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Syphilis: Symptoms & Signs, Treatment, Prevention, & More


Medically reviewed by: Dr. Kimberly Langdon (M.D) on 30th December 2021.



Syphilis is a sexually transmitted infection (STI) caused by a bacterium known as Treponema pallidum. It causes syphilitic sores to appear inside or outside the genitals, anus, and inside or surrounding the mouth, etc. That's the first symptom of syphilis.


There were around 88,0000 syphilis cases in the U.S. in 2016, mainly present in men, as per the data issued by The Centers for Disease Control and Prevention (CDC).


The infection can be spread via sex and direct skin-to-skin contact with syphilitic sores — labeled as syphilitic chancres, which are usually painless.


It may also spread through sharing of items, including razors with an infected person, touching the sores directly, etc.


Syphilis may also be spread via a placental connection from mother to child during pregnancy (congenital syphilis).


However, it can't be spread by sharing utensils, clothing, and clothing with the infected person.


The infection passes through various stages before it becomes lethal.


These stages may overlap with each other.


Syphilis symptoms in each stage are distinct and once the chancre disappears, there may be no symptoms for years.


However, if left untreated, it can lead to various health complications, like kidney problems, hepatitis, nerve palsies, meningitis, neurosyphilis, and even death.


Also, you may be prone to catching multiple STIs at once.


Thus, making it difficult to diagnose, treat and prevent them.


Thus, to lessen its risk, it is recommended to use condoms during sex.


However, if you feel any symptoms, or have been diagnosed with an STI before, call your doctor immediately.


He/she may recommend you get tested for syphilis, or multiple STIs at once.


So, in this article, we'll shed light on the signs and symptoms of syphilis, its prevention, cure, and much more. Let's dive in.




A Short Story of its Origin


Syphilis, a sexually transmitted infection, emerged as endemic syphilis around 3000 BC.


As per the data² issued by the Journal of Medicine and Life, syphilis emerged mainly in the South-Western Asian region, because of lesser temperatures of the post-glacial times, and spread to various corners of the world, including Europe.



Various Stages of Syphilis


Syphilis advances to various stages before it endangers our lives. Thus, each of these stages of syphilis has distinct symptoms. The stages include:


    • ● Primary syphilis


    • ● Secondary syphilis


    • ● Latent syphilis


    • ● Tertiary syphilis


The first two stages of syphilis tend to be more infectious.


When syphilis is hidden (latent), the infection is present in the body of a person for many years without any symptoms. This leads to the tertiary stage of syphilis which tends to be lethal.


Symptoms of tertiary syphilis include serious conditions, including death.


The following heading describes each of these stages as:



Primary Syphilis


In this stage of syphilis, the bacteria begin to multiply in an individual in 21 to 28 days after exposure.


At first, a person develops a small sore known as a chancre, which usually involves no pain, but is very infectious.


It is mostly present inside or around the vagina, penis, anus, rectum, or mouth, etc.


The sores usually show up within 1 to 12 weeks after exposure, however, it can remain on an individual's body for about 14 to 42 days on average.


Direct contact with a chancre increases the susceptibility to catching syphilis. This usually takes place during sex, including oral sex.



Secondary Syphilis


Rashes on the skin plus a sore throat usually develop during this stage of syphilis. The rash isn't itchy and is often found on the palms of the hands, and even soles.


However, it may occur on any body part and is often asymptomatic in many people.


Some other symptoms that secondary syphilis poses are:


    • ● Fatigue


    • ● Swollen lymph nodes


    • ● Fever³


    • ● Loss of hair and body weight


    • ● Joint pain


    • ● Headaches


These symptoms usually fade away with time, and oftentimes are mistaken for any other medical condition. However, a person still carries the infection.



Latent Syphilis


This is the third stage of syphilis.


Latent syphilis symptoms at this stage are barely noticeable.


This is because the primary and secondary symptoms of syphilis soon fade away, making a person feel asymptomatic.


However, the infection is still in the body and could be present for many years before it advances to tertiary syphilis.



Tertiary Syphilis


This is the last and the most dangerous stage of syphilis.


It affects almost 15-30 % of the individuals who don't receive the treatment on time.


Tertiary syphilis usually occurs decades after exposure to syphilis bacteria, and tends to be life-threatening.


Some long-term tertiary syphilis symptoms include the development of serious conditions, including mental illnesses, loss of memory and vision, damage to the bones and heart, neurological disorders, including meningitis (stroke), and neurosyphilis — a serious infection of the spinal cord or brain, etc.






If you suspect syphilis, see a doctor immediately. They will recommend that you get tested.


The testing procedure usually involves a blood test and a physical exam.


If you have an active sore, your physician may scrap a sample from an active sore to verify whether you have active syphilis bacteria or not.


If you show symptoms of tertiary syphilis, including nervous system conditions, your doctor may recommend you get a lumbar puncture, or spinal tap, during this examination.


Your doctor will collect your spinal fluid to test it for syphilis.


If you are a mother-to-be, your physician may recommend you get tested for syphilis.


This is because the infection can be present in your body without symptoms.


This can help prevent the spread of any syphilis to the fetus (congenital syphilis) — which is a life-threatening infection, even leading to the death of newborns.


You can even consider getting an at-home testing kit for syphilis.



Treatment & Cure


Like many STDs, syphilis symptoms are easy to detect, treat, and cure at early stages.


For instance, penicillin injection is given to individuals suffering from primary and secondary syphilis.


