Stages of Syphilis: Symptoms, Causes, Prevention, and Treatment

Syphilis is a highly infectious bacterial disease often spread through sexual activity, including oral and anal sex. Usually, the patient is unaware he or she has the disease, and unknowingly transmits it to his or her partner. Here’s what you need to know about the stages of syphilis symptoms, causes, prevention, and treatment. 

A person suspected of having the disease needs to take a confirmatory test for syphilis.

The infection begins with painless sores, usually on the genitals, rectum or mouth.  It is transmitted from one person to the next through the skin or contact with the mucous membrane, with these sores.

Stages of Syphilis: History and Incidence

Syphilis used to be a public threat. When the antibiotic penicillin was discovered in the late ‘40s, an effective treatment to syphilis was found. 

In the Philippines, cases of syphilis (along with gonorrhea, genital warts, herpes) is declining. As with any STD, syphilis carries a social stigma.

Philippine Dermatological Society figures from 2011 show that syphilis is one of the most prevalent infections in the country. 

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Stages of Syphilis: Signs and Symptoms to Watch Out For

The bacterium T. pallidum (Treponema pallidum), which causes syphilis, enters the body through direct contact with an infected person’s open sores or body fluids. 

The bacterium goes through microscopic skin cracks and mucus members wrapped around the penis, vagina, mouth and anus.

Signs of the disease may be so mild, the infected person hardly notices them. They can resemble pimples or rashes. 

Symptoms may appear and disappear. But that doesn’t mean the infection is gone. Medication is the only solution.

Here are the symptoms per stage of infection. They can vary with each stage, and do not follow a set  pattern. Symptoms do not occur in the  same order per patient.

Primary stage

A syphilis sore (or chancre) appears where the infection went through.  The sores are often firm, round, and painless, at times open and wet. The sores may come singly or in clusters.

They appear on the vulva, vagina, anus, penis and scrotum. In rare cases, they show up on the lips or mouth. Sores may also lie hidden in the vagina, rectum, under the foreskin and other body parts you have to look hard for in order to find.

Sores usually appear between three weeks and three months after infection. They go away after three to six weeks, with or without treatment.  

But that doesn’t mean the syphilis is gone.  An infected person has to take antibiotics to prevent the infection from worsening.

Secondary stage

Symptoms appear 3-12 weeks after the first episode of chancre and come in the form of rashes on your palms, the soles of your feet, and other places. You might have a hard time finding the syphilis rash, because it does not feel itchy.  

Other symptoms include:

• A sick feeling
• Signs of mild flu like sight fever, fatigue, sore throat, swollen glands, headache, and muscle pain.
• Mouth, vagina or anus sores
• Reduced weight
• Hair loss 

Symptoms may last two to six weeks.  They may appear and disappear over two years. Testing is important. What’s more, medication is also necessary to prevent syphilis from progressing to a  more dangerous stage.

Late stage

During the late stages of syphilis, serious symptoms appear.

This phase applies to patients who did not seek treatment for a long time, or 10 to 20 years after they first contracted the disease.

Complications at this point include:

• Tumors
• Blindness
• Paralysis
• Damage to the nervous system
• Brain damage
• Death

What are the risk factors in contracting syphilis? Those at higher are those who:

• Have unprotected sex
• Have numerous sex partners
• Are infected with HIV
• Are men who have sex with other men

Babies can also get syphilis from infected mothers. Most of these babies are asymptomatic. Some may show a rash on their palms or soles of their feet.  Complications that can develop later are: 

• Liver that is enlarged
• Jaundice
• Nose discharge 
• Swollen glands
• Abnormalities in the bone 
• Brain-related problems

See the pediatrician at once if you notice a discharge, sore, or rash around the groin.

How do I avoid contracting syphilis?

The best way is to refrain from vaginal, anal and oral sex. 

It is important to practice safe sex.  And it is also essential to get regular tests for sexually transmitted disease (STDs).

If you do contract this condition, do not panic. Syphilis can easily be cured. Make sure others do not get infected by:

• Admitting to your past and present partners that you are infected, so they can undergo a confirmatory test for syphilis, and treatments as well
• Refraining from having sex with anyone until you have completed treatment and the sores are fully healed
• Your sex partner is treated before he or she gets intimate with you or anyone again
• Wear a condom every time you resume  sexual activity after your treatment program is over 

How do I get treated for syphilis?

After undergoing a confirmatory test for syphilis, your health practitioner will recommend antibiotics – usually penicillin. In most cases, your sex partner must also undergo similar treatment.

Things to remember:

• Take all medication in the manner your doctor prescribes, even if symptoms disappear earlier during treatment
• Refrain from sexual activity until you and your partner are done with treatment to avoid reinfection.
• Don’t share medication with anyone. You and your partner should get separate doses of penicillin. 
• Note that reinfection can happen after treatment. Use condoms and/or dental dams on a regular basis. Get yourself tested now and then.

Syphilis can easily be cured, but prevention remains best practice. Speak to your doctor in case a confirmatory test for syphilis becomes necessary.

Learn more about sexually transmitted diseases, here.