How long does it take to cure syphilis

Syphilis is a sexually transmitted infection (STI). It is caused by bacteria and can cause serious health problems if left untreated. However, it is easy to cure if found early.

Syphilis is rare in Australia, but the numbers are increasing, especially in men who have sex with men and young Aboriginal and Torres Strait Islander people living in Queensland, Northern Territory, Western Australia and South Australia. There has also been an increase in the rate of syphilis in Victoria in recent years.

What are the symptoms of syphilis?

Some people with syphilis have no symptoms, so you may not know you have it unless you get tested. There are 4 stages of syphilis infection: primary, secondary, latent and tertiary.

The signs and symptoms of syphilis depend on the stage of disease.

Primary syphilis occurs 3 or 4 weeks after infection (although it can take up to 90 days for the sore to appear). Symptoms may include a single painless sore usually about a centimetre big at the site where the infection entered the body — such as on the penis, vagina, cervix, mouth or anus. There may also be swollen lymph nodes.

The sore, or sometimes multiple sores, can go unnoticed because it is usually painless and may be hidden from view in areas such as the back of the throat, vagina or anus.

These sores usually go away by themselves after 3 to 6 weeks, even with no treatment. However, even though the sore heals, if you haven’t been treated, you are still infectious and can pass it on to others.

Secondary syphilis can occur 7 to 10 weeks after the initial infection. Symptoms can last for 6 months or more and may include:

• a red rash on the palms, soles, chest or back
• fever
• enlarged glands in the armpits and groin
• sore throat
• hair loss
• weight loss
• headaches
• pain in the bones, muscles and joints
• tiredness
• ulcers in the mouth, nasal cavity or genitals
• neurological symptoms

Latent (sleeping) syphilis generally has no symptoms and it is only picked up on blood tests. If syphilis is not treated at this stage, it can remain latent or develop into tertiary syphilis. Latent syphilis is infectious within the first 12 to 24 months.

Tertiary syphilis can appear anywhere from 5 to 20 years after primary infection. At this stage, the bacteria can damage almost any part of the body including the heart, brain, spinal cord, eyes and bones, resulting in heart disease, mental illness, blindness, deafness and neurological problems.

CHECK YOUR SYMPTOMS — Use the sexual health and lower body Symptom Checker and find out if you need to seek medical help.

How is syphilis spread?

Syphilis is usually spread through skin-to-skin contact during vaginal, anal or oral sex. It can also be spread by direct contact with open sores on areas such as the lips, mouth, breasts or genitals.

Syphilis is highly infectious during the time when a sore or rash is present. It can also be passed on before people know they have it and by people who don't have any sores.

Syphilis can occasionally be spread by blood contamination, via needle-stick injury or sharing injecting equipment. It is extremely rare to get syphilis through a blood transfusion.

A pregnant woman with syphilis can pass the infection on to her baby via the placenta. This is called congenital syphilis.

Who is at risk?

In Australia, groups at particular risk of syphilis include:

• men who have sex with men
• female sexual partners of men who have sex with men
• Aboriginal and Torres Strait Islander people
• babies of mothers who have not had proper syphilis testing and treatment during pregnancy
• people who use or inject drugs

When should I see my doctor?

If you think you may have syphilis, it is important to see a doctor as soon as possible. Your doctor will confirm the diagnosis with testing and start treatment if required.

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How is syphilis diagnosed?

Your doctor will need to do a blood test to confirm a diagnosis of syphilis. The blood test detects the antibodies that the body produces to combat infection. A positive test shows that you have a current or past infection. It can take 3 months to develop antibodies, so the tests may be negative early on.

Your doctor may also do a swab test from a sore. When syphilis is diagnosed your doctor will report it to the local health authorities.

Pregnant women are routinely tested for syphilis.

It may also be a good idea to be tested for other sexually transmitted infections such as chlamydia, gonorrhoea and HIV.

Notifying partners

It is very important to tell previous sex partners who may have been exposed so that they can also be tested and treated if infected. Your doctor will help you decide who you need to tell and how you can tell them.

The Let Them Know website can provide advice and sample emails, SMSs and letters to send personally or anonymously.

How is syphilis treated?

Syphilis is usually treated with penicillin given by an injection into muscle. There are other treatments if you are allergic to penicillin. The amount of time you need to be treated depends on the stage of the infection. You may need repeat blood tests at 3, 6 and 12 months after treatment to check that the treatment has worked.

After treatment with penicillin, you may feel like you have flu for 24 hours, with a fever, aches and pains. This will soon go away and you don’t need any extra treatment. Rest and drink plenty of fluids.

It is safest not to have sex, even with a condom, until 7 days after you have completed the full course of treatment. Syphilis is very infectious, particularly during the early stages.

What if I’m pregnant?

If found early in the pregnancy, syphilis can be treated and reduce the risk of damage to the baby. All women are recommended to have a syphilis test in the first 12 weeks of pregnancy or at the first antenatal visit.

What are the complications of syphilis?

Syphilis can lead to serious complications if not treated. It can spread throughout the body over many years (tertiary syphilis) and lead to major problems in the brain, eyes and heart.

If not treated, congenital syphilis can have major impacts, including miscarriage, stillbirth, prematurity, low birthweight or death shortly after birth. Babies born with syphilis can develop major problems with their brain, bones, blood, organs, vision and hearing.

Can syphilis be prevented?

Practising safe sex is the best way to prevent syphilis infection.

It is safest to:

• always use condoms with water-based lubricant during sex
• always use dental dams for oral sex
• limit the number of people you have sex with, or just have sex with one partner who isn’t already infected
• avoid sex with someone infected with syphilis or who has symptoms of syphilis until they have finished treatment
• have regular STI check-ups — every 6 to 12 months

Resources and support

• "Syphilis: Do you know what to look for?" (PDF)

"Syph" "The Pox" or "Bad Blood"

Syphilis is a sexually transmitted disease (STD) that is found around the world. In the United States it is more widespread in parts of the south.

