What it means
Syphilis is caused by the bacterium Treponema pallidum. It spreads through vaginal, anal and oral sex, through shared needles, and from a pregnant parent to a baby. It does not spread through ordinary contact, toilet seats or sharing cutlery.
It has several stages, and the important thing to understand is that it is far easier to treat early than late.
What can vary
- Primary stage: a single painless sore (chancre) at the point of infection, usually 3-6 weeks after contact. It is often unnoticed because it does not hurt, and it heals on its own — which does not mean the infection has gone.
- Secondary stage: a rash that often does not itch, commonly on the palms, soles and trunk, with mouth and genital sores, fever and swollen glands. Again, symptoms often resolve.
- Latent stage: no symptoms at all, for months or years.
- Tertiary stage: uncommon where diagnosis and treatment are available, but it can affect the heart, nerves, eyes and bones.
Possible explanations
Diagnosis is by blood test, often combined with a specific antibody test. A sore can also be swabbed directly.
Treatment is with antibiotics, usually penicillin. This works very well at any early stage.
Warning signs
- A painless sore that does not heal — the single most important thing to have looked at.
- A rash that does not itch, particularly on the palms or soles.
- Sores in the mouth or on the genitals that come and go.
- Flu-like symptoms with the above.
- Vision or hearing changes, or difficulty with balance or walking — these need prompt assessment.
What to do next
Get tested if you have symptoms, or after a possible exposure with a new partner.
If you have been diagnosed, your partner should be tested and treated. In pregnancy, syphilis is tested for and treated because of the risk to the baby.
Self-care
No self-care treats syphilis, and delaying treatment has real consequences.
What helps: complete the full antibiotic course, avoid sexual contact until treatment is finished, and ensure partners are treated.
When to seek help
Routine: testing after a possible exposure.
Prompt: any sore or rash as described above.
Emergency: not typically, though neurological symptoms need urgent assessment.
How to talk about it
“I’ve got a sore that isn’t healing — should it be tested?”
“I had a possible exposure and I’d like a blood test.”
“My partner tested positive for syphilis.”
Myths and stigma
“Syphilis is a thing that only happens to other people.” Rates have been rising in many countries, particularly among people who use methamphetamine and among people who have experienced homelessness — both associations driven by healthcare access and stigma, not by character.
“Syphilis is incurable / is HIV.” It is neither. It is curable with antibiotics, and it is a different infection from HIV.
“You would notice if you had it.” The early sore is usually painless, and it goes away. Most people never notice it at all, which is why testing matters more than symptoms.
Prevention
- Condoms reduce but do not eliminate transmission, because sores can occur on skin not covered.
- Regular testing is the most important step, because syphilis is usually painless and easy to miss. Testing after a new partner is sensible.
- Do not share needles, razors or toothbrushes, and use sterilised equipment for tattoos and piercings.
- Pregnancy screening includes syphilis, and treating it in pregnancy protects the baby.
Related articles
Sources
Public sources are linked so you can read the detail rather than take this site’s word for it. None of this has yet been reviewed by a qualified clinician — see how we handle medical review.
References
Where this comes from
Linked so you can check it against a recognised public health source rather than take this site's word for it.
- Syphilis — CDC US Centers for Disease Control and Prevention (opens in a new tab)
- Syphilis — NHS NHS (opens in a new tab)
These are public sources from recognised health organisations, linked so you can read the detail rather than take this site's word for it. Reading them does not tell you whether any of it applies to you, and none of these articles has yet been reviewed by a qualified clinician. How we handle sourcing and review.