What is syphilis?

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems if you do not treat it. It is also easy to cure if you treat it early.

In the past 10 years, the number of syphilis cases reported in Australia has significantly increased.

What are the symptoms of syphilis?

The symptoms of syphilis depend on the stage of your infection. There are 4 stages of syphilis infection:

1. primary syphilis
2. secondary syphilis
3. latent syphilis
4. tertiary syphilis

Primary syphilis

Primary syphilis happens between 10 and 90 days after infection. Symptoms of primary syphilis include:

• a painless sore or sores in or on your mouth, anus, penis, vagina or cervix
• the sore is a roundish area of broken skin — the centre may be weepy and have pus coming from it
• the sores usually go away by themselves after 2 to 6 weeks

It is easy to not notice the sores because they are usually painless. They may also be hidden from view in your rectum or on your cervix.

However, even when the sore goes away, you can still pass syphilis on to others.

Secondary syphilis

Secondary syphilis happens between 7 and 10 weeks after infection. Symptoms of secondary syphilis include:

• a red rash on the palms of your hands, soles of your feet, chest or back — the rash is slightly lumpy, but not itchy or painful
• fever
• enlarged glands in your armpits and groin
• hair loss
• headaches
• tiredness

Often you may not notice these symptoms.

Latent syphilis

There are usually no obvious symptoms of latent syphilis. Infection is only found with blood tests.

If you do not treat syphilis at this stage, it can remain latent for life or turn into tertiary syphilis.

Tertiary syphilis

Tertiary syphilis develops in about 1 in 3 people with untreated latent syphilis.

The bacteria can damage almost any part of your body including your:

• heart — causing heart disease
• brain — causing mental illness
• spinal cord — causing neurological problems
• eyes — causing blindness
• bones

This can happen many years after you were first infected with syphilis.

Some people with syphilis have no symptoms. This is why it's important to be tested regularly.

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

What causes syphilis?

Syphilis is caused by bacteria called treponema pallidum.

How is syphilis spread?

You can get syphilis if you have unprotected skin-to-skin contact during vaginal, anal or oral sex.

Syphilis is very contagious during the primary and secondary stages when you have a sore or rash.

You can also pass on syphilis to someone else if you are in the early latent phase and do not have any sores.

If you are pregnant, your baby can catch congenital syphilis through your placenta.

Syphilis can occasionally be spread by blood contamination, needle-stick injury or sharing injecting equipment.

Your risk of getting syphilis through a blood transfusion is very low, due to:

• the screening of donors
• the way the blood is stored

Who is at risk?

In Australia, population groups at higher risk of syphilis include:

• males who have sex with males
• females of child-bearing age
• Aboriginal and/or Torres Strait Islander people
• people living in outback areas or regional and remote Australia

When should I see my doctor?

You should see your doctor, visit a family planning clinic or a sexual health clinic if you:

• are concerned that you have syphilis or another STI, even if you do not have any symptoms
• have had sexual contact with someone who has syphilis or another STI
• have any genital, anal or oral ulcers or lumps without a known cause

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is syphilis diagnosed?

Your doctor can diagnose syphilis by:

• examining you and ask you questions about your symptoms
• taking a swab from your sore to be looked at under a microscope
• doing a blood test to confirm a diagnosis

Blood tests to diagnose syphilis look for antibodies that your body makes to fight the infection. Your blood test results can tell you if you have syphilis now or if you had it in the past. It can take your body some time to develop antibodies. This is why your blood test results can be negative, even if you have just caught syphilis. If this happens to you, you should do another blood test 2 weeks later.

Sometimes you can also have other STIs at the time as you have syphilis. Your doctor may offer to test you for other STIs when testing for syphilis.

Syphilis is a nationally notifiable disease in Australia. This means that government health authorities must be told about all cases of syphilis. This is done so that infections can be tracked. It is important to try stop outbreaks because syphilis can cause long-term health complications.

Notifying sexual partners

If you have syphilis, it is very important you help with contact tracing. You will have to tell anyone you have had sex with during the past 12 months. They will need to be tested and treated if they have it. This will help stop you from being infected again. It also reduces the spread of syphilis.

