Syphilis is mainly spread through close contact with an infected sore. This usually happens during vaginal, anal or oral sex, or by sharing sex toys.

It may be possible to catch syphilis if you’re an injecting drug user and you share needles with somebody who’s infected, or through blood transfusions (this is very rare in the UK as all blood donations are tested for infections such as syphilis).

Syphilis can’t be spread by using the same toilet, clothing, cutlery or bathroom as an infected person.

To help protect you from syphilis and most STIs including chlamydia, gonorrhoea and HIV, you can:

• Use a condom every time you have vaginal or anal sex.
• Using a condom or dam during oral sex.
• Avoid sharing sex toys. If you do share them, wash them after each use or cover them with a new condom after every use.

First stage of syphilis (primary syphilis)

After initial infection, symptoms usually take around two to three weeks to develop. The main symptom in this stage is a small, painless sore or ulcer that you may not notice.

• The sore will typically be found on the penis, vagina or around the anus. Sometimes the ulcer can appear in the mouth or on the lips, fingers or buttocks.
• Usually people will only have one sore, but some may have several.

You may also experience swollen glands in your neck, groin or armpits.

These symptoms usually pass within two to eight weeks and if left untreated, the infection will then progress into secondary syphilis.

Second stage of syphilis (secondary syphilis)

The next stage of symptoms tends to develop a few weeks after the initial symptoms have passed. Symptoms of secondary syphilis include:

• A blotchy red rash that can appear anywhere on the body, but often develops on the palms of the hands or soles of the feet.
• Skin growths (similar to genital warts) – on women these are found on the vulva and for both men and women they may appear around the anus.
• White patches in the mouth.
• Flu-like symptoms such as tiredness, headaches, joint pains and a high temperature.
• Swollen glands.
• Some people may experience patchy hair loss.

After a few weeks, these symptoms will pass although they may sometimes come and go over several months before they disappear.

Latent stage of syphilis

The symptoms for primary and secondary syphilis may eventually go away, but this does not mean your body has cleared the infection. Even with no symptoms, you’ll still have the infection and this is the latent stage.

It is still possible to pass on syphilis during this stage. If left untreated, the syphilis infection can live in the body for many years without causing any symptoms.

Third stage of syphilis (tertiary syphilis)

Eventually syphilis will spread to parts of the body such as the brain, causing life-threatening problems, this is tertiary syphilis. People at this stage will start to experience serious conditions such as:

• Dementia symptoms.
• Meningitis.
• Stroke.
• Vision problems or blindness.
• Heart problems.
• Loss of co-ordination.

Syphilis can still be treated at this stage but it isn’t possible to reverse all the damage caused by the effects of tertiary syphilis.

The initial symptoms of syphilis can be so mild that people may not realise they have been infected. The only way to know if you have been infected is by getting tested.

Syphilis doesn’t go away if left untreated and can cause serious problems if left undiagnosed.

You should get tested for syphilis if:

• You’re worried you might have it
• A sexual partner has told you they have syphilis
• If you have symptoms of syphilis.

It is really important to get tested if you’ve had unprotected sex, you have multiple sexual partners, you’re a man who has sex with men, or you’ve had sexually transmitted infections in the past.

To diagnose syphilis, you’ll usually have a:

• Physical examination – A doctor or nurse will have a look at your genitals or other parts of your body to look for any growths or rashes.
• Blood test – This will show whether you have syphilis or have had it in the past; you will be advised to repeat the test a few weeks later if the first test is negative and it’s been less than 12 weeks since your last risk
• Swab test – If you have any sores, a swab will be used to take a small sample of fluid and syphilis can be diagnosed this way.

Whilst testing for syphilis you’ll probably be advised to test for other STIs such as chlamydia and gonorrhoea as it’s possible to have more than one STI at a time.

You should avoid having sex or close sexual contact until you get your test results.

To receive treatment for syphilis, you must first be tested to confirm you have the infection.

The type of treatment you need depends on how long you’ve had syphilis.

• Syphilis that has lasted less than two years is treated with an injection of penicillin into your buttocks, or a 2 week course of other antibiotic tablets if you are allergic to penicillin.
• Syphilis that has lasted over two years is treated with three penicillin injections in the buttocks over 3 weeks, or a 28 day course of other antibiotic tablets if you’re allergic to penicillin.
• If syphilis has begun to affect the brain, daily penicillin injections are given for two weeks, or a 28 day course of other antibiotic tablets if you can’t have penicillin.

To ensure the treatment has worked properly, it will be recommended that you have a follow-up test to ensure the infection has cleared.

Avoid any kind of sexual activity or close sexual contact with another person for two weeks after your treatment finishes. If you do engage in close sexual contact, you could become infected again or you could pass the infection on to somebody else.

If a woman becomes infected whilst she’s pregnant, or becomes pregnant when she already has syphilis, it can be very dangerous for her baby if left untreated.

Syphilis in pregnancy can cause miscarriage, stillbirth or a serious infection called congenital syphilis.

All pregnant women are offered a blood test to check for syphilis, HIV and other blood borne viruses, usually at around 8-12 weeks of pregnancy.

A syphilis infection during pregnancy can be very dangerous for the baby, but the screening test can ensure it is detected and treated as soon as possible. If you’re worried you may have been exposed to syphilis later in your pregnancy, the test can be repeated.

If you have found out you have syphilis, or any other STI, it is important you let previous partners know. Your current and past partners will need to get tested and treated to avoid any serious complications or transmitting the infection further.

You can choose to notify your previous sexual partners yourself, our clinic staff will support you with this, or the clinic can contact them by phone and advise them that they need to go for a check-up.

If you decide the clinic should contact your previous sexual partners, don’t worry. Your details will remain totally confidential and no information about you will be given out without your consent.