What you need to know about syphilis

If left untreated, syphilis can cause serious problems so get clued up on syphilis symptoms, causes, diagnosis and treatment.

If left untreated, syphilis can cause serious problems so get clued up on syphilis symptoms, causes, diagnosis and treatment.
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Concerned about syphilis? Characterised by small, painless sores or ulcers on the genitals or small skin growths similar to genital warts, syphilis is most commonly spread through sexual activity and can be effectively treated with antibiotics.

However, syphilis can cause serious problems if left untreated so if you have any concerns whatsoever, head for your local sexual health clinic to get tested as soon as possible.

We look at syphilis symptoms, causes, treatments and prevention tips:

What is syphilis?

Syphilis is a bacterial infection usually spread by sexual contact. Fortunately, it can easily be cured these days - if caught early enough, but it is important to get tested (and treated) as soon as possible if you think you might have syphilis, as it can cause serious problems if left untreated.

Get tested as soon as possible if you think you have syphilis, as it can cause serious problems if left untreated.

Syphilis cases currently stand at approximately 8,000 cases per year in the UK. The majority of these occur in men who have sex with men.



Syphilis causes

How is syphilis contracted? In nearly all cases, syphilis is caught through having some form of sex with an infected person. (Syphilis is not acquired from lavatory seats, as people sometimes claim!)

This may be through:

  • Vaginal intercourse
  • Anal intercourse
  • Oral sex and very rarely, through other forms of sexual contact

    In general, syphilis will only be transmitted if a mucous membrane of an infected person comes into contact with a mucous membrane of somebody else.



    Syphilis symptoms

    Syphilis symptoms vary depending on how long ago you were infected. There are three stages of syphilis, called primary, secondary and tertiary.

    • Primary syphilis

    With primary syphilis, between nine and 90 days after exposure to the germ, the first sign of infection appears.

    It's a painless lump, usually about the size of a 5p piece, located on the penis, the anus or the vulva or occasionally at some other point of sexual contact, such as the mouth or nipple.

    In fair-skinned people, the lump is dull red. But if your skin is darker, the lump may be blackish or brown. This 'primary' lump soon breaks down into a painless ulcer (a raw place). The glands nearby – for instance in the groins – are likely to be swollen.

    These ulcers go away on their own after about six weeks, making it look as though you are cured – but this isn't the case.

    • Secondary syphilis

    A few months later, secondary syphilis usually develops, in which the patient develops rashes, a sore throat, fever and probably general ill health. Warty lumps may also appear on the genitals.

    • Tertiary syphilis

    If the condition isn't promptly diagnosed and cured, the disease typically goes on to a tertiary (third) stage many years after the first infection, in which the germ may attack various organs of the body, including the brain.

    The diagnosis is made by taking samples from the lesions and examining them under a microscope, and also by a blood test if the ulcers have already disappeared. This looks for particular proteins in the blood called antibodies and a positive test means you have syphilis or have had it in the past. (Syphilis symptoms can mimic many other illnesses which is why a specific test for it is required.)



    Syphilis treatment

    Once the diagnosis has been made, the infection can be treated with a course of antibiotics (usually injectable penicillin but often other medicines, especially if you are allergic to penicillin). Treatment during the primary or secondary stages usually prevents long-term damage.

    If the course of antibiotics is taken correctly and finished, then the infection should be cured.

    ⚠️ If you are treated for syphilis, you are likely to remain contagious for some time so do not resume sexual contact with anyone until the doctor has told you it is safe to do so.

    The clinic will ask you to help them to trace your sexual contacts, so that they too can be treated.



    Where to find a sexual health clinic

    For information on where to get tested for syphilis or any other sexual health concerns, try one of the following:



      Last updated: 30-01-2020

      Dr Roger Henderson is a Senior GP, national medical columnist and UK medical director for LIVA Healthcare He appears regularly on television and radio and has written multiple books.
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