Syphilis FAQs

A disease of the past? No. Syphilis is alive and kicking despite effective treatments
What is it?

A thankfully uncommon but very unpleasant sexually transmitted disease caused by a bacterium.

What are the main symptoms?

The symptoms often follow four phases.

  1. In the first (primary) stage one or more painless sores usually appear on the throat, penis, testicles or around the anus. You'll probably have swollen glands. The infection can be spread by sexual contact at this stage. The sores clear up themselves in 2—6 weeks, but the infection does not.
  2. In the secondary stage (up to six months after the primary symptoms) a non-itchy rash may appear on the palms of the hands and soles of the feet. The rash usually appears as brown areas that are about the size of a penny. Active bacteria are present in this rash and the infection may be spread by any contact, sexual or non-sexual.
  3. If untreated, the disease now enters a "latent" phase during which the symptoms settle and the disease is no longer contagious.
  4. During late (or tertiary) stage infection (often lasting many years) serious damage to your heart, brain and nervous system can occur. Left untreated, late-stage complications will develop in 40% of those infected.
What's the risk?
  • In 2012, there were 2,978 cases of infectious syphilis diagnosed in genitourinary medicine (GUM) clinics in England.
  • Between 2003 and 2012 diagnoses of syphilis increased by 61% in men.
  • The total number of diagnoses is the highest since the mid-1950s.
What causes it?

An organism that is similar to a bacterium, and is called Treponema pallidum. Syphilis can be transmitted through oral sex as well as penetrative sex.

How can I prevent it?

Practising safer sex and reducing the number of sexual partners will help reduce the risk of infection.

Should I see a doctor?

Yes. Your best bet is to visit a specialist GUM clinic, which can provide a confidential service.

Diagnosis is made from a blood sample and, if you have a blister, from a swab.

In cases thought to be in the later stages you may have to undergo a lumbar puncture, which is a procedure to remove spinal fluid to check for nerve damage this is painful and often causes a severe headache.

What are the main treatments?

Penicillin (Bicillin) for primary and secondary infection for 10—14 days, injected into the muscle. For those allergic to penicillin, doxycycline once daily for 14 days, or tetracycline or erythromycin four times a day for 14 days.

For late-stage disease, the treatment course lasts up to 21 days.

How can I help myself?
  • Don't have unprotected sex until you've finished your treatment and your partner has also been tested. This will give your body time to heal and prevent the risk of re-infection.
  • A little salt-water solution will help the sores to heal.
  • Keep the affected area clean and dry.
What's the outlook?

Syphilis can be easily and effectively treated. Left untreated, however, it is potentially a very serious condition.


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Date published 08/04/14
Date of last review 08/04/14
Date of next review 08/04/17


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