What is syphilis? For many years, the medical community believed that syphilis was a thing of the past. International epidemiological data, however, show that syphilis has returned. Syphilis is a primarily sexually transmitted disease that progresses in stages and presents many different symptoms. It affects both men and women and, if not treated promptly, can cause serious damage. The good news is that today it is possible to diagnose and treat syphilis. It is caused by the bacterium Treponema pallidum and is characterized as “the great imitator” , due to its frequent and atypical appearances.
Syphilis: Cause of Occurrence The bacterium Treponema pallidum is responsible for the occurrence of syphilis. The bacteria enter the body through the anus, vagina, penis, mouth, or through breaks in the skin. They then continue their action in the body, causing serious damage to vital organs.
Who does syphilis concern? Any sexually active person can get syphilis, as the disease is transmitted through sexual contact. There are risk factors, however, that favor the transmission of syphilis such as: Sexual intercourse with multiple partners without protection. Sexual intercourse between men. Unprotected sexual intercourse. Infection with the virus that causes AIDS - HIV.
Syphilis & transmission Syphilis is a contagious disease, especially in its first and second stages. It is mainly transmitted through sexual contact, oral, vaginal, and anal, even when there is no penetration or ejaculation. Syphilis can also be transmitted through contact with the wound or ulcer of someone who has syphilis. It is worth noting that even when you do not have rashes or wounds, you transmit syphilis, as the infection remains in your body until you receive the appropriate drug treatment. Furthermore, syphilis can also be transmitted from mother to child, during pregnancy or childbirth. It is called congenital syphilis and its treatment is imperative as it can cause deformities in the child's skull, such as in the nose and teeth, as well as rashes on the soles of the feet and palms. You will not get syphilis from: toilet seats swimming pools jacuzzis bathtubs sharing clothes or food
Syphilis symptoms Syphilis progresses in stages, characterized by various symptoms and differing contagiousness. The disease is highly contagious in its early stages, specifically the first and second. In the third stage, syphilis is latent, meaning it is hidden. This implies that the infection is present, but its symptoms are not visible. Medical treatment is the only way to cure syphilis and halt its dangerous progression.
Stages of Syphilis The progression of syphilis occurs in stages, and the symptoms are different for each stage. However, in some cases, there might be an infection where no symptoms appear for many years, or when stages overlap, symptoms may manifest in a different order. Primary Syphilis The first stage of syphilis begins 10 to 90 days after infection. In this stage, one or more open, painless small sores, syphilitic chancres, appear, which the patient might not notice. The primary symptom in the first stage of syphilis is the syphilitic chancre. It is usually a small sore that does not itch or cause pain. Most often, it appears at the point where the bacterium entered, i.e., the genitals. This sore usually appears three weeks after exposure to the disease, and many people will not notice it as it might be hidden inside the vagina, rectum, or mouth. Syphilis sores usually appear: internally in the mouth (oropharynx, tongue) on the penis in the vagina in the anus If left untreated, the syphilitic chancre heals on its own within approximately six weeks. The sores of syphilis heal on their own and pave the way for the second stage of the disease, which progresses if there is no treatment. At this stage, syphilis is highly contagious. Secondary Syphilis The second stage of syphilis begins after the initial sores have healed and within 6 months. In this stage, symptoms spread to the torso, as well as to every part of the body, including the soles of the feet and the palms of the hands. In the second stage, rashes initially appear on the torso which may later become widespread on the rest of the body, palms, soles, and even in the mouth, while there is a possibility of subsequent lesions resembling warts. Additionally, symptoms such as a sore throat, swollen lymph nodes, muscle pain, or fever may be observed. In addition to skin manifestations, syphilis can also cause in the second stage: fever fatigue sore throat weakness hair loss weight loss swollen lymph nodes If untreated, these symptoms may completely subside within a few weeks. However, there is a possibility of relapse and reappearance of symptoms within the next 12 months. The second stage of syphilis can last from a few weeks to several months, after which the symptoms will disappear. At this stage, syphilis is contagious. Latent Syphilis Syphilis at this stage has no symptoms. This particular stage can last for many years. During this period, the disease ceases to be contagious...
Neurosyphilis If the bacterium that causes syphilis reaches the central nervous system, you may develop a type of syphilis called neurosyphilis, which causes symptoms such as: Headache Stiff neck Confusion or hearing loss
Imbalance Weakness Dementia Neurosyphilis can occur at any stage of syphilis.
Congenital Syphilis Congenital syphilis refers to the transmission of the disease from mother to fetus during pregnancy. The effects can be very severe for the fetus if syphilis is not detected early and treated in a timely manner. Mother-to-child transmission of syphilis can lead to: prematurity low birth weight fetal death perinatal death Mother-to-child transmission of syphilis can also lead to: deformed bones brain and nerve problems such as blindness and deafness severe anemia jaundice meningitis
Diagnosis of Syphilis Early diagnosis is crucial for treating syphilis, as it is more easily cured when detected in its early stages. The diagnosis of syphilis is made by a dermatologist-venereologist through specific blood tests, which will confirm the presence of antibodies produced by the body to combat the infection.
