Syphilis is a sexually transmitted infection (STI). It’s a bacterial infection that can be treated with antibiotics. If it’s not treated, it can cause serious and potentially life-threatening problems.

How do you get syphilis?

Syphilis is passed on through sexual contact like oral, vaginal or anal sex without a condom. It can also be passed on by sharing sex toys.

You can also get the infection if you have contact with a syphilis ulcer on someone’s genitals, bottom or inside their mouth.

It’s less common, but syphilis can also be spread:

  • from mother to child during pregnancy – this is known as congenital syphilis

  • by injecting drugs using a needle that’s been used by a person with syphilis

  • during a blood transfusion or organ transplant – this is rare in the UK as all blood or organ donations are checked for syphilis

Symptoms of syphilis

Symptoms of syphilis can be hard to notice. They’re often mild and change over time.

They can include:

  • small sores (ulcers) on your genitals and bottom, or in other areas like inside your mouth, on your lips or on your hands

  • a rash on the palm of your hands or soles of your feet – this rash does not itch

  • white or grey wart-like growth on your genitals or around your bottom

  • flu-like symptoms, like fever, tiredness and headaches

  • swollen glands

  • patches of hair loss

  • white patches inside your mouth

The infection has 3 stages – primary, secondary and late stage. Each stage has different symptoms.

Primary stage syphilis causes small sores (ulcers). The ulcers are very infectious but usually do not hurt. They can appear on your genitals, around your bottom, inside your mouth, on your lips or on your hands. The ulcers eventually disappear without needing treatment. At this stage, syphilis can also cause swollen lymph glands (lumps in your armpit, neck and groin).

Secondary stage syphilis can cause swelling of lymph glands and a skin rash. This often appears on your back or torso, palms of your hands or soles of your feet.

Late stage syphilis can happen from 7 to 30 years after getting the infection. It can affect bones, skin, the heart or the central nervous system. This stage can be life-threatening.

If you have any symptoms of syphilis, you should visit your local sexual health clinic or speak to your GP.

Getting tested for syphilis

Syphilis will not show up in tests immediately. It can take up to 12 weeks (84 days) after infection for it to show in test results.

So to get an accurate result, you should do the test at least 12 weeks (84 days) after sexual contact.

You can get tested at your nearest clinic, or you can order a postal test to do at home.

To test for syphilis, you’ll need to give a blood sample. If you do the test at a clinic, they might also check your body and genitals for signs of infection.

How to prevent syphilis

You can avoid getting syphilis or passing it on to others by:

  • using condoms for vaginal or anal sex

  • using a condom or dental dam during oral sex

  • washing sex toys or covering them with a fresh condom before sharing with another person (or use different sex toys with different partners)

  • if you inject drugs, use your own needles – do not share needles

You can get free condoms at sexual health clinics.

Regular testing helps reduce the spread of STIs. We recommend you test at least once a year. If you regularly have sex with new partners, we recommend testing every 3 months.

Is syphilis serious?

All sexually transmitted infections can be serious if they're not treated quickly. If you do not get treatment for syphilis, the infection will stay in your body. It can be latent for years, which means you will not see any signs or symptoms.

Eventually, it can lead to serious health problems that can be life-threatening. Untreated syphilis can cause:

  • heart problems, like angina or heart failure

  • brain problems which can include fits, problems with coordination, trouble with memory, dementia or personality changes

  • nerve problems, like pins and needles, pain in your joints, shooting pains

  • problems with other parts of your body, like skin, bones or liver

Some of these problems may not appear for many years after being infected with syphilis. It can still be treated at this stage. But it may not be possible to reverse any damage that’s been done.

Treatment for syphilis

Antibiotics are the recommended treatment for syphilis. This is usually given as an injection, or you can take tablets or capsules. When treated early, 90-100% of syphilis cases can be cured by a single injection of penicillin.

Some people will need more than one dose. For example, if they've had the infection for more than 2 years.

If you use our home STI tests, we’ll text you your results as soon as they are available. If you need treatment, we will help you get it.

When you’re having treatment, do not have any sexual contact until at least 2 weeks after your treatment has finished. This will reduce the risk of you passing syphilis on to anyone else.

Once you've been treated, you should go back to your sexual health clinic or GP for more blood tests. These will check that the infection has cleared.

The clinic will tell you when to do this test, but it should be at 6 and 12 weeks after your treatment.

Telling your partner

If you have syphilis, you should tell your current partner and anyone else you’ve had sex with in the last 6 months. They can have syphilis without knowing it, so it‘s important that they get a test.

When you get treatment for syphilis, the sexual health service should also offer to help you with telling your partners. They can help you do this anonymously, so you can let partners know they’ve had contact with an infection, without giving them your name.

Do you need help with something else?