Syphilis 101: Basics You Need to Know

What is syphilis?

Syphilis is a sexually transmitted infection (STI) affecting people of all sexes. Syphilis can be cured with medication.

Infection with syphilis has four stages: primary, secondary, latent, and tertiary. There are different symptoms associated with each stage of syphilis infection.

Left untreated, syphilis can cause significant health problems including organ damage and even death. Early treatment with antibiotics is essential to prevent these complications.

What are the symptoms of syphilis?

The symptoms of syphilis depend on the stage of infection.

In the primary stage of syphilis, one or more sores called chancres appear in the area where you were infected. Chancres are round, firm, and generally painless. Chancres may appear on the vulva, penis, scrotum, anus, or in or around the mouth. Chancres typically last for three to six weeks before resolving on their own. Even when the sore goes away, syphilis remains in the body and will progress to later stages unless treated with medication.

In the secondary stage, a rash involving the palms and soles of the feet is typical. The rash usually doesn’t itch and may be hard to see. Flu-like symptoms such as fever, fatigue, sore throat, body aches, or headache are also common. Additional symptoms can include sores of the mouth, anus, and vagina as well as weight loss and patchy hair loss. These symptoms will resolve on their own, but the disease will continue to progress without appropriate treatment.

Between the secondary and tertiary stages of syphilis, the disease enters a latent stage that lasts several years. During this stage there are no visible signs or symptoms of infection. Not all people with untreated syphilis will go on to develop tertiary syphilis after latent infection.

Tertiary stage syphilis can cause serious health issues including blindness, paralysis, and damage to the brain, heart, and blood vessels. It is critical to start treatment as soon as possible after infection with syphilis due to the seriousness of the symptoms associated with this stage.

How can you catch syphilis?

You can get syphilis through vaginal, anal, or oral sex with someone who is infected. Prolonged contact with infected areas, including deep kissing, can also result in infection. Syphilis cannot be spread through casual contact such as shaking hands.

Prior infection with syphilis does not protect you from getting syphilis again.

Syphilis can be spread to babies during pregnancy. Infection with syphilis may cause low birth weight, premature delivery, stillbirth, and many other dangerous complications. Pregnant people with syphilis should talk with their doctor.

Is syphilis treatable/curable?

Syphilis can be cured with antibiotics. Even if symptoms improve, the infection will not go away on its own.

Taking every dose of the antibiotics as prescribed is critical to ensure the infection is cured. Talk with your doctor if your symptoms do not go away within a few days after completing your antibiotic course.

It’s important to abstain from sex for seven days following your last dose of antibiotics to prevent spreading syphilis to any sexual partners.

If you have syphilis, your doctor may be able to prescribe antibiotics for your sexual partner(s) without needing to see them.

Infants infected with syphilis can be treated with antibiotics, though some effects of infection may be irreversible.

Preventing syphilis transmission

Use of condoms and other barrier devices during vaginal, anal, and oral sex can help reduce spread of syphilis but do not completely eliminate the risk.

Because syphilis chancres are often painless and can appear in locations you don’t frequently examine, you or your partner may have syphilis without knowing it. Regular testing is recommended for people who have unprotected sex or engage in other activities that put them at higher risk for syphilis infection.

There is no vaccine against infection with syphilis.

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Marvin So

Marvin So is an M.D. candidate at the University of Minnesota School of Medicine. He is avidly trying to explore Minnesota via bike and canoe.

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