Healthier Scotland. Scottish Government

Syphilis symptoms and how it's caught

What are the early symptoms of syphilis?

Early syphilis is easy to miss. Many people show no sign that they're infected.

Early syphilis can make some people feel very ill, especially the 'secondary stage' with a rash and fever.

You may see two stages:

• A few days after sex a small sore on the penis, the opening of the vagina, anus, mouth or tongue can appear. This is often painless and heals by itself, although it can be painful and look just like genital herpes.
• A few days to many weeks later a rash can develop, notably affecting the palms. Mouth ulcers occur. Moist, warty lumps may grow round the anus. People can feel ill and feverish. Rarely, vision and hearing can be affected.

Syphilis isn't always easy to spot, because it can look like other common conditions. It can fool even the experts unless you get the correct blood test.

Most people with syphilis have no visible signs. This is bad for you because of the risk of damage to your health in later life.

If you do have it, you can still pass it on to others, even if you've never had any symptoms.

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Long-term effects of syphilis

Later on, syphilis can damage many organs if it remains untreated. The skin, heart, brain, eyes, bones and nervous system can all be affected.

This can lead to mental illness, shooting pain, disfiguring skin lesions, loss of vision and heart disease. Usually this takes twenty years or more.

Adequate treatment at any time can stop further trouble, though it does not repair any damaged organs.

You remain infectious to other people for about two years from initial infection if you are not treated.

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How syphilis is caught

Syphilis spreads best by contact between moist skin areas anywhere on or in the body. People remain infectious to others for about two years from initial infection if they are not treated.

Some of the ways you can catch it include:

• kissing
• oral sex without a condom or dam
• mutual masturbation
• anal sex without a condom
• vaginal sex without a condom
• kissing or licking the anus without a dam
• handling a used condom or dam.

Syphilis in heterosexual men and women is more likely in those having sex with overseas partners, or with multiple partners at the same time.

In recent outbreaks, syphilis has been more likely in men having sex with men who have had:

• casual sex in saunas, cruising areas and gay sex venues
• multiple sexual partners, especially at the same time
• oral sex without using condoms.

Syphilis makes HIV easier to pass on and catch, and HIV can make syphilis harder to treat.

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Syphilis and pregnancy

Syphilis can be passed from a mother to her unborn baby. This is why all women are offered syphilis testing in pregnancy.

It can be successfully treated during pregnancy with a course of antibiotics. The treatment does not harm the unborn baby.

If syphilis is left untreated during pregnancy it causes serious birth defects, miscarriages or stillbirths.

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How to prevent infection with syphilis

To reduce the risk of getting syphilis:

• use condoms for anal and vaginal sex
• use a condom or dam for oral sex
• reduce the number of partners you have sex with
• be extra careful if having sex in places where syphilis is more common.

Remember - you can have syphilis for many years without any obvious symptoms that might make you or your GP think you have it. To keep yourself safe, regularly get tested for syphilis if you have been at risk.

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