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Syphilis Risks & Complications

How syphilis is transmitted

Syphilis is transmitted sexually, through direct contact with a syphilis sore, rash, or mucous membrane, usually during unprotected oral, vaginal or anal sex. Sores, or chancres (pronounced SHANG-ker), occur on the lips and mouth, vagina, penis, anus, and/or rectum. Pregnant women with syphilis can also pass the infection along to their unborn children. Syphilis cannot be contracted from doorknobs, toilet seats, swimming pools, hot tubs, bathtubs, shared clothing or eating utensils.

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How can I prevent getting or spreading syphilis?

The only way to prevent contracting syphilis 100% is abstinence. Otherwise, practicing safer sex by consistently using latex or polyurethane condoms or dental dams can help avoid contracting syphilis. Condoms lower the risk for spreading syphilis, which is particularly high among men who have sex with men, but do not eliminate the risk of contracting the infection from sores on areas of the body that a condom doesn’t cover. Being in a mutually monogamous relationship with someone who is not infected with syphilis will also prevent infection. Discussing sexually transmitted diseases (STDs) and testing with your new partner before engaging in sexual relationship is another way to help prevent getting syphilis.

Getting tested for STDs regularly for syphilis and other STDs can potentially save your life. Syphilis is easiest to cure in the earlier stages and it is important to cure this disease before it causes internal organ damage.

What you need to know about the stages of syphilis

The primary stage is the first stage of syphilis and usually includes small painless sores known as chancres. These sores occur from about 2 weeks to 3 months after exposure. This makes it possible to have syphilis without being aware of the infection. If a patient has been infected for a year or less, the disease is referred to as an “early case.” Early case syphilis infections are more infectious and easier to spread. That being said, any stage of a syphilis infection makes it easier to transmit or contract HIV. Syphilis-related vision loss and irreversible damage to the brain and other organs can occur in as little as one year.

The secondary stage of syphilis lasts between one and three months and usually begins between six weeks and six months after exposure to the bacteria. Secondary syphilis is characterized by a flat rosy-colored, non- itchy rash that usually covers the palms of the hands and soles of the feet. In some cases, the rashes may occur on other parts of the body or resemble rashes caused by other ailments. Additional signs of secondary syphilis include hair loss, white patches inside the mouth, genital warts, and flu-like symptoms such as fever and swollen lymph glands that last for weeks or even months. Secondary stage symptoms include fever, fatigue, headaches, sore throat, weight loss, muscle aches, swollen lymph glands and patchy hair loss. Although symptoms disappear after the primary and secondary stages, the latent (hidden) and late stages are more severe.

Without treatment during the primary or secondary stages, syphilis progresses to the latent stage, at which time the infection becomes dormant and does not cause symptoms for an extended period of time, up to 20 years. During the latent stage, the infection is still detectable by blood testing, despite the lack of symptoms. A syphilis infection can be treated and cured at this stage, but any damage done to internal organs is irreversible. If the syphilis infection progresses through the latent stage without treatment, it enters the terminal tertiary stage.

The tertiary stage of syphilis typically occurs between 10 and 30 years after the initial infection. At this time, entirely new and life-threatening symptoms occur. Debilitating side-effects include, but are not limited to blindness, loss of motor skills, dementia, and damage to the central nervous system and internal organs, such as the heart, brain, eyes, kidneys, and bones. In most cases, tertiary stage syphilis is distinguished by a descent into mental illness, followed by death.

When is syphilis most contagious?

Syphilis is the most contagious during the early (primary and secondary) stages, but it can be contracted at any stage. A single sore appears during the primary stage (approximately 21 days post exposure) and syphilis is easiest to spread when this sore is present. These sores or chancres look like a mucous patch (lesion) or wart-like patch in or on the vulva, vagina, penis, cervix, anus, rectum, lips, tongue or on the original infected area during sexual contact. If a syphilis infection is detected during the primary or secondary stage, it can be easily and quickly cured with a round of antibiotics.

Can I become infected with syphilis more than once?

Yes, you can get reinfected with syphilis because it is caused by bacteria. Even after successful treatment, it is still possible (and very likely) to get reinfected with syphilis if your partner has not been treated. Since syphilis sores can be out of sight in the vagina, anus, under the foreskin or in the mouth, it may not be apparent that you or your partner has been infected. For this reason, it is advisable that both you and your partner get tested and treated together, and abstain from sexual activity until the syphilis sores have healed and the treatment is complete for both partners.

What complications can result from untreated syphilis?

During the tertiary stage of syphilis, small, rubbery lesions may develop on the bones, skin, nervous system tissue, and/or arteries of the heart or the brain. Due to these lesions and other health complications, these individuals are susceptible to heart attack, paralysis, blindness, stroke, numbness and dementia. Tertiary syphilis is lethal. While antibiotics can cure a syphilis infection even during these late stages, they cannot reverse any permanent damage done to the body by syphilis-related complications.

If you have syphilis, it is important to tell your partner(s)

You should inform your partner about your syphilis infection as soon as possible. Syphilis is not only a highly contagious disease, it is a potentially fatal one as well. If you test positive for syphilis, chances are your sex partner has it as well. For this reason, it is wise for you and your partner to get tested and treated for syphilis together, so that you can minimize your chances of re-acquiring the infection or passing it along to someone else. At STDcheck.com we offer our FDA-cleared Syphilis Test. If you test positive for syphilis, you are eligible for a phone consultation with a doctor who may advise you about available treatments. Our doctors recommend getting retested 3 months after your initial treatment in order to be sure that the Treponema pallidum bacterium has not re-entered your system and was totally cleared of the bacteria in the first place.

If you are pregnant, get tested for syphilis

Syphilis is very harmful to infants and unborn babies. It can cause a mother to miscarry or the baby to be stillborn. Syphilis can easily be transmitted to a fetus from the placenta or transfer to the baby in the birth canal during delivery. It can cause serious or even fatal infections. Infants with congenital syphilis are often born prematurely and if left untreated, syphilitic babies will likely develop serious issues in internal organs like the heart, brain, skin, eyes, ears, bones and teeth. Syphilis can be treated during pregnancy with antibiotics to both decrease the risk of spreading it to the baby and stop the infection’s progression in the mother.

If a chancre is present on the breast or nipple, mothers should not breastfeed.

HIV and syphilis

According to the CDC, a person is 2-5 times more likely to contract HIV if exposed when syphilis sores are present. Oral, anal, vaginal, or penile syphilis sores also make it easier to contract HIV and spread it to others. It is easier to contract or transmit because syphilis sores bleed easily and are more likely to come in contact with mucous openings in the penis, vagina, anus and/or mouth.

  1. "Prevention - STD Information from CDC." Centers for Disease Control and Prevention. https://www.cdc.gov/std/prevention/default.htm
  2. "Dental Dams." Center for Young Women's Health. https://youngwomenshealth.org/2017/08/07/dental-dams/
  3. "Condom Fact Sheet In Brief | CDC." Centers for Disease Control and Prevention. https://www.cdc.gov/condomeffectiveness/brief.html
  4. Jacobson, Mark, MD, and Sulggi Lee, MD. "Diagnosis and Treatment of Syphilis." HIV InSite - a Project of University of California San Francisco. http://hivinsite.ucsf.edu/InSite?page=md-ward86-syphilis
  5. "Syphilis." Medline Plus. U.S. National Library of Medicine. https://medlineplus.gov/syphilis.html
  6. French, Patrick. "Syphilis." British Medical Journal 334:143-47. doi:10.1136/bmj.39085.518148.BE. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1779891/

Medically Reviewed by on Jun 18, 2019

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