What is syphilis? Syphilis is a highly contagious sexually transmitted infection (STI) that starts with a painless, ring-shaped sore. Syphilis symptoms will progress in phases, and left untreated, the disease can badly damage the heart and the brain. There is a syphilis cure, and we will examine the various syphilis stages, causes, and potential complications along the path to treatment.
Statistics show that syphilis infection is on the rise in the United States. The number of reported primary and secondary cases increased by 19% nationwide between 2014 and 2015. Around 60% of those cases were among bisexual, gay, and other men who have sex with men.
Recognizing the early-stage lesions of syphilis will make the infection easier to diagnose and treat. Prevention methods like abstinence, safe sex, and monogamous relationships can also reduce the risk of recurrence.
The Stages of Syphilis
There are four stages of syphilis, which include:
- Primary syphilis
- Secondary syphilis
- Latent syphilis
- Tertiary syphilis
The primary stage of syphilis begins around three weeks following infection with a small sore, before producing rashes and sore throat in the secondary stage. Symptoms seem to disappear in the latent stage. If syphilis reaches the tertiary stage, the effects can be deadly.
Syphilis Stages and Their Symptoms
Each stage of syphilis presents unique symptoms. Some of which you may not notice at all, while others can be mistaken for symptoms of unrelated infections.
During the primary or first stage of the infection, sores will appear on your body (mouth, genitals, or anus). The open sores are called chancres, and tend to be round, firm, and painless. They are usually located where the infection entered the body.
Because they are not painful, many sufferers may miss them.
There can be one sore or many, which will last for approximately three to six weeks regardless of whether your syphilis is being treated. A disappearing sore is NOT a sign that the infection is clearing up; further treatment is still needed.
The second stage of syphilis brings with it rashes and mucous membrane sores. The rash can appear while the primary stage sores are healing or several weeks afterward. This rash itself isn’t itchy, but may appear irritated and red in color.
This rash tends to begin on the palms and soles of the feet but can show up in other places. The rash can be accompanied by other symptoms like fever, headaches, fatigue, sore throat, swollen lymph glands, patchy hair loss, weight loss, and muscle aches.
The mucous membrane lesions are sores that are often found in and around the mouth, vaginal, and anal areas.
During this stage of syphilis, the symptoms and signs of syphilis disappear and become dormant. This stage can last for years with no obvious signs of syphilis.
The tertiary stage of syphilis usually occurs 10 to 30 years after the previous stages if the infection isn’t treated. If this stage of syphilis does occur, it usually spreads and attacks a number of organs and their systems like the brain, the heart, and nerves. Continuing to leave this untreated can result in paralysis, blindness, dementia, deafness, impotence, and even death.
It is during the tertiary stage (typically around the 15-year mark) of the infection that gummatous syphilis can occur. This form of syphilis involves the formation of chronic gummas, a type of soft, tumor-like masses that can develop in the skin, bones, and liver. These usually disappear after medical treatment has been completed.
While not actual stages themselves, syphilis can spread to the brain, nervous system, and eyes to become neurosyphilis and ocular syphilis.
Ocular syphilis can lead to changes in your vision and the possibility of blindness. Neurosyphilis can often have symptoms like:
- Severe headaches
- Trouble coordinating the movements of your muscles
- Paralysis (this can affect one part of your body or even multiple areas)
It should be noted that during the first two stages of the infection, the sufferer is still very contagious. Contagiousness decreases during the latent stage, and is non-existent during the tertiary stage.
What Causes Syphilis?
Syphilis is an infection caused by the bacterium Treponema pallidum. The infection is primarily transmitted by sexual contact (including vaginal, anal, and oral contact), but is not limited to these forms. Kissing the areas near or on open sores can lead to transmission of the bacteria as well.
Women who are pregnant and infected with syphilis can pass it to their unborn child. Mothers with chancres on the breasts, including nipples or areolae, risk spreading the infection to any nursing children.
Treponema pallidum dies quickly outside of the human body. This means that contracting syphilis from objects like toilets seats, utensils and other shared personal spaces/items is nearly impossible.