It is one of the most commonly used antibiotics which can cure syphilis.


However, people who are allergic to penicillin can be treated with different antibiotics, including Azithromycin, Ceftriaxone, Doxycycline, etc.


A rapid plasma reagin (RPR) testing procedure was carried out using a blood test for syphilis.


It does that by determining the nonspecific antibodies created by your body while combating the infection.


Thus, the RPR testing method helps detect the presence of syphilis.


If you have neurosyphilis, you will be given a regular dose of penicillin through veins, including a brief hospital stay.


Unfortunately, the complications caused by late syphilis are irreversible.


The bacteria can be destroyed but the treatment mostly relies on easing aches and discomfort.


During treatment, it is best to avoid any sexual activity until your chancres are fully healed.


Also, if you are sexually active inform your spouse as well.





The best preventive measure against syphilis is to not have sex during this time.


If you should have sex, then using condoms is the second-best option.


You may also consider using dental dams, getting screened for multiple STIs, including syphilis, avoiding using shared needles with an infected person, etc.



Some Other Complications Related to Syphilis


Some other complications associated with syphilis include miscarriages in pregnant women, stillbirths or premature births, or being vulnerable to other STDs, including gonorrhea, chlamydia, and herpes, etc.


It can also lead to congenital syphilis (an infection that also has stages starting with premature births, rashes, then affecting the brain, or spinal cord, or both, in newborns).


This may lead to seizures, fever, birth defects, skin rashes, swollen liver, jaundice, etc, in babies.


It is also important to know that a person with syphilis is more vulnerable to getting HIV.


Talking to your doctor about how to diagnose syphilis at early stages is necessary to prevent catching multiple STIs.




When to Get Tested for Syphilis?


As aforementioned, RPR testing helps detect the presence of syphilis — an STD which sometimes has no symptoms in many persons.


Thus, syphilis in its primary stage can go undiagnosed.


Also, symptoms in the second stage often overlap with the symptoms of other illnesses.


Thus, getting tested for syphilis is the only way to know if you have got syphilis or not.


This holds if you are sexually active, or don't use condoms every time you have sex, are a pregnant mother, are in prison, or have multiple spouses.


If your test comes positive, don't worry!


Your doctor will prescribe you treatment that you must follow on time, even if symptoms disappear.


Also, it is best to prevent any sexual activity during this time, and consider getting tested for multiple STIs including HIV/AIDS.


Also, it is important to inform your spouse about your test results, so that he/she can also get tested on time.


They can get early treatment if they also come up positive.


This also helps prevent getting reinfected, since syphilis can be developed more than once if not taken seriously.



Can You Get Tested For Multiple STIs at once?




Getting regularly tested helps us in detecting STIs at their initial stages, thus, enabling you to diagnose, treat, and prevent them on time.


Multiple STIs can occur if you don't get tested frequently. This holds for syphilis, too.


If left untreated, it poses a higher risk of getting HIV/AIDS, and other sexually transmitted diseases (STDs).


A standard panel helps detect as many as eleven STIs in one step.


It includes getting tested for chlamydia, gonorrhea, HIV-1 & HIV-2, herpes (both HSV-1 & HSV-2), Hepatitis B, & Hepatitis C, etc.


Thus, getting tested for multiple STIs is the best option to consider, because you are never aware of how many STIs you could be simultaneously carrying.


This holds if you are sexually active, or are polygamous.


Therefore, it is important to find a trustworthy physician with whom you can share your entire sexual history.


This not only benefits you but also your spouse and your overall sexual health.


To get tested, you will have to go to a clinic or order an at-home testing kit.


The procedure usually involves a blood or urine test collected by you or a nurse.


The results often come within 7 to 21 days on your registered email or phone number.




A Word From Us


The signs and symptoms of syphilis are different in various stages.


For instance, primary syphilis develops soon after exposure and leads to sores on the genitals, or mouth area, or both.


This advances into secondary syphilis, which causes body rashes.


Then this is followed by the latent stage, which remains in the body for decades, and is often asymptomatic.


The final stage, known as the tertiary stage, is fatal and affects body organs including, the heart, brain liver, and skin, etc.


Syphilis can still be treated at this time, however, there is always a risk of permanent organ failure or damage.


Many newborns with congenital syphilis may be asymptomatic initially.


However, with time physical symptoms, like loss of hearing and vision start developing.


Therefore, strict action needs to be taken to decrease the chances of getting syphilis, especially if you are sexually active, or you have had an STI in the past.


For people living with HIV/AIDS⁴, getting screened for syphilis is advised every 90 days rather than yearly.


Moreover, many STIs like gonorrhea and chlamydia have overlapping symptoms. This holds for syphilis, too.


Many common skin infections, like Pityriasis rosea — a viral skin rash, usually present on the thigh region, upper arms or legs, etc, resemble syphilis.


Thus, it is hard to detect whether you are carrying more than one STI or not.


Also, if you are sexually active with your spouse who already carries multiple STIs, including herpes, HIV/AIDS, or genital warts, etc, simultaneously then you may be susceptible to getting affected by more than one STI at once.


This holds even if you already carry a different STI.


In the meantime, abstaining from any sexual activity and practicing safe sex are always recommended.


What do you think is the most effective way to prevent catching syphilis? We think it is getting tested for multiple STIs, including syphilis.


Medically reviewed by: Dr. Kimberly Langdon (M.D) on 30th December 2021.

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