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Syphilis fact sheet

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What is syphilis?

Syphilis (SIF-uh-luhss) is a sexually transmitted infection (STI) caused by bacteria (germ). It progresses in stages. Syphilis is easy to cure in its early stages. But without treatment, it can hurt your body's organs, leading to severe illness and even death.

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How is syphilis spread?

Syphilis is spread through direct contact with a syphilis sore or rash during vaginal, anal, or oral sex. The bacteria can enter the body through the penis, anus, vagina, mouth, or through broken skin. An infected pregnant woman can also pass the disease to her unborn child. Syphilis is not spread by contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

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What are the symptoms of syphilis?

Each stage of syphilis has different symptoms. A person infected with syphilis can pass it to others during the first two stages.

Primary stage
A single sore, called a chancre (SHANG-kuhr), appears in the first, or primary stage. Sometimes, more than one sore appears. The time between infection with syphilis and the start of the chancre can range between 10 to 90 days (21 days average). The chancre is usually firm, round, small, and painless. It appears at the spot where the infection entered the body, such as the vulva, vagina, cervix, tongue, lips, or other parts of the body. In this stage, syphilis can be passed to others through contact with the chancre during vaginal, anal, or oral sex. The chancre lasts 3 to 6 weeks and heals with or without treatment. If the infection is not treated, it moves to the secondary stage.

Secondary stage
The secondary stage can start as the chancre is healing or a few weeks after it has healed. It typically starts with a rash on 1 or more areas of the body. Some or all of these symptoms can appear:

  • Skin rash with rough, red, or reddish-brown spots both on the palms of the hands and bottoms of the feet. The rash usually does not itch. Rashes on other parts of the body may not look the same.
  • Sores on the throat, mouth, or cervix
  • Fever
  • Swollen glands
  • Sore throat
  • Patchy hair loss
  • Headaches and muscle aches
  • Weight loss
  • Tiredness

In this stage, the infection can be passed to others through contact with open sores or rash during vaginal, anal, or oral sex. Rash and other symptoms will go away with or without treatment. But without treatment, the infection will move to the latent and possibly late stages of disease.

Latent stage
The latent, or hidden, stage starts when symptoms from the first and second stages go away. The latent stage can last for many, many years. During this stage, the infection lives in the body even though there are no signs or symptoms. The infection cannot be passed to others during the latent stage. Sometimes, symptoms from the secondary phase come back. If this happens, the infection can be passed to others until the symptoms go away again. Without treatment, the infection will advance to the late stage in some people.

Late stage
About 15 percent of people with untreated syphilis will advance to the late stage. This can happen within a few years or as many as 20 years or more after first becoming infected. In the late stage, the disease can hurt your organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can lead to nerve problems, paralysis, blindness, dementia, and other health problems. Some people may die from the disease. You will only reach the late stage if you do not receive treatment earlier. If you have syphilis, get treated as soon as possible to avoid these problems.

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How do I found out if I have syphilis?

A doctor can tell if you have syphilis. The most common ways include:

  • Taking a sample of your blood and sending it to a lab for testing.
  • Looking at the fluid from a syphilis sore under a special type of microscope. This can only be done during primary and secondary stages, when a sore is present.

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How is syphilis treated?

Penicillin (an antibiotic) is the preferred drug to treat syphilis at all stages. The dose and length of treatment depends on the stage of syphilis and symptoms of the disease. For people who are allergic to penicillin, other drugs might work during the first and second stages. But they cannot be used by pregnant women. In late syphilis, treatment will prevent further harm, but damage already done to body organs cannot be reversed. Treatment does not protect you from getting syphilis again. You can get syphilis again after being cured if you are exposed to it.

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What happens if syphilis isn't treated?

Without treatment, syphilis can lead to severe illness and even death. Having syphilis also increases your risk of getting or giving HIV, the disease that causes AIDS. The open sores caused by syphilis make it easier for HIV to spread through sexual contact. If you have syphilis, you are thought to be 2 to 5 times more likely to get HIV if exposed. Untreated syphilis also can cause problems during pregnancy.

