Syphilis – The Basics

What is Syphilis?

Syphilis is a curable sexually transmitted infection (STI) caused by a tiny bacterium known as Treponema pallidum. This germ can affect almost any part of the body, leading to various symptoms.

Signs and Symptoms of Syphilis

The signs of syphilis can vary, but the most common include:

  • Ulcers: Painful sores that can appear on the genitals or inside the mouth.

  • Skin Rashes: These rashes can show up on different parts of the body.

  • Swollen Lymph Glands: You may notice swelling in the lymph nodes, which can be a sign of infection.

In some cases, syphilis can be "hidden", meaning it may not display any noticeable symptoms. This is why routine blood tests are so important; often, people find out they have syphilis only through testing. If left untreated, syphilis can lead to serious health problems, affecting the heart and brain, among other vital parts of the body.

Getting Treated for Syphilis

The good news is that syphilis can be easily cured with antibiotics. If you are diagnosed with syphilis, your healthcare provider will prescribe the appropriate treatment to clear the infection.

Where to Get Tested

Most testing for syphilis takes place at specialised clinics known as sexual health or genitourinary medicine (GUM) clinics. However, your family doctor (also known as a GP) or hospital doctors can also perform tests for syphilis. It is a common practice for all pregnant women to be offered syphilis testing as part of their routine antenatal care. If you have syphilis, it is advised to undergo routine tests for other STIs, including HIV.

How Common is Syphilis?

While syphilis is not extremely common in the UK, it is important to be aware of its presence. In 2014, there were about 4,300 diagnosed cases of syphilis in England. In comparison, more than 206,000 cases of chlamydia were reported in the same year. Most syphilis cases were found among men who have sex with men.

How Do You Catch Syphilis?

Syphilis can be transmitted in several ways:

  • Unprotected Sex: Engaging in vaginal, anal, or oral sex without protection with someone who has the infection.

  • Touching Sores: Coming into direct contact with ulcers or rashes of someone infected with syphilis.

  • Blood Transfusions: While very rare, syphilis can be passed on through blood transfusions.

  • From Mother to Baby: An infected mother can pass the infection to her unborn baby during pregnancy.

It’s important to remember that you cannot catch syphilis from hugging, sharing baths or towels, swimming pools, toilet seats, or sharing cups, plates, or cutlery.

Understanding syphilis is crucial for keeping yourself and others safe. Being aware of the signs, how it spreads, and the importance of testing can help in early diagnosis and treatment.

What Should I Look Out For If I Have Syphilis?

Many people don't notice any symptoms of syphilis at all, and it might only be found during a blood test. However, some individuals may experience one or more of the following signs:

  • Sore spots (ulcers) on the genitals, near the anus, or in the mouth

  • A rash on the skin

  • Swollen lymph nodes, especially in areas like the groin or neck

Symptoms can show up as early as a week after being infected, but sometimes it can take several months before you notice anything unusual.

How Can I Get Tested for Syphilis?

The main way to test for syphilis is through a blood sample. Some sexual health clinics may also do tests using samples from any sores or ulcers if you have them. Before you leave the clinic, they will explain how and when you will receive your test results.

How is Syphilis Treated?

Syphilis can be cured easily with the antibiotic penicillin, usually given as an injection in your buttock. The number of injections you need depends on how long you’ve had the infection. If you're allergic to penicillin, they will provide a different type of antibiotic.

All treatments at sexual health clinics are free of charge and will be provided during your visit.

Important Information About Your Treatment

The antibiotics used to treat syphilis are very effective. After treatment, some people may feel unwell with a high temperature, headache, and aching muscles. This is known as the Jarisch-Herxheimer reaction (JHR) and usually happens within 12 hours of treatment. The JHR typically lasts only a few hours and improves on its own. If you do experience this, taking paracetamol may help you feel better.

What About My Partner?

Since syphilis is a sexually transmitted infection (STI), it's really important that your sexual partner gets tested for syphilis and other STIs. If you've had other sexual partners in the past, some of them might need testing too. Your doctor will give you advice on this.

If you want, and with your permission, the clinic can contact your partner for you without revealing your name. This is called partner notification.

When Can I Have Sex Again?

You should wait to have sex until both you and your partner have been treated. Your doctor will let you know when it's safe to start having sex again.

What Happens if Syphilis is Not Treated?

If syphilis is not treated, it can cause harm to your nervous system, which includes your brain, spinal cord, and nerves, as well as your heart. These problems can take many years to develop, but they happen very rarely in this country because treatment is very effective.

How Will I Know If I Have Been Cured of Syphilis?

You will find out if you have been cured by having blood tests after your treatment is finished. Your doctor will explain this process to you.

Can Syphilis Be Caught Again?

Yes, it is possible to get syphilis again. Having syphilis once doesn't protect you in the future. To prevent this from happening, make sure your partner has been treated before you have sex with them again.

To protect yourself with new partners, always use a condom for anal, oral, and vaginal sex. Make sure that both you and your new partner have a sexual health check-up before having any unprotected sex (sex without a condom).

Preventing Syphilis: Essential Steps

To prevent syphilis, it's important to get tested regularly, especially if you have new or multiple sexual partners. Use condoms consistently and correctly during all sexual activities, as they greatly reduce the risk of transmission. Consider discussing the option of doxyPEP (doxycycline post-exposure prophylaxis) with your healthcare provider, as it can help lower the chances of getting syphilis if taken after potential exposure. By being proactive with testing, practising safe sex, and exploring prevention methods like doxyPEP, you can help protect yourself and others from syphilis. Click here for condoms; here for testing and here for DoxyPEP.

Syphilis in Pregnancy

This topic is covered in a separate section, or you can check information from the British Association for Sexual Health and HIV (BASHH).