Syphilis: Symptoms, Stages and Treatment

Syphilis is a sexually transmitted infection that has been rising sharply in many countries. It’s easily cured with antibiotics, but left untreated it can damage the heart, brain and eyes, and harm babies during pregnancy.

Imagine noticing a small painless sore on your genitals that heals by itself in a few weeks. You forget about it. Two months later, a rash appears on your palms and soles. A blood test confirms syphilis, and a single course of treatment cures it.

Symptoms by stage

• Primary: a painless sore (chancre) where the infection entered, often on the genitals, anus or mouth, appearing about three weeks after infection and healing on its own
• Secondary: weeks later, a non-itchy rash (often on palms and soles), flu-like symptoms, swollen glands, patchy hair loss, white patches in the mouth
• Latent: no symptoms, but the infection remains
• Tertiary: years later, serious damage to the heart, brain, nerves, eyes and other organs

Syphilis can affect the eyes, ears or nervous system at any stage. Sudden vision or hearing changes need urgent attention.

Testing and treatment

A blood test diagnoses syphilis. Treatment is usually penicillin injections; other antibiotics are used if you’re allergic. Avoid sex until treatment is finished and you’ve been told it’s safe, and tell recent partners so they can be tested.

But why does pregnancy testing matter?

Syphilis can pass to a baby during pregnancy, causing miscarriage, stillbirth or serious lifelong problems. The WHO recommends testing all pregnant women. Treatment during pregnancy prevents most of these outcomes.

Condoms reduce the risk but don’t prevent all transmission. Regular testing is recommended if you have new or multiple partners.

Sources: World Health Organization (Syphilis), US CDC (Syphilis), UK Health Security Agency, British Association for Sexual Health and HIV.