Syphilis is a sexually transmitted infection (STI). It can cause brain, nerve, and tissue damage when it is not treated. It can also be deadly.
Syphilis is caused by bacteria. It is spread through contact with a syphilis sore. This may happen during oral, anal, or genital sex with an infected person
Things that may raise the risk of this problem are:
- Not using a latex condom during oral, anal, or genital sex
- Having more than one sex partner
- Having other STIs
Symptoms will depend on what stage the syphilis is in. There are three main stages as well as a resting phase.
Primary Stage: 7 to 90 Days After Infection
A single sore appears. It will happen in the area where the infection was passed. Common sites are the external genitals, rectum, tongue, inside of the mouth, or lips.
It will start as a raised and painless sore called a chancre. It will break down to form an ulcer. It lasts for 3 to 6 weeks. The ulcer will heal on its own.
Without treatment, the infection may move to the secondary stage. This can happen even if you cannot see the ulcers anymore.
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Secondary Stage: Several Weeks to Months after the Original Sore
This stage features a non-itchy rash. The rash may appear as rough, red, or reddish brown spots on the palms of the hands or soles of the feet. Other rashes may also appear in other places on the body. These rashes may appear as:
- Small blotches, blisters, or scales
- Moist warts in the groin
- Slimy white patches in the mouth
The rash may happen with flu-like symptoms, such as sore throat, fever, and muscle aches.
Without treatment, the symptoms will go away within a few weeks. But there may be repeated episodes during the next few years.
Latency (Resting) Stage: May Last for Years
The infection is still present but there are no symptoms. It may or may not progress to the third stage. Blood tests for syphilis will be positive during this stage.
Tertiary (Third or Late) Stage
This stage may start years after the initial infection. It is rare in developed countries. In this stage, the infection damages the:
- Brain and nerves
- Heart and blood vessels
- Bones and joints
Damage can be harsh enough to cause death. Symptoms are:
- Small bumps called gummas on the skin, bones, or internal organs
- Central nervous system damage, such as weakness, numbness, trouble walking, problems with balance, memory and mental health problems, and loss of bladder control
You will be asked about your symptoms and health history. A physical exam will be done.
You will have:
- Samples taken from lesions
- Blood tests
- A spinal tap
Syphilis is treated with antibiotics.
People with syphilis should also avoid sexual contact until treatment is complete and the infection is gone.
To lower the risk of this infection:
- Do not have oral, anal, or genital sex.
- Limit sex to one partner who is not infected.
- Use latex condoms during sex.
American Sexual Health Association
Centers for Disease Control and Prevention
Sex Information and Education Council of Canada
Bibbins-Domingo K, Grossman D, et al. Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2016 Jun 7;315(21):2321-2327.
Latent syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/latent-syphilis. Accessed October 19, 2020.
Primary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/primary-syphilis. Accessed October 19, 2020.
Secondary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/secondary-syphilis. Accessed October 19, 2020.
Syphilis-CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm. Accessed October 19, 2020.
Tertiary syphilis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tertiary-syphilis. Accessed October 19, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG Last Updated: 4/28/2021