Syphilis Facts, Symptoms And Treatment Options



Syphilis is another common sexually transmitted disease, but it can be more dangerous than gonorrhea or Chlamydia because its health complications can be much more severe. It can be transmitted to both men and women through unprotected sex.

Syphilis prevalence in men and women

There were more than 100,000 cases of syphilis reported in the US in 2017 and approximately 30,000 of them are primary and secondary stages which are the most transmissible. Most of those were detected in gay, bisexual or MSM (men having sex with other men) relationships.

Approximately 900 cases of congenital syphilis were reported in 2017 as well. This refers to syphilis transmitted from mothers to newborn babies. Most of them were reported among black and Hispanic mothers.

Syphilis can be transmitted through vaginal, anal or oral sex

 People who have syphilis develop syphilitic sores which are also known as chancres. These sores can appear around the genitalia, inside the vagina, around or inside the anus as well as in close proximity to the mouth. Getting in direct contact with these sores can spread the virus from person to person and this can happen through vaginal, anal or oral sex. Mothers can also transmit the disease to their newborns during delivery.

Syphilis symptoms can appear between 10 and 90 days from the moment of infection, but the most typical timeframe is around 21 days.

Syphilis symptoms

This STD has various symptoms which can be confused with the symptoms of other diseases. It is characterized by several stages and the progression of the illness through these stages can take several weeks or months, depending on the patient.

Primary stage syphilis

A short period of time after the infection, one or more syphilitic sores or chancres will appear on the body. They usually show up around the genital organs or the anus. These sores are round, firm, and painless and they can last for approximately 3 to 6 weeks.

Chancres in various parts of the body heal themselves automatically, but if the infected person doesn’t receive treatment, syphilis can progress to a secondary stage of infection.

 Secondary stage syphilis

The most popular symptom of secondary stage syphilis consists of skin rashes on the mucous membranes next to chancres situated in various parts of the body. These rashes usually appear when the syphilitic sores are healing or after they are completely healed.

These skin rashes can appear as reddish or brown spots on palms and bottoms of feet, but in some cases, they are so small that they are barely noticeable and they don’t cause itching.

Another common symptom of secondary stage syphilis consists of gray or white lesions which usually develop in warm parts of the body such as inside the mouth or around the groin area. These lesions don’t cause pain and can be easily noticeable when fully developed.

Other symptoms associated with secondary stage syphilis include a sore throat, hair loss, swollen lymph glands, and fatigue. All the symptoms will eventually disappear on their own, but the virus remains in the body and it can progress to latent or tertiary stage syphilis if treatment is not promptly administered to the infected person.

Latent stage syphilis

This stage of syphilis progression doesn’t show any symptoms at all. The infected person has the virus in the body and can function normally, but the illness can still be transmitted to another person. Latent syphilis is defined as early (less than 12 months from the moment of infection) or late (more than 12 months).

Tertiary stage syphilis

This final stage of syphilis is the most dangerous because it can be life-threatening if the infected person doesn’t seek immediate medical care. It can appear approximately 10 to 30 years after the moment of infection and it is characterized by severe infections of joints, liver, blood, eyes, heart, and other organs.

Potential complications – ocular syphilis and neurosyphilis

One of the worst things about the syphilis virus is that it can quickly invade the nervous system and wreak havoc in the body at any moment of infection. When the syphilitic bacteria affect the nerves, the resulting illness is called neurosyphilis.

This health condition can lead to numerous complications such as paralysis of certain limbs, altered behavior, dementia, difficulties with muscle coordination, etc.

Another potential complication of syphilis consists of ocular syphilis. This basically means that at any stage of the infection, the virus can alter the visual system and cause blurred vision and even complete blindness. Patients who are at high risk for syphilis such as men who have sex with other men or HIV patients should be tested for ocular syphilis by their healthcare providers to avoid dangerous complications.

Syphilis can be transmitted by infected mothers to newborn babies

Pregnant women should be tested for syphilis early on during the gestation period. If the first test is positive then subsequent tests should be done in the third semester as well as before delivery. There is a 40% chance for the baby to die after birth if the infected mother transmitted this disease to the newborn, depending on how long ago the infection occurred.

