The Basics


What is syphilis? Learn how to prevent, manage, and treat syphilis with safe practices, lifestyle, and medicine.

Medically Reviewed By:

Dr. George Abraham

Last Updated:

December 3rd, 2022

What is Syphilis?

Syphilis is a common Sexually Transmitted Infection (STI). If untreated, syphilis progresses through multiple stages and causes serious health problems. Doctors can treat syphilis with medication. 

Stages and Symptoms

Primary Stage

Syphilis begins with a single sore, called a chancre (pronounced SHANG-kur), that’s usually small and painless. A chancre might be on or near the

  • Penis

  • Vagina

  • Anus

  • Rectum

  • Lips

  • Inside of the Mouth

The sore heals in 3-6 weeks, even if you do not receive treatment. But, the disease isn’t gone, and you need treatment. Treatment stops syphilis from progressing to the next stage.

Secondary Stage

You may have rough, red/reddish-brown rashes on your palms and soles of your feet; sores on your mouth, vagina, or anus. And, you may notice more symptoms:

  • Fever

  • Feeling tired

  • Sore throat

  • Swollen lymph nodes

  • Weight loss

  • Hair loss

  • Muscle aches

These symptoms get better, even if you do not receive treatment. But, you need treatment because the disease is still present, and treatment stops syphilis from progressing to the next stage.

Latent Syphilis

There are no symptoms in latent syphilis. But the syphilis bacteria still live in your body. This stage can last for years. Latent syphilis within the first year of infection is called Early Latent Syphilis, and you can still spread the disease. After the first year of infection, latent syphilis is called late latent syphilis.

Tertiary Syphilis

Tertiary syphilis is rare: most people with syphilis never develop the tertiary stage. The tertiary stage can appear 10-30 years after your first infection. Tertiary syphilis harms your heart, blood vessels, brain, and nervous system, and it can cause death.  


Untreated syphilis can spread to eyes (ocular syphilis), ears (otosyphilis), and the brain and nervous system (neurosyphilis). 

Eyes (Ocular Syphilis)

Ocular Syphilis can cause:

  • pain and redness in your eyes

  • sensitivity to light

  • floating spots in your vision

  • Blurry vision

Ocular syphilis can progress to even cause blindness.

Ears (Otosyphilis)

Otosyphilis can cause:

  • ringing in your ears (tinnitus)

  • dizziness and head spinning (vertigo)

Otosyphilis can progress to even cause hearing loss.

Brain (Neurosyphilis)

Neurosyphilis can cause: 

  • Headache

  • Trouble moving

  • Weakness

  • Numbness

  • Trouble focusing, thinking, remembering, and making decisions


If you are pregnant and have syphilis, the disease could spread to your baby. This could cause problems with the baby’s birth or health. Get tested for syphilis during your pregnancy. And if you test positive, get treatment right away.

Getting Tested—Do You Have Syphilis?

Anyone who is sexually active can have syphilis. If you notice symptoms, stop having sex and see your healthcare provider (doctor, clinic, hospital). Or, if your recent sexual partner is diagnosed with syphilis, stop having sex and see your healthcare provider.

You cannot diagnose syphilis with symptoms alone. Some people do not get rashes and sores; or, the rashes and sores could be caused by a different disease.  That’s why you have to get tested.

Sexually active people should get tested every year if they:

  • Are a gay or bisexual man

  • Have HIV

  • Take pre-exposure prophylaxis (PrEP) for HIV prevention

  • Have sexual partners who have had syphilis before

Your doctor may test you for syphilis using a blood test or using fluid from a syphilis sore.

Testing Positive for an STI: What to Do

There are 4 steps everyone should take after testing positive for an STI, like syphilis.

  1. Stop Having Sex

Doctors can treat STIs with just medicine or an injection (‘shot’). But if untreated, syphilis can spread and cause severe problems. Keep seeing your doctor.

  1. See Your Doctor

Doctors can treat STIs with just medicine or an injection (‘shot’). But if untreated, syphilis can spread and cause severe problems. Keep seeing your doctor.

  1. Get Tested for Other STIs

STIs often come in groups. If you have syphilis, you’re at risk for other STIs. Get tested.

  1. Tell Your Partner

If you are diagnosed with an STI, you should tell your recent sexual partners. This protects your partners’ health because they can get tested and treated.

Partner Services

Talking to your partner about your STI can be hard. If you want to stay anonymous, you can ask your health department or doctor to tell your partner, without mentioning your name.

Or, you can ask a Partner Services Representative to be with you and provide support while you tell your partner.

Treatment: How to Feel Better

Medication: Antibiotics

Syphilis can be treated with medication from your doctor. The treatment stops any progression But the treatment might not cure the damage on your skin and organs. That’s why it’s important to see a doctor early if you see signs of syphilis.

Use Antibiotics the Right Way

Remember to take antibiotics exactly how your healthcare professional tells you. You may feel better in 1 to 2 days. Don’t stop antibiotics because you’re feeling better. You need to finish taking the antibiotics so you don’t get sick again.

Transmission: Protecting Family and Friends

Syphilis spreads by touching a chancre of someone with syphilis. This often happens during vaginal, anal, or oral sex. Pregnant people can transfer syphilis to their child during pregnancy.  You can get syphilis again, even if you have been infected before and received treatment. 

The best way to avoid syphilis and protect your partners is to not have sex. But, when you do have sex, use safe sexual practices around STIs:

Safe Sexual Practices Around STIs

  1. Protect

Using condoms can cover syphilis sores and prevent spread. But syphilis can spread from sores in other parts of the body.

  1. Test

Make sure you and your partner are tested for STIs before having sex. If you are diagnosed with an STI, tell your partner.

  1. Wait

Do not have sex until you have finished your STI treatment.