sore throat
  • Swollen lymph glands
  • Patchy hair loss
  • Muscle aches
  • Mucous spots or sores in the mouth
  • Tiredness
  • Lumps or warts in warm, moist areas

Stage 3 – LatentThis stage usually appears when syphilis is untreated and “hidden.” A person can be in this stage of the infection for years. It can go on to stage 4, which can be serious.

Stage 4 – TertiaryA few people develop tertiary, or late syphilis. This is when the bacteria damage the heart, eyes, brain, nervous system, bones, joints, or other parts of the body. This stage can occur 10-30 years after first contact with the infection, can last for years, and can cause death.

Tertiary syphilis can cause:

  • Mental illness
  • Blindness
  • Heart disease
  • Paralysis
  • Brain damage

Should I get tested for syphilis?

You should talk to your health care provider about being tested for syphilis if…

  • You are pregnant
  • You are having unprotected sex
  • You have signs or symptoms of syphilis
  • You have had anal, oral, or vaginal sex with someone diagnosed with syphilis
  • You have been diagnosed with another sexually transmitted infection
  • You are using IV drugs or having sex with someone who uses IV drugs

How is syphilis diagnosed?

Syphilis can be diagnosed by a physical exam, studying a sample of the fluid taken from a sore under a microscope, or more commonly a blood test.

Where can I get tested and treated for syphilis?

You can be tested and treated for syphilis at your health care provider’s office, an STI clinic, a hospital clinic, Planned Parenthood, or other family planning health centers and health departments.

How is syphilis treated?

Syphilis must be treated with antibiotics. Syphilis is usually treated with penicillin, but other antibiotics can be used for patients allergic to penicillin. Some people with early stage syphilis may get a mild fever, headache, or a swelling of sores after treatment. This usually isn’t serious. After treatment, health care providers will continue follow up appointments for about a year to ensure the treatment worked. You need to treat syphilis early, because damage caused by the disease cannot be undone.

Is there a connection between syphilis and HIV?

The genital sore (chancre) caused by syphilis makes it easier to get and pass on HIV infection. You are 2 to 5 times more likely to get HIV (if exposed to it) if you have syphilis.

How can I prevent spreading syphilis?

  • If you’re diagnosed with syphilis, stop having sex right away.
  • Don’t have sexual contact or any direct contact – even with a condom – until you’ve finished treatment and your health care provider says it’s OK to have sex.
  • If you find out you have syphilis, you need to tell your sexual partner(s) to get tested and treated quickly. Your State Health Department can help to get your sexual contacts treated.

How can I avoid getting syphilis?

The fewer sex partners you have, the less chance you have of getting syphilis. If you have sex, make sure you use a latex condom (polyurethane if you are allergic to latex). However, using condoms when sores are present doesn’t protect against the disease. The condom may not cover sores on the body that can pass on the bacteria.

Can you get syphilis again?

Yes. Having syphilis once doesn’t protect a person from getting it again. Because syphilis sores can be hidden in the vagina, rectum, or mouth, it may not be obvious that your sexual partner has syphilis.