What are the Symptoms of Syphilis?

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. You may know syphilis as a disease from medieval times that killed some notable famous people (rumoured to include King Edward IV), but Syphilis is still very much present in the modern world, despite being around for centuries.

Syphilis rates in the UK have been rising in recent years. Reported cases of syphilis in England increased by more than 8% in 2021 compared with the previous year. So why are syphilis rates rising, and how can we protect ourselves against this potentially very dangerous disease? 

Syphilis is a serious infection that can cause long-term complications including neurological disorders if left untreated. It can affect various organs in the body and can even be fatal in some cases. Early diagnosis and treatment are crucial to prevent complications and reduce the spread of the infection.

In this article, we will discuss the symptoms of syphilis and why it is important to get tested and treated for this disease.

Why are syphilis rates rising in the UK?

Despite medical advances and improved public health measures, syphilis is still an infection every sexually active person needs to be aware of. Rising syphilis rates could be a result of changes in sexual behaviour and the increased use of dating apps for anonymous hookups. 

Another reason for growing syphilis rates is that the infection can be difficult to diagnose, especially in its early stages, when symptoms may not be noticeable. Some people may not seek medical treatment for syphilis (or other STIs for that matter) due to stigma, or lack of access to healthcare.

Syphilis is a highly contagious disease that can spread through sexual contact, including vaginal, anal, or oral sex, as well as through direct contact with syphilis sores or rashes. It can also be transmitted from infected mothers to unborn babies during pregnancy or delivery.

Syphilis rates are highest among men who have sex with men (MSM) and among people living with HIV. Having HIV can make you more likely to contract syphilis. This is because the HIV infection weakens the immune system, making it harder for the body to fight off other infections. The presence of syphilis can also make it easier for HIV to spread by increasing the amount of the virus in the infected person's blood and genital secretions.

Symptoms of Syphilis

Syphilis has four stages, each with its own set of signs and symptoms. However, not everyone infected with syphilis will experience all the symptoms, and some people may not show any symptoms at all. The symptoms of syphilis can also be similar to those of other STIs, so it is important to get tested if you think you may have been exposed to syphilis.

Primary Syphilis

The first stage of syphilis (known as the primary stage) typically begins with a small, painless sore, called a chancre. The syphilis sore usually appears at the site of initial infection, which can be the genitals, anus, mouth, or other parts of the body. It generally appears within 10 to 90 days after exposure and can last for 3 to 6 weeks. Not every syphilis infection will develop a sore, and some may even develop multiple sores.

Secondary Syphilis

The second stage is known as secondary syphilis, which typically begins a few weeks after the first syphilis sore appears. During this stage, the infection can spread throughout the body, causing a variety of signs and symptoms, including:

• Skin rash: The rash can appear anywhere on the body and may be rough, red, or reddish-brown in colour. The rash is usually not itchy and may be accompanied by small, wart-like growths known as condyloma lata.

• Fever and fatigue: Some people may experience flu-like symptoms, including fever, fatigue, and muscle aches.

• Sore throat and swollen lymph nodes: Some people may develop a sore throat and swollen lymph nodes.

• Patchy hair loss: Some people may experience patchy hair loss, particularly in the eyebrows and eyelashes.

• Headaches: Some people may experience headaches and other neurological symptoms, such as confusion, memory loss, and seizures.

Latent Syphilis

After the secondary stage, syphilis enters a latent stage, during which there are no visible symptoms. The latent syphilis stage can last for several years, and the infected person may not even be aware that they have syphilis. However, during this stage, the infection can still be transmitted to others through sexual contact.

Tertiary Syphilis

If left untreated, syphilis can progress to the tertiary stage, which can cause serious complications and damage to the body's organs, including the heart, brain, and nervous system. Tertiary syphilis symptoms can include:

• Neurosyphilis: Neurosyphilis occurs when the syphilis bacteria invade the nervous system, causing symptoms such as headaches, confusion, memory loss, and seizures.

• Cardiovascular syphilis: Cardiovascular syphilis can cause damage to the heart and blood vessels, leading to heart failure and other cardiovascular complications.

• Gummatous syphilis: Gummatous syphilis can cause soft, tumour-like growths on the skin, bones, and other organs.

Testing for Syphilis

A syphilis test typically involves a blood test that detects the presence of antibodies produced by the body in response to the infection. There are two main types of blood tests for syphilis: the treponemal test and the non-treponemal test. The treponemal test detects antibodies specific to the bacteria that cause syphilis, while the non-treponemal test detects antibodies that are produced as a general response to infection.

If you think you may have been exposed to syphilis through unprotected sex with an infected person, or you are experiencing any of the syphilis symptoms we have discussed, you can order a home STI test kit here. iPlaySafe provides quick and discreet home STI testing services integrated with an app where you'll receive your results and medical support, if necessary. If you test positive, additional testing by a specialist healthcare provider would be required to determine the stage of the infection.

Treatment for Syphilis

Syphilis is treated with antibiotics, usually penicillin. The specific course of treatment depends on the stage of infection and your overall health. For example, if you have primary or secondary syphilis you may only need a single injection of penicillin, while those with more advanced stages of the infection may require a longer course of antibiotics.

When treating syphilis, you must complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished. This is because antibiotics not only kill the bacteria that cause syphilis but also prevent further damage to the body's organs. If you test positive or are undergoing syphilis treatment, you must avoid sexual contact during the course of treatment and for a period of time after treatment is completed, as you could still be contagious even after your symptoms have resolved.

In some cases, syphilis can cause permanent damage to the body's organs, even with treatment. Regular follow-ups with a healthcare provider are important to monitor for any long-term complications and ensure that the infection has been fully treated.

Preventing Syphilis

The most effective way to prevent syphilis is to practice safe sex, including using condoms and getting tested regularly. If you're sexually active you should take an STI test at least once every six months, and you should know your partner's sexual health status before you get intimate.

If you are pregnant, you should get tested for syphilis as part of routine prenatal care. If you are diagnosed with syphilis during pregnancy, prompt treatment can prevent transmission of the infection to your unborn baby.

In conclusion, syphilis is a highly contagious sexually transmitted infection that can cause a variety of symptoms. If you're sexually active, it's vital to have awareness about and get tested for syphilis regularly. Public Health England has launched a national action plan to address the rising rates of syphilis and other sexually transmitted infections, which includes increasing access to testing and treatment, improving sexual health education, and promoting the use of condoms and other forms of protection during sexual activity.

Buy your home STI testing kit here.