Mothers who have syphilis and are about to have a baby are treated with penicillin therapy to help to eliminate the virus from the body. The success rate of penicillin is approximately 98% and those women who are allergic to it can receive penicillin desensitization before treatment.

If mothers are not treated for syphilis before giving birth, the baby can develop serious complications afterwards. For example, most babies have problems developing correctly, experience seizures or they simply die. It is paramount to test pregnant women for syphilis to avoid a totally preventable loss of lives.

Diagnosing syphilis

Diagnosing syphilis can be easily done using two types of blood tests - nontreponemal test and treponemal test. If both of these tests are positive then the patient in question has syphilis. The tests are efficient for men and women of all ages as well as for newborns that are suspected to have syphilis from their mothers.

Syphilitic patients are more likely to get HIV in the future

Approximately half of the men who have sex with other men who have primary or secondary syphilis are infected with the HIV virus in the United States. Patients who already have syphilis are also up to 5 fold more likely to get the HIV virus, in comparison with healthy individuals.

Syphilis treatment options

This dangerous sexually transmitted disease can be cured using different types and dosages of penicillin. For example:

  • Patients who have primary or secondary stage syphilis should get Benzathine penicillin G 2.4 million units injected in a single dose
  • Patients who have latent syphilis should get Benzathine penicillin G2 million units injected in 3 doses
  • Patients who have neurosyphilis or ocular syphilis should get Acqueous crystalline penicillin G 18-24 million units every day for up to 14 days

Although the treatment can be effective in curing syphilis, the damage this disease caused to the body of an infected patient will not be cured.  Infected patients who were treated and healed can get syphilis again if they have unprotected sex with an infected partner.

Patients who receive treatment for syphilis should stop any sexual activity until the virus is completely eliminated from the body. Additionally, infected patients should inform previous sexual partners about their STD so that those in question can receive adequate medical treatment to prevent syphilitic complications.

Testing for syphilis should be done by pregnant mothers, men who have sex with other men (MSM), people who are infected with the HIV virus as well as patients who take PrEP for HIV prevention. Lastly, anyone who is sexually active should do routine syphilis tests, just as a safety measure.

Syphilis prevention methods

As with any other sexually transmitted disease, using a latex condom while having sex is paramount to reduce the likelihood of getting syphilis from an infected partner. However, syphilitic sores can be present outside the area protected by the condom, so extra caution is necessary during the intercourse.

One of the best ways to prevent syphilis and other STDs is to be involved in a monogamous relationship with a healthy partner.

Syphilis summarized

  • Syphilis is a dangerous STD which can affect sexually active men and women of all ages
  • There were approximately 100,000 cases of syphilis in the US in 2017
  • Syphilis develops in 4 stages – primary, secondary, latent, and tertiary. Each stage has different symptoms and the disease can progress for decades, causing a wide variety of health complications
  • Common symptoms of syphilis include sores (chancres), skin rashes, gray lesions in warm areas of the body as well as hair loss, fatigue, and multiple infections in the joints, liver, heart, and eyes during the later stages of the disease
  • Syphilis can be transmitted from infected mothers to babies, causing serious complications which can result in the death of the newborn
  • Testing for syphilis can be done using 2 different tests - nontreponemal test and treponemal. If both are positive, the patient has syphilis
  • This STD can be treated with different types of penicillin in various dosages. It can be healed, but one can get syphilis again from an infected partner
  • People who have syphilis are up to 5 times more likely to get HIV in comparison with those who don’t have syphilis
  • Using latex condoms is one of the most popular ways of preventing syphilis while having vaginal, anal or oral sex.


The Comprehensive STD Panel Includes the Following Tests: Chlamydia Test, Gonorrhea Test,  HIV-1 and HIV-2 Tests, Herpes-type 1 and herpes-type 2 Tests, Hepatitis A Test, Hepatitis B Test, Hepatitis C Test, and Syphilis Test.