Your doctor can help you work out who you need to contact.

If you are worried about telling recent sexual partners that you have syphilis, you can send them an anonymous text message or email through some websites, such as Let Them Know.

How is syphilis treated?

Syphilis is usually treated with an antibiotic medicine called penicillin. You can take this as an injection into your muscle. If you are allergic to penicillin, there are other treatment options available.

Your sexual partners will also need to be tested and treated.

After treatment with penicillin, you may feel like you have the flu for 24 hours. If you feel unwell, rest and drink plenty of fluids. This will soon go away, without any extra treatment.

You should also be sure to:

• avoid all sexual contact for 7 days after you have started your treatment, or until you have finished your treatment and symptoms have gone away, whichever is later
• avoid sex with any of your sexual partners from the past 12 months until they have been tested and treated — this will help prevent re-infection
• get tested for syphilis again 3 months, 6 months and 12 months after you were diagnosed to make sure the infection has gone away

What if I have syphilis and am pregnant?

If you are pregnant, you will be tested for syphilis at:

• your first antenatal visit
• weeks 28 to 32 of your pregnancy
• week 36 of your pregnancy

If you are at high risk of syphilis, you will also be tested again around 6 weeks after your baby is born.

It is important you are tested and treated for syphilis during pregnancy if you have it. If you do not treat syphilis, you can pass it onto your baby (known as congenital syphilis).

Congenital syphilis may cause these serious complications:

• miscarriage
• stillbirth
• premature birth
• serious birth defects
• low birthweight
• death shortly after birth

You safely take treatment for syphilis while pregnant. If you treat your infection early, you can reduce the amount of damage congenital syphilis does to your baby.

Can syphilis be prevented?

You can prevent syphilis and other STIs by practicing safe sex. This means you should:

• Always use a condom with a water-based lubricant when you have vaginal, oral or anal sex, or a dental dam if you are having oral sex.
• Avoid having sex if you or your partner have ulcers or sores on their genitals and/or mouth.
• Have regular sexual health checks.

If you have previously had syphilis and recovered, you can still get it again.

The Australian Government is responding to the increase in cases of syphilis in Australia on a national level. The government is working with state and territory governments to help reduce spreading of syphilis.

Complications of syphilis

If left untreated, syphilis can cause serious complications for you and your partner including:

• meningitis (brain infection)
• nervous system problems
• liver problems, heart failure
• blindness or hearing loss
• mental illness
• problems with bones and joints
• death

Syphilis can also be passed to your baby during pregnancy. This can be very serious — read What if I have syphilis and am pregnant?

Resources and support

• The Let Them Know website helps you send free, anonymous text messages or emails to sexual partners to help with contact tracing.
• If you have been sexually assaulted, you can contact 1800RESPECT on 1800 737 732 24 hours a day, 7 days a week for confidential information, counselling and support services.
• If you want to get tested for syphilis, see your doctor or call your nearest sexual health clinic:
  • Australian Capital Territory — Canberra Sexual Health Centre
  • New South Wales — Sexual Health Info Link
  • Northern Territory — Sexual health services
  • Queensland — List of Queensland sexual health and HIV services
  • South Australia — Sexual health services
  • Tasmania — Sexual health services
  • Victoria — StaySTIFree
  • Western Australia — Could I have it?

Looking for information for Aboriginal and/or Torres Strait Islander people?

Young Deadly Free has resources to encourage STI testing in remote Aboriginal communities.

You can also watch the Young Deadly Free video on STIs and blood-borne viruses made for Aboriginal and/or Torres Strait Islander people across Australia.

Looking for information for sexually and gender-diverse families?

Drama Down Under is a website specifically for men with male sexual partners. Learn more about STIs, contact tracing and receive reminders when it's time to be retested.

Read about syphilis on the Gay Men's Health Australia website, and the SAMESH website.

Do you prefer to read in languages other than English?

The Stay STI Free website has fact sheets on syphilis and other STIs in Chinese, Korean and Spanish.

Visit All Good to learn more about sexually transmissible infections and how to protect yourself in a range of community languages.