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What is Syphilis?

Syphilis is a sexually transmitted infection (STI) caused by bacteria known as Treponema pallidum it is easily passed from one person to another through sexual contact and by direct skin contact with someone who has syphilis sores or a syphilis rash. 

Signs and Symptoms

You may not notice the signs and symptoms.

Syphilis develops in three stages:

Primary syphilis

Sores (usually painless) appear where the bacteria has entered into the body. Symptoms may appear 2-3 weeks after coming into contact with an infected person. 

In women these are found mainly on the vulva (lips around the opening to the vagina), clitoris, cervix, urethra (tube where urine comes out) and the anus.

In men they are found mainly around the penis and foreskin, urethra and anus.

The sores may take 2-6 weeks to heal and are very infectious.

Second stage syphilis

If the infection remains untreated the second stage usually occurs some weeks after any sores have appeared and healed. Syphilis is still infectious at this stage and can be passed on to others.

Symptoms may appear as a painless non-itchy rash. It can appear in patches or spread all over the body but often seen on soles of the feet or palms of the hands. You may experience a flu-like illness, loss of appetite, swollen glands, tiredness, white patches on the tongue or roof of the mouth, patchy hair loss.

Third stage syphilis

If untreated, third stage syphilis can cause very serious damage to internal organs, bones, nervous system, heart, brain and eyes and can lead to death.


You can only be certain you have syphilis if you have a test.  This can be conducted at a Genitourinary Medicine (GUM) or sexual health clinic.

You may want to present for a test even if you don’t have symptoms especially if:

  • You, or a partner thinks you might have symptoms
  • You have recently had unprotected sex with a new partner
  • You, or a partner have had unprotected sex with other partners
  • A sexual partner tells you they have a sexually transmitted infection
  • You have another sexually transmitted infection
  • You are pregnant or planning a pregnancy

You will be given a genital examination and asked to give a blood sample. You will be checked for rashes or watery growths and the mouth and throat area may be checked.

All tests are free through NHS services. Treatment is also free unless you go to your general practice when you may have to pay a prescription charge for the treatment.


First and second stage syphilis is treated using a single antibiotic injection or a course of injections or by taking antibiotic tablets or capsules for about 10-14 days but sometimes longer.

What happens is Syphilis is not treated?

Without proper treatment the infection can spread to other parts of the body causing serious, long-term complications to the heart, brain, eyes, other internal organs, bones and nervous system. This damage could also lead to death.

Protection against Syphilis

It is strongly advised not to have sexual intercourse, including vaginal, anal or oral sex until you and your partner(s) have finished treatment and any follow-up treatment. This is to prevent re-infection or passing the infection on to someone else.

If it is not possible to avoid sexual intercourse:

  • Use condoms (male or female) every time you have vaginal or anal sex.
  • If you have oral sex, cover the penis with a condom or the female genitals and male or female anus with a latex or polyurethane (soft plastic) square.
  • If you are a woman and rub your vulva against a female partner’s vulva one of you should cover the genitals with a latex or polyurethane square.
  • Avoid sharing sex toys.

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Fact Zone

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