After the appearance of symptoms, a doctor’s visit is necessary for proper diagnosis. The doctor will typically ask questions about your medical and sexual history and perform a physical exam as well as a quick blood or urine test. They may also draw fluid from one of your sores or lesions and send it for testing to identify syphilis-causing bacteria.
A test on extracted spinal fluid can also be done, but usually as a last resort due to the invasive nature of the procedure. It is common when doctors suspect that syphilis is affecting your nervous system.
For pregnant women, many obstetricians will include a test for syphilis as part of routine antenatal care. This testing will not ensure treatment for the pregnant woman, but will also help prevent the fetus from contracting congenital syphilis.
How to Prevent Syphilis
As there is currently no vaccine to prevent syphilis, the best way to avoid the infection is through abstinence. Practicing safe sex with condoms and dental dams can help prevent bacteria transmission, but they are not foolproof. It is possible to spread the disease even with the use of protection.
Latex barriers should cover all open sores or lesions for highest efficiency.
Being in a long-term monogamous relationship where both partners are regularly tested for sexually transmitted infections can also keep the chances of syphilis low.
Also avoid sharing sex toys, or needles in the case of drug use
In the case of unborn children, screening for syphilis is strongly encouraged as the bacteria that causes syphilis can go relatively unnoticed in early stages.
A number of health complications can come with syphilis in addition to the symptoms that the bacteria brings. Syphilis increases your risk of contracting HIV. It can also cause neurological issues such as:
- Hearing loss
- Visual problems
- Bladder incontinence
- Sexual dysfunction in men (impotence)
- Loss of pain and temperature sensations
- Sudden, sharp pains
Cardiovascular problems may include damage to the heart valves, inflammation of the aorta and aneurysms.
In pregnant women, syphilis can cause birth defects and a greater chance of miscarriage. If born, the child has a greater chance of developing:
- Developmental delays
- Swollen liver or spleen
- Infectious sores
If syphilis remains undetected in the newborn, they can develop problems with their bones, eyes, ears, teeth, and brain.
Who Is at Risk for Syphilis?
Essentially anyone who has sexual intercourse is at some risk of contracting syphilis. Those people who engage in frequent sexual activities with different partners raise their risk levels, especially if no condoms are used.
Men who have sex with men face higher rates of infection than other groups. Having sexual relations with a person with syphilis gives you a three percent to 10% chance of gaining syphilis yourself.
Syphilis Treatment Tips
Once the infection has been diagnosed, syphilis treatment is relatively simple. A course of the antibiotic penicillin can usually clear out the bacteria quickly. The earlier the infection is caught, the quicker the treatment will be.
Those suffering from neurosyphilis will often get a daily dose of penicillin until the bacteria is eliminated from the system.
For those who are allergic to penicillin, alternative prescription drugs may include doxycycline, azithromycin, or ceftriaxone.
How long you have been infected will determine the dosage. For those who have only had syphilis for a year or less, one dose of penicillin may do the trick. Anything longer than a year may take a few doses.
You may also be wondering, how long is syphilis contagious after treatment? After all, left untreated, the bacteria can stay dormant for years before rising again. How long does it take to cure syphilis? After your prescribed dosage of medications, you may still be contagious until all of the sores and symptoms of the disease have disappeared.
How do you know if syphilis is cured? To be safe, your doctor will most likely recommend periodic blood tests. Once all tests are negative for syphilis bacteria and all wounds are healed, you are considered safe.
A few tips to consider:
- After being diagnosed, contact past sexual partners as a warning. As previously mentioned, the infection can go dormant. If they are unaware, they may not have secured treatment.
- While treatment can cure you of syphilis, it may not be able to undo damage that the infection has caused. That is part of the reason why early detection is important.
If You Think You Have Syphilis, Get Tested!
Syphilis can seriously damage the body if left untreated. Deafness, heart disease, and neurological disorders are all possible outcomes, and why getting treated as soon as possible is so important.
Syphilis treatment is very simple once diagnosed. For most people, it is a simple course or two of the antibiotic penicillin.
Know the early signs, and protect yourself and your partner by always practicing safe sex and undergoing regular testing for STIs.
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