In the initial stages of syphilis, a sample can be taken from the sores caused by syphilis and sent to the laboratory for evaluation. The antibodies produced by the body to fight the infection remain in the body for years, so testing can determine if there is a current or past infection. If the test is positive, the doctor will determine the stage of syphilis by evaluating the test results and taking a complete medical history of the patient. Generally, syphilis can be diagnosed by examining a sample from: blood sores or other lesions cerebrospinal fluid
Positive syphilis diagnosis After a positive diagnosis, the first step is adherence to the treatment recommended by the dermatologist - venereologist. If the test is positive, the doctor will determine the stage of syphilis by evaluating the test results and taking a complete medical history of the patient. The immediate next step is to inform your partner(s) that you have been diagnosed with syphilis so that they can also be tested and, if necessary, receive treatment. This will prevent syphilis from spreading to other people and also prevent your own potential re-infection. Avoid sexual intercourse for at least one week and until treatment is complete and you no longer have sores on your body. When you resume sexual contact, do not be afraid to ask your partner about their sexual health and, of course, take protective measures.
Syphilis treatment Syphilis can be treated at all stages, but more easily in the initial ones. The dermatologist - venereologist will recommend treatment for syphilis after evaluating the stage and symptoms of the disease. The main treatment for syphilis is penicillin, while in case of allergy there are alternative antibiotic options. The most commonly preferred treatment is an antibiotic called penicillin. Patients receiving treatment should be monitored at regular intervals determined by the doctor. Some patients may need more doses of penicillin, others may be re-infected, etc. If the infection occurred within the last year, a single injection of penicillin can stop its progression. Otherwise, it may require more doses of the medication. If someone is allergic to penicillin, another antibiotic will be administered. Side effects of penicillin are very rare and may include fever, headache, nausea, chills, and acute pain, however, these symptoms usually do not last longer than 24 hours. The prognosis for most patients who follow treatment is good. In contrast, those who do not comply with treatment or delay receiving treatment for syphilis may face serious, often life-threatening conditions.
Syphilis: After treatment Syphilis can be treated at all stages, but it is easier in the early stages. After receiving treatment, the patient should: Undergo periodic blood tests to determine if they are responding to treatment. Avoid sexual contact until it is confirmed that the infection has been treated. Inform recent sexual partners so they can also be tested and, if necessary, receive treatment. Get tested for other sexually transmitted diseases and HIV, as syphilis sores bleed easily, allowing HIV to penetrate the body during sexual contact.
Syphilis & prevention Reducing the risk! True prevention of syphilis, as with other sexually transmitted diseases, is abstinence from sex. However, you can reduce the risk of infection by properly using a condom during sexual intercourse. A condom prevents syphilis from spreading by preventing contact with any sores it causes. However, often sores appear in areas not covered by the condom. These sores can transmit the disease of syphilis. A mutually monogamous long-term relationship also reduces the chances of syphilis infection. The greater the number of sexual partners, the greater the risk of exposure to syphilis and other sexually transmitted diseases. Furthermore, do not hesitate to discuss your sexual health with your partner, as well as whether they get tested for sexually transmitted diseases.
Bibliography https://www.ncbi.nlm.nih.gov/books/NBK534780/ https://www.who.int/health-topics/syphilis#tab=tab_1 https://share.upmc.com/ https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm https://my.clevelandclinic.org/health/diseases/4622-syphilis https://www.aad.org/public/diseases/a-z/syphilis-treatment
Written by Facemed Clinic Scientific Team on Apr 9, 2020 - Reviewed by Dr. Christoforos Loizidis updated Jun 17, 2025 Clinical Dermatology HPV Warts Chlamydia Gonorrhea VIEW ALL FIND OUT THE COST BOOK APPOINTMENT ONLINE
Is syphilis 100% curable?
Yes, antibiotic medication will cure syphilis, but it cannot reverse any damage it has caused to body organs. If, for example, syphilis has caused hearing loss, this will persist after treatment.
How is syphilis transmitted?
Syphilis is transmitted through contact with a syphilitic sore via vaginal, anal, or oral sex. It is also transmitted from a pregnant woman to the fetus.
Can syphilis be transmitted through the use or touching of objects such as a toilet?
No, syphilis is mainly transmitted through direct skin contact with the affected area and sexual contact. The syphilis bacterium cannot survive outside the human body.
Is there a risk of contracting syphilis from kissing?
Yes, although it is rare. You can get infected if you come into contact with a syphilis sore.
How is the treatment administered?
The antibiotic is administered to the patient by intramuscular or intravenous injection, depending on the stage of syphilis and the patient's condition.
