Syphilis is a serious sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. If left untreated, syphilis can lead to severe, life-threatening damage to your internal organs. However, it is also a highly curable infection with the right medical care. Understanding its stages, symptoms, and the importance of early diagnosis is crucial for your health and the health of your partners.
Syphilis infection progresses through distinct stages, each with different signs and symptoms. It is vital to remember that even if symptoms disappear, the infection remains in your body and requires treatment.
Primary Stage: This stage typically begins with the appearance of one or more painless sores, called chancres, at the site where the bacteria entered the body (penis, vagina, anus, rectum, or mouth). These sores are firm and round, often going unnoticed. They usually heal within 3 to 6 weeks, but the infection persists and can spread.
Secondary Stage: This stage can begin as the primary sore is healing or several weeks after it has healed. It is characterized by a rough, reddish-brown rash that can appear on the palms of the hands and the bottoms of the feet. Other symptoms may include fever, swollen lymph glands, a sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. These symptoms will also disappear without treatment, but the infection will progress.
Latent Stage: This is a period with no visible signs or symptoms. Without treatment, the infection remains dormant in your body for years, continuing to cause internal damage that can manifest in later, more severe stages.
Tertiary Stage: This is the most severe stage, which develops in a small percentage of people with untreated syphilis, often 10 to 30 years after the initial infection. Tertiary syphilis can lead to extensive damage to the heart, blood vessels, brain, and nervous system, and can ultimately be fatal.
Without treatment, the syphilis bacteria can spread to other parts of the body, causing severe and potentially irreversible damage. This can occur at any stage of the infection.
Neurosyphilis: The bacteria spread to the brain and nervous system, which can cause severe headaches, muscle weakness, changes in mental state, confusion, and even dementia.
Ocular Syphilis: This affects the eyes, potentially leading to eye pain, redness, changes in vision, and even permanent blindness.
Otosyphilis: This affects the ears, with symptoms that may include hearing loss, tinnitus (ringing or buzzing in the ears), and dizziness or vertigo.
Syphilis is a disease that disproportionately affects certain populations. According to the CDC, gay and bisexual men accounted for the majority of new syphilis cases in recent years. Additionally, rates of syphilis infection are higher among certain racial and ethnic minority groups, including Black and Hispanic individuals.
These disparities are not due to race or sexual orientation themselves, but are often linked to socioeconomic factors, healthcare access, and social inequities that put these communities at a higher risk of exposure and inadequate treatment. Open, honest discussions with a healthcare provider are the best way to assess your risk and determine if testing is needed.
The only way to completely avoid STIs is to abstain from vaginal, anal, or oral sex. If you are sexually active, you can significantly reduce your risk of contracting syphilis by:
Being in a mutually monogamous relationship with a partner who has been tested and confirmed to be free of syphilis.
Use a condom correctly every time you have sex. While condoms can prevent contact with sores on areas they cover, syphilis can still be transmitted through contact with sores in areas that are not covered.
Avoiding recreational drugs and excessive alcohol consumption, as they can impair judgment and lead to risky sexual behaviors.
Regular testing for syphilis is crucial for sexually active individuals, particularly if you:
Yes, syphilis is curable with the right antibiotics from a healthcare provider. Penicillin is the preferred treatment and can cure the infection in all stages. However, treatment may not reverse any organ damage that has already occurred, especially if the disease has progressed to the later stages.
Syphilis is typically diagnosed with a simple blood test. If a chancre is present, a doctor may also test fluid from the sore to confirm the diagnosis.
The latent stage is dangerous because the infection is still in your body and continues to cause internal damage, even though there are no visible symptoms. Without treatment, it can progress to the severe tertiary stage.
Even after the sores from the primary or secondary stage of syphilis heal, the infection is still active in your body. Without treatment, it will continue to progress to more dangerous and damaging stages.
