Last Updated February 2021 | This article was created by editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

What is syphilis?

Syphilis is a serious infection passed from one person to another through sexual contact. It is caused by a bacteria (germ). You can get syphilis by touching the blood or sores of a person who has syphilis, especially sores on the person’s mouth, penis, vagina, or anus (the opening to the rectum).

Should I tell my sex partner I have syphilis?

Yes, you should tell your partner that you have syphilis. Then your partner can find out if they also have syphilis. If you’re not comfortable telling your sex partner, your doctor can help you. In some places, the local health department can tell sex partners that they may have syphilis and should get a test. If you wish, your name can be kept secret.

Symptoms of syphilis

The first stage of syphilis is called primary syphilis. It usually occurs 10 days to 3 months after exposure. In men, the first sign of syphilis may be a sore on the penis. In women, the first sign may be a sore around or inside the vagina. You might not even notice the sore, because syphilis sores do not usually hurt. The sores go away after 3 to 6 weeks. You may also have enlarged lymph nodes (glands) in your groin.

If you don’t treat syphilis early, it spreads from the sore into your blood. When syphilis gets into your blood, it can move into the secondary stage and cause many problems. The most common sign is a rash. The rash is usually reddish-brown and can occur anywhere on the body (even on the palms of the hands and the soles of the feet). The rash appears 2 to 10 weeks after the appearance of the sores. Other signs of secondary syphilis include fever, swollen lymph nodes, sore throat, body aches, sores in the mouth, and fatigue.

After recovering from the secondary stage of syphilis, the disease can move into the latent stage. This stage produces no symptoms, but the infection is still present in the body.

After many years, people who have syphilis and don’t get treatment may develop the fourth stage of syphilis, called tertiary syphilis. This stage can cause problems in the brain and spinal cord. Tertiary syphilis may damage the heart and other organs, also.

Some people who have syphilis don’t have any signs of infection. In other people, the signs may be very mild. They might not even know they have it. But even if they have no signs or the signs go away on their own, the infection is still alive and can cause serious health problems many years later.


What causes syphilis?

Syphilis is caused by bacteria called Treponema pallidum. You can get syphilis by having sex with an infected person (coming into direct contact with a syphilis sore). It can also be passed from an infected mother to her baby during pregnancy.

How is syphilis diagnosed?

A blood test can tell for sure if you have syphilis. Sometimes other tests can show how far the syphilis has spread. For example, your doctor may want to look at your spinal fluid. This is a way to see if the syphilis bacteria have spread to your nervous system.

Can syphilis be prevented or avoided?

The only way to prevent or avoid syphilis altogether is to abstain from sex, including vaginal, anal, and oral sex. That is not always practical. Safe sex (using protection) lowers your chances of getting syphilis. This includes using condoms during sex and using “dental dams” during oral sex.

Syphilis treatment

Syphilis can be cured with penicillin, which is an antibiotic. The penicillin is given as a shot. If you have had syphilis for 1 year or less, you only need to get 1 shot. If you have had syphilis longer than 1 year, you will need 2 or more shots. If you’re allergic to penicillin, be sure to tell your doctor.

If you have an advanced case of syphilis, you may need stronger treatment. You may get shots of penicillin every day for 10 days. This can be done in the doctor’s office or at a clinic. A few people have to go to the hospital to be treated with penicillin intravenously (through an IV).

If you’re pregnant, it’s very important to get treated right away. Syphilis can cause birth defects and even death in an unborn baby.

How will I know my syphilis has been cured?

After your treatment, your doctor will ask you to come back several times for blood tests. These tests will show if the antibiotic killed all the syphilis bacteria.

What is the connection between syphilis and HIV?

Syphilis can be passed from one person to another during sex. If you got syphilis, you could also have gotten HIV or another sexually transmitted infection (STI), such as chlamydia or gonorrhea. If you have a syphilis sore, it’s easier for HIV infection to get into your body through the sore. If you have syphilis, you should be tested for HIV, chlamydia, and gonorrhea.

A simple exam and some lab tests can show if you have these infections. If you have HIV and syphilis, make sure your doctor knows about the HIV, so you can get the right treatment and continued care.

Living with syphilis

If you have syphilis, it can be cured completely. But you may have it and not know it. Syphilis bacteria can live, inactive, in your spleen and lymph nodes for decades without your knowing it. That is why it is important to talk to your doctor, especially if you have multiple sex partners. Your doctor can test you to see if you have syphilis. The earlier the treatment, the better.

Questions to ask your doctor

  • What is the best treatment for me?
  • How long will my treatment last?
  • What stage of syphilis am I in?
  • Have I passed syphilis on to my unborn baby?
  • Is it possible to have sex with my partner without giving him/her syphilis?
  • Am I at risk of developing any other diseases?
  • I have a sore on my genitals. Are there any steps I can take to stop it from hurting?
  • Are there any medicines or supplements I should avoid taking while I’m being treated for syphilis?