Overview
Syphilis is a sexually transmitted infection (STI) that spreads when you have vaginal, anal or oral sex with someone who has the infection. A bacteria causes it. Antibiotic medication treats syphilis. Untreated syphilis can lead to serious health problems, including blindness and damage to your brain, heart, eyes and nervous system.
What are the stages of syphilis?
Syphilis can progress through four different stages. The infection causes different symptoms in each stage. People are very contagious in the first and second stages and can easily pass the infection to their sex partners. The stages of syphilis are: primary, secondary, latent and late (tertiary) syphilis.
Primary syphilis: The first stage happens two to 12 weeks after exposure to someone with syphilis. During this stage, a smooth, hard sore called a chancre develops on your genitals or mouth. A chancre is small and usually painless, so you may not even know it’s there. The sore goes away on its own in a few weeks or months. However, this doesn’t mean you don’t have syphilis anymore. If you don’t receive treatment with medication, the infection moves to the second stage. You can pass syphilis through vaginal, anal or oral sex during this stage.
Secondary syphilis: About one to six months after the syphilis sore goes away, a rough, bumpy syphilis rash appears. The rash can cover your entire body, including your palms and soles (bottoms) of your feet. The rash doesn’t usually itch. You may also have symptoms such as:
- Fever.
- Fatigue.
- Wart-like sores.
- Muscle aches.
- Weight loss
- Headaches.
- Hair loss.
- Swollen lymph nodes.
You can pass syphilis infection during this stage during vaginal, anal or oral sex. These symptoms can come and go for months or years. Just because the syphilis rash is gone or you aren’t having any of the above symptoms doesn’t mean you no longer have the infection. You still need treatment with medication. Without treatment, the infection will move to the latent stage.
Latent syphilis: If you don’t receive treatment during the first two stages, the infection moves into the latent stage. In this stage, there are no outward signs or symptoms of syphilis. Some people experience mild flare-ups from time to time. At this stage, the infection can damage your heart, bones, nerves and organs. This stage can last up to 20 years. It’s rare to pass syphilis to your sex partners during the latent stage. Without treatment, the infection progresses to the late stage.
Late (tertiary) syphilis: For many people, symptoms don’t progress past the latent phase, either because the infection cures itself or because symptoms are too mild to notice. About 20% of people progress to the late syphilis phase, which causes a range of serious health problems. These problems occur slowly and include:
- Brain damage, dementia and cognitive health problems.
- Heart disease.
- Movement disorders and muscle problems.
- Nerve damage.
- Seizures.
- Vision problems, including blindness.
What is congenital syphilis?
Congenital syphilis occurs when a pregnant person passes the infection to the fetus during pregnancy. Syphilis causes severe health problems (including death) in babies and young children. Your pregnancy care provider should screen you for STIs at one of your first prenatal visits. It’s important to receive treatment right away if you have syphilis.
How common is syphilis?
According to the Centers for Disease Control and Prevention (CDC), there were about 134,000 cases of syphilis in 2020. The infection is more common in men and people assigned male at birth (AMAB). Men who have sex with men (MSM) are diagnosed with syphilis more than any other group.
Who might get syphilis?
Anyone who’s sexually active can get syphilis, but your risk is higher if you:
- Have unprotected sex, especially if you have several partners.
- Are a man who has sex with men (MSM).
- Have HIV.
- Have had sex with someone who’s tested positive for syphilis.
- Tested positive for another STI, such as chlamydia, gonorrhea or herpes.
Symptoms
When to see a doctor
Complications
- High blood pressure.
- Diabetes.
- Heart failure.
- Some types of heart valve disease.
Prevention
- Control high blood pressure, high cholesterol and diabetes.
- Don't smoke or use tobacco.
- Eat a diet that's low in salt and saturated fat.
- Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
- Get good sleep. Adults should aim for 7 to 9 hours daily.
- Maintain a healthy weight.
- Reduce and manage stress.
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