Syphilis is a sexually transmitted infection caused by a bacteria called Treponema pallidum. Syphilis is easily spread through anal, vaginal, oral, sharing sex toys or or coming into contact with infected semen or vaginal fluids. Symptoms can include infected sores, blisters or ulcers on the genitals, anus or mouth. Syphilis can be difficult to diagnose and may not show any symptoms for years. However, if left untreated, syphilis can cause significant damage to your heart, brain and nervous system.

The infection develops in three separate stages - early (primary and secondary syphilis), latent and the late stage so it can sometimes be hard to recognise the symptoms of syphilis.

In 2023, there were a reported 9,513 of new syphilis diagnoses in the UK, with a 9.4% increase in new cases from 2022. This staggering number of new syphilis diagnoses is the largest annual number reported since 1948.

Data also showed a larger proportional increase among heterosexual men and women, with a 21.8% increase than those among gay, bisexual and other men who have sex with men, which showed a 7.3% increase. 

What are the symptoms of syphilis?

There are four stages to syphilis: primary, secondary, latent and tertiary. The first two stages are the most infectious stages.

The primary stage usually occurs up to three months after being infected and can cause a small, painless ulcer on the genitals, anus or inside the mouth and can often go unnoticed. This sore is called a chancre and remains on the body (or mouth) for approx 2-6 weeks. The sores can be passed on through sexual contact or oral sex which is why this stage is highly infectious. Typically, the sores can disappear without syphilis treatment.

Secondary (2nd stage)

In the secondary stage, the bacteria from syphilis spreads into the body and you may notice a rash, either on the palms of the hands or soles of the feet but it can occur anywhere. You may also experience a sore throat at this stage.

Other symptoms of secondary syphilis are: 

• Hair loss
• Fever
• Fatigue
• Swollen lymph nodes
• Ulcers 
• Aching joints

Often, in this stage syphilis is mistaken for another condition. The symptoms will go away with or without treatment (without treatment, syphilis will still remain in your body).

Latent (3rd stage)

The third stage of syphilis is called the latent, or hidden stage. Primary and secondary symptoms disappear and there are no noticeable symptoms in the latent stage. However, the bacteria remains in the body and can affect the brain, heart, skin, bones and other organs. This stage isn’t infectious and can last for years before progressing to tertiary syphilis.

Tertiary (4th stage)

This is the last stage of syphilis and can occur years or decades after the initial infection. This stage can be life threatening and can include blindness, deafness, memory loss, heart disease, strokes, mental illness or neurosyphilis (an infection of the brain or spinal cord).

How is syphilis diagnosed?

Syphilis is usually diagnosed by a simple blood test. If you have been exposed to syphilis, it can take up to 3 months to show on a test so it may be worth having a second test if the first one was negative. The test for syphilis usually involves a blood test and removing a sample of fluid from any sores using a swab.

How is syphilis treated?

Syphilis is treated with antibiotics, either as a single injection, a course of injections or tablets.

• Injection: Usually 1 injection directly given into your buttocks. You may need 3 injections at weekly intervals if you have had syphilis for a long time.
• Tablets: If you cannot have the injection, you may be given a course of antibiotic tablets. The course will usually last 2-4 weeks, depending on how long you have had syphilis.

Your partner will also need treatment and you should avoid sexual activity for at least two weeks AFTER your treatment finishes. 

What happens if I’m pregnant?

All pregnant women are offered a blood test for syphilis in the UK. This is because syphilis can be very dangerous for the baby if not treated - resulting in miscarriage, stillbirth or a serious infection. It's easy to treat syphilis in pregnancy and the treatment will not harm the baby.

How can I prevent myself from catching syphilis?

Condoms! Condoms reduce the risk of catching sexually transmitted infections by preventing any sexual fluids from being transferred. By using a condom (or dam) every time you have vaginal, anal or oral sex reduces the risk of contracting syphilis. We have a wide variety of condoms available from regular, king size, super king or trim as well as flavoured and fun condoms so there’s plenty of variety available. Unsure which condom to choose? Read our blog on What type of condom should I buy?

To find out more about syphilis, syphilis symptoms or treatment click here (directed to NHS website)