What is syphilis?

"Syph" "The Pox" or "Bad Blood"

Syphilis is a sexually transmitted disease (STD) that is found around the world. In the United States it is more widespread in parts of the south.

What causes syphilis?

Syphilis is caused by bacteria (Treponema pallidum) that enter through your skin, mouth, or anus. This causes a painless skin ulcer (chancre) to form at the infection site. After an ulcer forms, syphilis spreads through your blood. This causes a skin rash. Later on, in some people, syphilis can cause damage to any organ of the body.

How can I get syphilis?

You can get syphilis if part of your body touches the skin ulcer or rash of someone with syphilis. This happens most often during sex. A pregnant woman with syphilis can pass the infection to her unborn child. This is called congenital syphilis.

What are the signs and symptoms?

Syphilis has four stages.

Stage 1, Primary syphilis

  • Within 10 days to 3 months after sex with someone who has syphilis, one or more painless ulcers will form where there was contact. Ulcers usually form within 3 to 4 weeks.
  • Within 1 to 5 weeks, ulcers heal without treatment. But, this does not mean you no longer have syphilis. See your health care provider for treatment even if your ulcers go away.

Stage 2, Secondary syphilis

  • Begins 2 weeks to 6 months after the ulcer heals. This stage usually begins within 6 weeks.
  • During this time, the bacteria will travel through your body causing a widespread rash. The rash can look very different from person to person. It is often found on the palms of the hands and the soles of the feet.
  • As the bacteria spread through your blood, you may get a fever, a sore throat, and swollen glands. You may also feel generally weak and tired.
  • Like primary syphilis, the signs and symptoms of secondary syphilis go away on their own without treatment in 2 to 6 weeks. But, you still have syphilis and it is dangerous. You should see your health care provider even if you do not have signs or symptoms. If you do not, you may get sicker.

Stage 3, Latent syphilis

  • After the signs of secondary syphilis go away, the infection becomes hidden (latent). Without treatment you will still have syphilis for 20 years or more even though you will not have any signs or symptoms. People with latent syphilis may sometimes have symptoms (flare-ups) like skin rash, fever, a sore throat, swollen glands or feeling weak and tired. This is most common during the first year of Stage 3.

Stage 4, Tertiary or Late syphilis

  • About one of every four people who don't get any treatment within 20 years of their first skin ulcer, will get this type of syphilis.
  • Late syphilis can damage any organ in your body.

Can syphilis cause other problems if it's not treated?

Yes. If you progress to Stage 4 syphilis, the damage to your body will get worse as time goes on. If your brain and spinal cord are affected you may become permanently mentally ill and paralyzed. You may also become blind and your bones and heart may be harmed. (Your aorta may become inflamed. This is the large blood vessel that connects to your heart.) Stage 4 syphilis can cause many other health problems. These problems may be mild or they may be serious enough to threaten your life.

If you have syphilis, it will make it easier for you to get HIV, the virus that causes AIDS. If you have HIV and syphilis, it's even more important for you to get proper treatment quickly. Because you have both diseases, you are at a greater risk for serious health problems.

A pregnant woman with syphilis may pass this infection to her unborn baby. This is called congenital syphilis. It can cause the baby to die before it is born - a stillbirth. A baby who has syphilis at birth may suffer permanent damage to their liver, brain, eyes, teeth, bones, glands and lungs.

How will I know if I have syphilis?

If you have skin ulcers or a rash, your health care provider should examine you. He or she will take a sample from your ulcer or rash and use a microscope to look for bacteria. Even if you don't have symptoms, your provider can find out if you have syphilis by testing your blood.

Health care providers give one of these blood tests to all pregnant women in New York State when they give birth. These tests help find out which babies are at risk for congenital syphilis.

Is there a cure?

Yes. Penicillin is the first-choice treatment for every stage of syphilis. It usually cures the disease. If you are allergic to penicillin, your health care provider can use a different medicine unless you are pregnant. All pregnant women must be treated with penicillin to effectively treat the baby. In those cases, you can still be treated safely because your doctor will take precautions to prevent an allergic reaction to the medicine. It is important for you to visit your health care provider to be sure the disease is cured.

When can I have sex again?

If you have been treated for syphilis, you should not have sex for 7 days after your treatment is over. Also, if your sex partners are not treated you can get syphilis again. Do not have sex with any partner who has syphilis until 7 days after he or she finishes treatment.

What about my partner(s)?

Syphilis is spread through sex. So, even if your sex partners don't have any symptoms they should be checked for syphilis.

Can I get this infection again?

Yes. You are at risk for getting syphilis again if your partner(s) aren't properly treated before you have sex again. You are also at risk if you have unprotected sex. Unprotected sex means sex without a condom.

How can I prevent syphilis?

Not having sex (abstinence) is the only sure way to avoid infection.

If you choose to be sexually active, use latex or polyurethane condoms each time you have oral, anal or vaginal sex. This will lower your chances of giving or getting syphilis. But, using condoms will not totally stop your risk of giving or getting syphilis. This is because condoms do not cover ulcers and rashes that may be on other parts of your body or your partner's body. Condoms do help prevent the spread of other STDs including HIV, the virus that causes AIDS.

If you are sexually active, you and your partner( s) should get a full physical checkup. This includes a complete sexual history and testing for HIV and common STDs such as gonorrhea, Chlamydia, syphilis, herpes, genital warts and trichomoniasis.

Will anyone know the results of the exams?

Your test results and any treatment will be kept absolutely confidential. No one can find out your results, except you. If you are under 18 you can be checked and treated for STDs without getting permission from your parents.

To learn more:

If you have more questions about syphilis, or you want to know how to find a clinic near you, call your local health department or family planning program.

You can also find a testing center near you at