Syphilis
What is Syphilis?
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. This infection spreads through direct contact with syphilis sores during vaginal, anal, or oral sex. The infection progresses through different stages if left untreated. Each stage has different symptoms and health risks.
Without treatment, syphilis can damage your heart, brain, nerves, eyes, and other organs. The good news is that syphilis is completely curable with antibiotics when caught early. Early detection through blood testing is key to preventing long-term health problems. Many people with syphilis don't know they have it because symptoms can be mild or easily missed.
The infection can also pass from a pregnant person to their baby during pregnancy or childbirth. This is called congenital syphilis and can cause serious health problems for the newborn. Regular testing is important for sexually active people, especially those with new or multiple partners.
Symptoms
Syphilis symptoms vary depending on the stage of infection. Here are the most common signs:
- Small, painless sores or ulcers at the infection site, usually on genitals, anus, or mouth
- Skin rashes that often appear on palms of hands or soles of feet
- Swollen lymph nodes in the neck, armpits, or groin
- Fever, fatigue, and muscle aches
- Sore throat and patchy hair loss
- Weight loss and headaches
- Vision problems or eye pain
- Difficulty coordinating muscle movements in later stages
Many people with syphilis have no noticeable symptoms, especially in the early stages. The initial sore often heals on its own within 3 to 6 weeks. This can give a false sense that the infection is gone when it actually continues spreading in your body.
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Causes and risk factors
Syphilis spreads through direct contact with a syphilis sore during sexual activity. The sores can appear on or around the genitals, anus, rectum, lips, or in the mouth. You can get syphilis from vaginal, anal, or oral sex with someone who has the infection. The bacteria enter your body through small cuts or mucous membranes. You cannot get syphilis from toilet seats, doorknobs, swimming pools, or sharing eating utensils.
Your risk increases if you have unprotected sex, have multiple sexual partners, are a man who has sex with men, or have HIV. Using drugs or alcohol can also increase risk by affecting decision-making about safe sex practices. Having syphilis once does not protect you from getting it again. If you've been treated successfully, you can still get reinfected if exposed to the bacteria again.
How it's diagnosed
Doctors diagnose syphilis through blood tests that detect antibodies your body makes in response to the infection. The RPR test measures antibodies produced when syphilis is present. A positive result suggests an active infection. The Treponema pallidum antibody tests, including the TP-PA test and T. pallidum Ab test, confirm the presence of antibodies specific to the syphilis bacteria.
Immunoglobulin M levels can indicate a recent infection because IgM antibodies rise within days after initial exposure. Rite Aid offers syphilis testing as an add-on to our preventive health panel at Quest Diagnostics locations nationwide. Your doctor may also examine any visible sores or take a sample from a sore for additional testing. Early detection through blood testing allows for prompt treatment before the infection causes serious damage.
Treatment options
Syphilis treatment focuses on killing the bacteria and preventing complications. Here are the main treatment approaches:
- Penicillin antibiotics given as an injection, which is the most effective treatment for all stages
- Alternative antibiotics like doxycycline or azithromycin for people allergic to penicillin
- Longer treatment courses for late-stage syphilis or infections affecting the nervous system
- Abstaining from sexual activity until treatment is complete and sores have healed
- Notifying and testing all recent sexual partners so they can get treatment if needed
- Follow-up blood tests at 6 months, 12 months, and sometimes 24 months to confirm the infection is cured
- Practicing safer sex with condoms to reduce risk of reinfection
- Getting tested regularly if you remain at higher risk for sexually transmitted infections
Treatment kills the bacteria and prevents further damage but cannot reverse any organ damage already caused by the infection. This is why early detection and treatment are so important.
Need testing for Syphilis? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
The first symptom, usually a painless sore, appears 10 to 90 days after infection. The average time is about 21 days or 3 weeks. Many people don't notice this sore because it's painless and may be hidden in the mouth, rectum, or vagina. The sore heals on its own even without treatment, but the infection remains in your body.
No, syphilis will not go away without antibiotic treatment. Even though the initial sore heals on its own, the bacteria remain in your body. The infection will progress through different stages and can eventually damage your organs, including your heart and brain. Early treatment with antibiotics is essential to cure the infection and prevent serious complications.
Syphilis blood tests are highly accurate, especially when used together. The RPR test is a good screening tool but can sometimes show false positives. The Treponema pallidum antibody tests are very specific and confirm whether you truly have syphilis. Your doctor may use multiple tests to get the most accurate diagnosis.
Yes, you can get syphilis multiple times throughout your life. Having syphilis once does not make you immune to future infections. If you are cured with antibiotics but later have unprotected sex with someone who has syphilis, you can become infected again. This is why safer sex practices and regular testing are important if you remain sexually active.
Syphilis is primarily transmitted through sexual contact with an infected person's sores. However, a pregnant person can also pass syphilis to their baby during pregnancy or childbirth. You cannot get syphilis from casual contact like hugging, sharing food, using public toilets, or touching doorknobs. Direct contact with infectious sores is required for transmission.
Untreated syphilis progresses through stages and can cause serious health problems. In late stages, it can damage your heart, blood vessels, brain, nerves, eyes, liver, bones, and joints. This can lead to blindness, paralysis, dementia, deafness, and death. Damage from late-stage syphilis cannot be reversed even after treatment, making early detection critical.
Blood tests can usually detect syphilis antibodies within 1 to 4 weeks after infection. However, it may take up to 90 days for antibodies to appear in some cases. If you think you were exposed to syphilis, get tested right away and then again 6 weeks and 3 months later if initial tests are negative. This ensures the infection is caught even if antibodies take time to develop.
Condoms can reduce your risk of getting syphilis but do not eliminate it completely. Syphilis spreads through contact with infectious sores, which can appear on areas not covered by a condom. Using condoms consistently and correctly during vaginal, anal, and oral sex provides important protection. Combining condom use with regular testing offers the best prevention strategy.
Yes, syphilis during pregnancy can cause miscarriage, stillbirth, premature birth, and serious health problems for the baby. Babies born with congenital syphilis may have bone damage, severe anemia, organ damage, blindness, or deafness. All pregnant people should get tested for syphilis early in pregnancy. Treatment during pregnancy can prevent transmission to the baby.
If your partner tests positive for syphilis, you should get tested right away even if you have no symptoms. Avoid sexual contact until both of you complete treatment and get clearance from a doctor. Your partner should notify anyone they've had sexual contact with in the past 3 to 12 months so those people can also get tested. Early treatment prevents complications and stops the spread of infection.