What causes syphilis?

Syphilis is caused by bacteria (Treponema pallidum) that enter through your skin, mouth, or anus. This causes a painless skin ulcer (chancre) to form at the infection site. After an ulcer forms, syphilis spreads through your blood. This causes a skin rash. Later on, in some people, syphilis can cause damage to any organ of the body.

How can I get syphilis?

You can get syphilis if part of your body touches the skin ulcer or rash of someone with syphilis. This happens most often during sex. A pregnant woman with syphilis can pass the infection to her unborn child. This is called congenital syphilis.

What are the signs and symptoms?

Syphilis has four stages.

Stage 1, Primary syphilis

• Within 10 days to 3 months after sex with someone who has syphilis, one or more painless ulcers will form where there was contact. Ulcers usually form within 3 to 4 weeks.
• Within 1 to 5 weeks, ulcers heal without treatment. But, this does not mean you no longer have syphilis. See your health care provider for treatment even if your ulcers go away.

Stage 2, Secondary syphilis

• Begins 2 weeks to 6 months after the ulcer heals. This stage usually begins within 6 weeks.
• During this time, the bacteria will travel through your body causing a widespread rash. The rash can look very different from person to person. It is often found on the palms of the hands and the soles of the feet.
• As the bacteria spread through your blood, you may get a fever, a sore throat, and swollen glands. You may also feel generally weak and tired.
• Like primary syphilis, the signs and symptoms of secondary syphilis go away on their own without treatment in 2 to 6 weeks. But, you still have syphilis and it is dangerous. You should see your health care provider even if you do not have signs or symptoms. If you do not, you may get sicker.

Stage 3, Latent syphilis

• After the signs of secondary syphilis go away, the infection becomes hidden (latent). Without treatment you will still have syphilis for 20 years or more even though you will not have any signs or symptoms. People with latent syphilis may sometimes have symptoms (flare-ups) like skin rash, fever, a sore throat, swollen glands or feeling weak and tired. This is most common during the first year of Stage 3.

Stage 4, Tertiary or Late syphilis

• About one of every four people who don't get any treatment within 20 years of their first skin ulcer, will get this type of syphilis.
• Late syphilis can damage any organ in your body.

Can syphilis cause other problems if it's not treated?

Yes. If you progress to Stage 4 syphilis, the damage to your body will get worse as time goes on. If your brain and spinal cord are affected you may become permanently mentally ill and paralyzed. You may also become blind and your bones and heart may be harmed. (Your aorta may become inflamed. This is the large blood vessel that connects to your heart.) Stage 4 syphilis can cause many other health problems. These problems may be mild or they may be serious enough to threaten your life.

If you have syphilis, it will make it easier for you to get HIV, the virus that causes AIDS. If you have HIV and syphilis, it's even more important for you to get proper treatment quickly. Because you have both diseases, you are at a greater risk for serious health problems.

A pregnant woman with syphilis may pass this infection to her unborn baby. This is called congenital syphilis. It can cause the baby to die before it is born - a stillbirth. A baby who has syphilis at birth may suffer permanent damage to their liver, brain, eyes, teeth, bones, glands and lungs.

How will I know if I have syphilis?

If you have skin ulcers or a rash, your health care provider should examine you. He or she will take a sample from your ulcer or rash and use a microscope to look for bacteria. Even if you don't have symptoms, your provider can find out if you have syphilis by testing your blood.

Health care providers give one of these blood tests to all pregnant women in New York State when they give birth. These tests help find out which babies are at risk for congenital syphilis.

Is there a cure?

Yes. Penicillin is the first-choice treatment for every stage of syphilis. It usually cures the disease. If you are allergic to penicillin, your health care provider can use a different medicine unless you are pregnant. All pregnant women must be treated with penicillin to effectively treat the baby. In those cases, you can still be treated safely because your doctor will take precautions to prevent an allergic reaction to the medicine. It is important for you to visit your health care provider to be sure the disease is cured.

When can I have sex again?

If you have been treated for syphilis, you should not have sex for 7 days after your treatment is over. Also, if your sex partners are not treated you can get syphilis again. Do not have sex with any partner who has syphilis until 7 days after he or she finishes treatment.

What about my partner(s)?

Syphilis is spread through sex. So, even if your sex partners don't have any symptoms they should be checked for syphilis.

Can I get this infection again?

Yes. You are at risk for getting syphilis again if your partner(s) aren't properly treated before you have sex again. You are also at risk if you have unprotected sex. Unprotected sex means sex without a condom.

How can I prevent syphilis?

Not having sex (abstinence) is the only sure way to avoid infection.

If you choose to be sexually active, use latex or polyurethane condoms each time you have oral, anal or vaginal sex. This will lower your chances of giving or getting syphilis. But, using condoms will not totally stop your risk of giving or getting syphilis. This is because condoms do not cover ulcers and rashes that may be on other parts of your body or your partner's body. Condoms do help prevent the spread of other STDs including HIV, the virus that causes AIDS.

If you are sexually active, you and your partner( s) should get a full physical checkup. This includes a complete sexual history and testing for HIV and common STDs such as gonorrhea, Chlamydia, syphilis, herpes, genital warts and trichomoniasis.

Will anyone know the results of the exams?

Your test results and any treatment will be kept absolutely confidential. No one can find out your results, except you. If you are under 18 you can be checked and treated for STDs without getting permission from your parents.

To learn more:

If you have more questions about syphilis, or you want to know how to find a clinic near you, call your local health department or family planning program.

You can also find a testing center near you at http://gettested.cdc.gov/.