Syphilis

Symptoms

Syphilis, caused by the bacteria Treponema pallidum, often doesn't cause any symptoms in its early stages. But if left untreated, it can progress to affect the entire body.

Syphilis typically has three stages, and there can be different symptoms in each.

Primary Syphilis

The symptoms of the first stage of the infection, primary syphilis, usually appear 10 days to 3 months after sexual contact with an infected person. A painless red sore called a chancre can appear on the genitals in the area where the infection occurred. Enlarged lymph nodes (swollen glands) also might be present in the area. Depending on the type of sexual contact, a chancre might also develop on the mouth or in the rectal area. Chancres are the primary way that syphilis is transmitted between people, but often are unrecognized. Even without treatment, chancres will heal after 3 to 6 weeks, but if the infection isn't treated the disease will progress to the second stage.

Secondary Syphilis

The secondary stage usually begins weeks to months after the chancre sore appears. Syphilis bacteria enter the blood and spread through the body, causing many different symptoms, including rash (small red spots), fever, headache, loss of appetite, weight loss, sore throat, muscle aches, joint pain, a generally ill feeling, and enlarged lymph nodes.

The rash of secondary syphilis can develop anywhere on the body, including on the palms and on the soles of the feet. Gray or white wart-like patches of skin called condylomata can appear on the moist areas around the mouth, anus, and vagina. These lesions are full of bacteria and very contagious.

The symptoms of secondary syphilis will eventually go away. But in this stage, syphilis can also affect the liver, kidneys, and eyes, or cause meningitis. The symptoms of secondary syphilis will eventually go away, but without treatment, the infection can advance to the third stage. This is true even if an infected person did not have symptoms of primary or secondary syphilis.

Late (Tertiary) Syphilis

After the secondary stage, people with syphilis who have not been treated progress to the latent stage, where they have no more symptoms but are still infected. Some of them go on to have symptoms of late syphilis, which can appear many years later and can damage the eyes, large blood vessels, heart, bones, and central nervous system (called neurosyphilis).

Symptoms of this late stage of syphilis can include memory loss, problems with mental function, walking, balance, bladder control, and vision, in addition to impotence and loss of feeling, particularly in the legs.

Treatment

A doctor can test for syphilis with a physical exam and blood tests and treat it with antibiotics. The doctor also can check for other STDs, such as gonorrhea, chlamydia, and HIV.

Anyone who is sexually active should see a doctor to be screened for syphilis and other STDs. Someone who has had sexual contact with a person who has syphilis, or has any symptom of the illness, should be seen by a doctor for testing and treatment as soon as possible.

Preventing STDs

Because syphilis is an STD, the best way to prevent getting it is to abstain from having sex. Sexual activity with more than one partner or with someone who has more than one sex partner also increases the risk of contracting an STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a woman's risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

Because many STDs often don't have obvious symptoms, people might not know when they're infected, so sexually active teens should get screened regularly for STDs so that they don't lead to other more serious health problems.

A teen who is being treated for syphilis also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it's important to encourage them to talk to a trusted adult who can provide the facts.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it's important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don't have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It's also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your area also might offer guidance.

Reviewed by: Larissa Hirsch, MD
Date reviewed: June 2010