Syphilis

What is it and how do I get it?

Syphilis is one of the most easily caught STIs but it can be hard to spot.

Although it's easy to treat, it can cause serious health problems in both men and women.

Syphilis spreads best by contact between moist skin areas anywhere on or in the body, for example you can catch it by kissing, vaginal, anal or oral sex without a condom, mutual masturbation or by handling a used condom

Syphilis in heterosexual men and women is more likely in those having sex with overseas partners, or with multiple partners at the same time.

In recent outbreaks, syphilis has been more likely in men having sex with men who have had:

• casual sex in saunas, cruising areas and gay sex venues
• multiple sexual partners, especially at the same time
• oral sex without using condoms.

Syphilis makes HIV easier to pass on and catch, and HIV can make syphilis harder to treat.

What are the symptoms?

Early syphilis is easy to miss unless you get the correct blood test. Many people show no sign that they're infected.

Early syphilis can make some people feel very ill, especially when they get to a stage where they develop a rash and fever.

You may see two stages:

• A few days after sex a small sore on the penis, the opening of the vagina, anus, mouth or tongue can appear. This is often painless and heals by itself, although it can be painful and looks just like genital herpes
• Later (a few days up to many weeks) a rash can develop. This is most notable on the palms of your hands.  Mouth ulcers occur. Moist, warty lumps may grow round the anus. People can feel ill and feverish. Rarely, vision and hearing can be affected.

If you do have it, you can still pass it on to others, even if you've never had any symptoms.

What does getting tested involve?

A blood test is the only reliable way to tell if you have syphilis or not. It takes about a week to process and return the results.

How can I get tested?

It is best to get tested and treated for syphilis at your local Genito-urinary Medicine (GUM) or Terrence Higgins/Brook clinic. You can get tested at a local Contraception and Sexual Health (CaSH) clinic but if you test positive you will be referred to the GUM clinic for treatment.

Sexual health staff at the clinics are used to dealing with this type of illness. They will be able to give you further advice on how to stay healthy and make sure you get any other support or treatment you need.

GUM clinics are specialist clinics that deal with STIs. They are totally confidential and you don’t need to have been referred by your GP to use them you can make an appointment over the phone yourself.

If you want to find out more information about GUM and CaSH clinics, have a look at our 'What to expect: GUM clinics' and 'What to expect: CaSH clinics' pages.

What does treatment involve?

Early syphilis infections can be easily treated with a 10-14 day course of antibiotics. Penicillin is normally used, though other antibiotics can be used if you are allergic to penicillin.

Late stage syphilis infections and those in people with HIV are more complicated to treat.

Partners need to take care not to re-infect each other until both have been given the all clear.

Late stage syphilis is treated with antibiotic injections.

Once the treatment has finished, a second test is carried out to make sure the infection has gone. Further tests may be required for up to a year.

Although the infection will be gone after a successful treatment, some blood tests will remain positive for life.

What are the health effects?

Late stage syphilis can damage many organs if left untreated. The skin, heart, brain, eyes, bones and nervous system can all be affected. This can lead to mental illness, shooting pain, disfiguring skin lesions, loss of vision and heart disease. Usually this takes twenty years or more.

Adequate treatment at any time can stop further trouble, though it does not repair any damaged organs.

You remain infectious to other people for about two years from initial infection if you are not treated.

If you have syphilis whilst you are pregnant and you leave it untreated it can cause serious birth defects, miscarriages or stillbirths.