Last Reviewed: November 2006

What is syphilis?

Syphilis is a bacterial infection, primarily a sexually transmitted disease (STD).

Who gets syphilis?

Any sexually active person can be infected with syphilis, although there is a greater incidence among young people between the ages of 15 and 30 years. It is more prevalent in urban than rural areas.

How is syphilis spread?

Syphilis is spread by sexual contact with an infected individual, with the exception of congenital syphilis, which is spread from mother to fetus. Transmission by sexual contact requires exposure to moist lesions of skin or mucous membranes.

What are the symptoms of syphilis?

The symptoms of syphilis occur in stages called primary, secondary and late. The first or primary sign of syphilis is usually a sore(s), which is painless and appears at the site of initial contact. It may be accompanied by swollen glands, which develop within a week after the appearance of the initial sore. The sore may last from one to five weeks, and may disappear by itself even if no treatment is received. Approximately six weeks after the sore first appears, a person will enter the second stage of the disease. The most common symptom during this stage is a rash, which may appear on any part of the body including trunk, arms, legs, palms, soles, etc. Other symptoms may occur such as tiredness, fever, sore throat, headaches, hoarseness, loss of appetite, patchy hair loss and swollen glands. These signs and symptoms will last two to six weeks and generally disappear in the absence of adequate treatment. The third stage, called late syphilis (syphilis of over four years' duration), may involve illness in the skin, bones, central nervous system and heart.

How soon do symptoms appear?

Symptoms can appear from 10 to 90 days after a person becomes infected, but usually within three to four weeks. Symptoms are often not noticed or are thought to be minor abrasions or heat rash and medical care is not sought.

When and for how long is a person able to spread syphilis?

Syphilis is considered to be communicable for a period of up to two years, possibly longer. The extent of communicability depends on the existence of infectious lesions (sores), which may or may not be visible.

Does past infection with syphilis make a person immune?

There is no natural immunity to syphilis and past infection offers no protection to the patient.

What is the treatment for syphilis?

Syphilis is treated with penicillin or tetracycline. The amount of treatment depends on the stage of syphilis the patient is in. Pregnant women with a history of allergic reaction to penicillin should undergo penicillin desensitization followed by appropriate penicillin therapy. A baby born with the disease needs daily penicillin treatment for 10 days.

What are the complications associated with syphilis?

Untreated syphilis can lead to destruction of soft tissue and bone, heart failure, blindness and a variety of other conditions which may be mild to incapacitating. More important, a female with untreated syphilis may transmit the disease to her unborn child, which may result in death or deformity of the child. Physicians and hospitals are required to test pregnant females for syphilis at prenatal visits. Tests of newborns or their mothers are required at the time of delivery.

What can be done to prevent the spread of syphilis?

There are number of ways to prevent the spread of syphilis:

  • Limit your number of sex partners;
  • Use a male or female condom**;
  • If you think you are infected, avoid sexual contact and visit your local STD clinic, a hospital or your doctor;
  • Notify all sexual contacts immediately so they can obtain examination and treatment;
  • All pregnant women should receive at least one prenatal blood test for syphilis.

** Remember that use of condoms may prevent the disease if the initial contact sore is on the penis or in the vaginal area. However, transmission can occur if the sore is outside the areas covered by the condom.