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What is syphilis?

Syphilis is a serious bacterial infection. It is usually passed from one person to another by sexual contact. If it is not treated, syphilis can lead to permanent brain, nerve, and tissue damage.

How does it occur?

The bacteria that cause syphilis enter the body through an opening such as the vagina, mouth, penis or rectum. They can also enter through a cut or break in the skin.

During the early stages of syphilis, sores form on the body, usually near the genitals. If you have sex with someone who has these sores and your body touches the sores, you may get infected with syphilis. When you touch a sore on an infected person, some of the bacteria may stay on your skin. If the bacteria then get near any moist area of your body (such as the vagina, mouth, or rectum) or on any cuts or breaks in your skin, you may get syphilis. Once inside the body, the bacteria spread quickly through the bloodstream.

If a woman has syphilis during pregnancy, the infection can spread to the baby. It can cause serious problems for the baby, sometimes even death.

What are the symptoms?

The symptoms of syphilis depend on the stage of the disease. During the first stage, smooth, red, painless sores called chancres appear. People usually get chancres near the genitals, but they can form anywhere on the body. Women may not know they have a chancre if it is inside the vagina. Chancres on the penis can usually be seen. These painless sores may appear 10 days to 3 months after contact with an infected person. The sores last 3 to 6 weeks.

If you are infected with syphilis and you do not get treatment, the disease will develop into the second stage. This second stage is called secondary syphilis. It begins 6 to 12 weeks after contact with an infected person and may last for weeks to as long as a year. Symptoms during the second stage of syphilis can include:

  • a pink or red, bumpy, scaling skin rash that does not itch and may come and go
  • brown sores about the size of a penny
  • swollen lymph nodes ("glands")
  • flu symptoms such as fever, body aches, sore throat, headache, tiredness, and loss of appetite
  • hair loss in clumps, causing patchy baldness
  • gray or pink patches of fatty tissue in damp areas of the body (also highly infectious)
  • wartlike growths in the anal area.

The rash may include spots on the palms of the hands and soles of the feet. You can easily infect other people if they have contact with the rash or the gray or pink patches of fatty tissue. The rash usually heals within several weeks or months.

Sometimes the symptoms of the second stage are so mild that the disease moves into the next stage without your knowing that you need to get care.

Often the second stage of syphilis is followed by a latent period. During latent syphilis you don’t have any symptoms even though you have not been treated for the disease. This latent period may last a few years or it may last the rest of your life.

One in three people who have latent syphilis develop the third stage of syphilis. This third stage is called tertiary syphilis and starts anywhere from 2 to 30 or more years after the second stage. During this stage, the disease can affect your brain, blood vessels, and heart. It can lead to severe heart disease, brain damage, paralysis, and death.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Your provider will look for chancres on the skin, including the vagina, cervix, penis, and anal area. If you have sores, scrapings from the sores will be examined under a microscope to look for the syphilis bacteria. Your provider will also test a sample of your blood.

How is it treated?

Syphilis is treated with penicillin. If you are allergic to penicillin, your healthcare provider may prescribe other antibiotics. Because other antibiotics may not work as well as penicillin, you will need to be checked after treatment.

If you are in a relationship, you may take your partner to your healthcare provider for education and treatment.

Cases of syphilis are required by law to be reported to the local health department. The clinic staff will ask about people with whom you have had sexual contact. These people will then be told that they have had contact with someone who has syphilis. This can help protect them against the infection. (Your name will not be given.) The Centers for Disease Control and Prevention (CDC) follows these infections so they can find epidemics in the early stages. This allows the CDC to take steps to prevent new infections and to get as many people as possible checked and treated.

How long will the effects last?

Without treatment, the symptoms and effects of syphilis can last from a week to a lifetime. If syphilis is treated with antibiotics during an early stage, the symptoms go away after several weeks and the disease is cured. If the infection is not treated but your symptoms go away after the first stage, you will still be at risk of having second or third-stage syphilis. During the third stage of syphilis, antibiotics can still be used to kill the bacteria. However, any damage already done to the blood vessels, brain, or heart will not go away.

How can I take care of myself?

  • Follow your healthcare provider's instructions and take all of your medicine as prescribed. Be sure to tell your provider if you are allergic to penicillin or other medicines.
  • Keep all follow-up appointments.
  • Ask your provider if you need to be tested for other sexually transmitted diseases.

What can be done to help prevent syphilis?

If you have syphilis, you can help prevent spread of the infection if you:

  • Tell everyone with whom you have had sex in the last several months about your infection. Or you can ask the clinic staff to tell them. Your sexual contacts need to be treated even if they don’t have any symptoms. Do not have sex until both you and your partner have finished all of the medicine and your provider says it's OK.
  • Do not expose other people to your body fluids and open sores. Do not have sexual intercourse or other intimate physical contact with anyone until you have been treated.
  • Wash your hands after you use the toilet and before you touch any food, dishes, or utensils.

If you do not have syphilis or any symptoms but you have had sex without a condom, see your healthcare provider to be checked for infection.

If you have been raped and are at risk of having been infected, you should be tested and treated for STDs.

You can lower your risk of getting syphilis from someone else if you:

  • Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
  • Have just 1 sexual partner who is not sexually active with anyone else. Make sure your partner has been tested for syphilis and other infections.
Developed by Phyllis G. Cooper, RN, MN, and RelayHealth.
Published by RelayHealth.
Last modified: 2010-09-03
Last reviewed: 2010-01-04
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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