​What you need to know​​

Syphilis basics

​What is syphilis and how do you get it?

Syphilis is a curable, bacterial sexually transmitted infection (STI).  A syphilis infection may increase one's risk of becoming infected with HIV. Syphilis can cause serious health complications even years after becoming infected.

Anyone who is sexually active can get syphilis through vaginal, anal, or oral sex without a condom. You get syphilis by direct contact with a syphilis sore (called a chancre) during sex. Most commonly the sores are at sites of sexual contact. Syphilis can also spread from an infected pregnant person to their unborn baby.​

You cannot get syphilis through casual contact with objects, such as:

• Toilet seats

• Doorknobs

• Swimming pools

• Hot tubs

• Bathtubs

• Sharing clothing or eating utensils
  
  

​There are four stages of syphilis: primary, secondary, latent, and tertiary. Each stage has different signs, symptoms, and treatments. At any stage, syphilis can infect the brain and nervous system, the eye, or the ear. Treatment will stop your infection from moving to the next stage. It will also prevent passing it to someone else.

Primary Stage

At this stage one or many sores will appear where syphilis enters the body.  A sore is called a chancre. These sores can occur anywhere, but are usually found around the:

• Penis

• Vagina or front hole

• Anus or back hole
  

• Rectum

• Lips or in the mouth

Sores are usually firm, round, and painless. The sores may not be noticed. They usually last 3‑6 to six weeks and will heal on their own. Even after the sores go away, syphilis is not cured. Treatment is still needed to stop the infection from moving to the next stage.

Secondary Stage

This stage usually starts with a rash. The rash can show up when your primary sores are healing or several weeks after the sores have healed.

The rash:

• Usually won't itch

• May be so faint that it isn't noticed

• Found on the palms of your hands and/or the bottoms of your feet

• Looks dry or rough

• Looks red to reddish-brown

Other symptoms may include:

• Mouth sores

• Wart-like growths around the vagina, penis, or anus

• Fever

• Swollen lymph glands

• Sore throat

• Patchy hair loss

• Headaches

• Weight loss

• Muscle aches

• Fatigue (feeling very tired)

The symptoms from this stage will go away on their own. But syphilis is not cured. Treatment is needed to stop the infection from moving to the next stage.​​

Latent Stage

There are no visible signs or symptoms of infection. Without treatment, syphilis will remain in your body. Although you will not have symptoms during this stage, syphilis can still cause complications.

Tertiary Stage

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it occurs 10 to 30 years after the infection began. Tertiary syphilis is very serious and can result in death. It may damage many different organ systems including:

• Nerves

• Brain

• Blood vessels

• Heart

• Skin

• Bones

• Liver​​
  
  

Neurosyphilis, ocular syphilis, and otosyphilis

Without treatment, syphilis can spread to the brain and nervous system, the eye, or the ear. This can happen during any of the stages.

• Brain (neurosyphilis)

• Severe headache

• Muscle weakness and/or trouble with muscle movements

• Changes to your mental state

• Trouble focusing

• Confusion

• Personality change

• Dementia

• Problems with memory

• Problems with thinking

• Decision making

• Eyes (ocular syphilis),

• Eye pain and/or redness

• ​Changes in your vision or even blindness

• Ears (otosyphilis)

• Hearing loss

• Ringing, buzzing, roaring, or hissing in the ears (tinnitus)

• ​Dizziness or vertigo (feeling like you or your surroundings are moving or spinning)
  
  

How do I avoid getting syphilis?

If you are sexually active, do the following to lower your chances of getting syphilis:

• Have an honest and open conversation with your health care provider. Ask them if you should get tested for syphilis or other STIs.

• Have sex only with partner(s) who have been tested and who do not have syphilis.

• Use condoms every time you have sex.

• ​​​​Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

• If you think you were exposed to a syphilis sore or someone who has tested positive,  tell your health care provider.
• You may need treatment to prevent developing syphilis yourself.
• Ask about doxy PEP (Doxycycline Post-Exposure Prophylaxis).
• ​​Doxy PEP is medicine you take within 72 hours after having sex. It reduces your risk of infection from syphilis, chlamydia, and gonorrhea.

Get Tested

Testing is the only way to know if you are infected. Regular testing is the best way to identify infection early. Most of the time, health care providers will use a blood test to test for syphilis. Some will diagnose syphilis by testing fluid from a syphilis sore.

Early treatment can prevent complications from syphilis. Speak with a health care provider to determine how often you should get tested. ​​