Healthier Scotland. Scottish Government

Syphilis treatment

How syphilis is treated

First and second stage syphilis is treated using a 10-14 day course of antibiotics. Penicillin is normally used, though other antibiotics can be used if you are allergic to penicillin.

Late stage (tertiary) syphilis is treated with antibiotic injections.

Once the treatment has finished, a second test is carried out to make sure the infection has gone. Further tests may be required for up to a year.

Although the infection will be gone after a successful treatment, some blood tests will remain positive for life.

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Where to get treated for syphilis

It is best that treatment for syphilis is carried out through a sexual health service.

Staff at sexual health services are used to dealing with this type of illness. They will be able to give you further advice on how to stay healthy and make sure you get any other support or treatment you need.

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Syphilis and HIV

Syphilis is more complicated to treat in people who also have HIV, partly because it can progress more rapidly.

Staff at a sexual health service will make sure that both infections are treated in the best way possible.

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Important things to remember during syphilis treatment

Your partner should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it.

While you are being treated and until you get a clear test result:

• do not have any kind of sex
• avoid skin contact with your partner and others.

This will stop you from infecting your partner if they are clear, and stop you being re-infected if they also have syphilis.

Successful treatment for syphilis will not protect you from getting it again in the future.

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Side-effects of syphilis treatment

A small number of people experience a reaction to the initial treatment with antibiotics known as the Jarisch-Herxheimer reaction. It is thought that the reaction is triggered by a large amount of bacteria dying at the same time due to antibiotic treatment.

This causes flu-like symptoms such as fever, headaches, and muscle and joint pain. The reaction normally only lasts 24 hours, and causes no serious problems.

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Syphilis treatment and contraceptive pills and patches

Some of the antibiotics used to treat syphilis, including penicillin, can stop contraceptive pills and patches from working properly. If you are taking the contraceptive pill, tell the staff at the sexual health service or your GP.

You should avoid sex of any kind until you have been tested to make sure that the infection has gone.

Read more about using contraceptives

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Syphilis treatment during pregnancy

Syphilis in pregnancy can be successfully treated. There are no risks to your unborn baby from the antibiotics used to treat syphilis.

It is vitally important that pregnant women receive treatment for syphilis, as untreated syphilis causes serious birth defects, miscarriages or stillbirths.

Read more about sexual health and pregnancy

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