Syphilis The number of people being diagnosed with syphilis in the UK has risen substantially. This fpa factsheet explains how it's transmitted, the symptoms to be aware of and how it's treated.

In this article

What is syphilis? How's it passed on?

What are the symptoms? What's the treatment?

Advice and support How to avoid STIs

Syphilis is a sexually transmitted infection caused by a bacteria known as Treponema pallidum.

Syphilis is usually passed from one person to another during vaginal, oral or anal sex. It can be passed on by direct skin contact with someone who has syphilis sores or a syphilis rash, and by sharing sex toys.

Syphilis can also be transmitted by blood transfusion. All blood donors in the UK are screened to detect this before blood is used.

You can't get syphilis...

from kissing, hugging, sharing baths or towels, swimming pools, toilet seats, cups, plates or cutlery

Syphilis can be passed from a pregnant woman to her unborn baby - this is known as congenital syphilis. All pregnant women are tested for syphilis.

The signs and symptoms are the same in women and men, but they can be difficult to recognise and you might not notice them.

Syphilis can develop in three stages, known as primary, secondary and tertiary syphilis. If you do get symptoms, you might notice the following:

Primary syphilis:

• One or more sores (chancres) - usually painless, they appear where the bacteria entered the body, usually two to three weeks after you've come into contact with syphilis
• The sores can appear anywhere on the body - in women they're found mainly in the genital area and on the cervix, in men they're found mainly in the genital area and on the penis
• Less commonly, they may be found in the mouth, lips, tonsils, fingers or buttocks

The sores are very infectious and can take up to six weeks to heal. By this time, the bacteria will have spread to other parts of the body, becoming known as secondary syphilis.

Secondary syphilis:

• A painless, non-itchy, very infectious rash that can occur all over the body or appear in patches, mostly on the palms of hands and soles of feet
• Flat, warty-looking growths on the vulva of women or anus in men and women
• Flu-like illness, tiredness and loss of appetite, with swollen glands, possible patchy hair loss and white patches in the mouth

Tertiary syphilis:

If left untreated, after many years syphilis can cause serious damage to the heart, brain, eyes and other internal organs, and lead to death. This is rare in the UK.

It's important to get tested quickly if you think you have syphilis. Testing is free on the NHS from genitourinary medicine clinics, sexual health clinics and from your GP.

The test involves a blood test and an examination of the genital area and anus. Your body, mouth and throat will also be examined.

A swab (like a cotton bud) will be used to take a sample of discharge and cells from any sore.

Treatment for primary and secondary syphilis involves either a single antibiotic injection, a course of injections, antibiotic tablets or capsules. Penicillin is the most common treatment, so tell your doctor if you're allergic to penicillin. Treatment usually lasts up to 14 days.

Some antibiotics interact with the combined oral contraceptive pill and contraceptive patch, making them less effective, so check this with your doctor or nurse.

To avoid reinfection, any sexual partners should also be treated.

What happens if it's not treated?

Without treatment the infection can cause serious long-term damage and lead to death.

Go to your GP, a genitourinary medicine clinic or a sexual health clinic. All services are confidential.

You can call fpa's helpline on 0845 122 8690.

• Male and female condoms, when used correctly, can help protect against STIs
• Before you have sex, talk to your partner about using condoms
• Use condoms every time you have vaginal or anal sex
• If you have oral sex, use a dam

This article was last reviewed in August 2007.