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Can syphilis cause problems during pregnancy?

Yes. Pregnant women can pass syphilis to their babies during pregnancy and childbirth. It can cause miscarriage, stillbirth, or death soon after birth. An infected baby may be born without signs of disease. However, if not treated right away, the baby may have serious problems within a few weeks. Babies born with syphilis may develop skin sores, rashes, fever, jaundice, anemia, or a swollen liver and spleen. Untreated babies may become developmentally delayed, have seizures, or die.

All pregnant women should be tested for syphilis. Pregnant women with syphilis are treated right away with penicillin. For women who are allergic to penicillin, no other drugs are available for treatment. So, doctors try to help women with this allergy become less sensitive to the penicillin so it can be used. Penicillin will prevent passing syphilis to the baby. But women who are treated during the second half of pregnancy still are at risk of premature labor and problems with the unborn baby.

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How can I keep from getting syphilis?

There are steps you can take to lower your risk of getting syphilis:

  • Don't have sex. The surest way to keep from getting syphilis is to practice abstinence. This means not having vaginal, oral, or anal sex.
  • Be faithful. Having a sexual relationship with one partner who has been tested for syphilis and is not infected is another way to lower your risk of getting infected. Be faithful to each other. This means you only have sex with each other and no one else.
  • Use condoms. Syphilis sores can occur in places that are covered by a condom, as well as areas that are not covered. So, using a condom the right way and every time you have vaginal, anal, or oral sex might lower your risk. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex use a male latex condom. A dental dam might offer some protection during oral sex (mouth to vagina/anus).
  • Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STIs, including syphilis. If you use one of these methods, be sure to also use a latex condom every time you have sex.
  • Talk with your sex partner(s) about STIs and using condoms. It's up to you to make sure you are protected. Remember, it's your body! For more information, call the Centers for Disease Control and Prevention at 800-232-4636.
  • Talk frankly with your doctor and your sex partner(s) about any STIs you or your partner has or has had. Talk about symptoms, such as sores or discharge. Try not to be embarrassed. Your doctor is there to help you with any and all health problems. Also, being open with your partners can help you protect your health and the health of others.
  • Have a yearly pelvic exam. Ask your doctor if you should be tested for syphilis or other STIs, and how often you should be retested. Testing for many STIs is simple and often can be done during your checkup. The sooner syphilis is found, the more likely it can be cured quickly and easily.
  • Avoid using drugs or drinking too much alcohol. These activities may lead to risky sexual behavior such as not wearing a condom.

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Who should get tested for syphilis?

Ask your doctor about getting tested for syphilis if:

  • You have symptoms and signs of syphilis.
  • You think you might have been exposed to someone with syphilis.
  • You are pregnant. All pregnant women should be tested for syphilis at their first prenatal checkup. Some pregnant women should be tested again, later in the pregnancy. Ask your doctor about retesting.
  • Your or your partner's sexual behavior puts you at risk for STIs (such as having sex with multiple partners, having unprotected sex, or having sex with men who have sex with men). Ask your doctor how often you should be retested.
  • You are a sex worker.
  • You have exchanged sex for drugs.
  • You are in prison.

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I just found out I have syphilis. What should I do?

  • Follow all your doctor's treatment orders. Even if the symptoms go away, you still need to finish treatment. If symptoms continue after treatment, see your doctor.
  • Avoid any sexual activity while you are being treated for syphilis. Don't have sexual contact until the syphilis sores are completely healed.
  • Tell your sex partner(s). Your sex partner(s) should get tested for syphilis and treated if needed.
  • After you have completed treatment for syphilis, get retested after 6 months and 12 months. Some doctors recommend more frequent follow-up tests.
  • Get tested for HIV. If your test result is negative, ask your doctor if you need to be retested and when.
  • Once you have been treated and cured, take steps to lower your risk from getting syphilis again.

More information on syphilis

For more information about syphilis, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

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Content last updated: July 08, 2011.

Resources last updated: July 28, 2009.

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