Syphilis
Syphilis is a common STI, which you can pass easily. In 2024, there were over 13,000 new syphilis diagnoses in England.
There is a simple test for syphilis and effective treatment to cure it.
To order a test, please click here.
There is a simple test for syphilis and effective treatment to cure it.
To order a test, please click here.
What is it and how do I get it?
Syphilis is an STI caused by the bacteria Treponema Pallidum.
You can pass it through:
Pregnant people can also pass untreated syphilis to the baby during pregnancy and birth.
You can NOT pass it by:
You can pass it through:
- Vaginal Sex
- Anal Sex
- Oral Sex
- Direct Contact with Infected Sores
- Sharing Injection Drug Equipment
- Sharing Sex Toys
- Mutual Masturbation
Pregnant people can also pass untreated syphilis to the baby during pregnancy and birth.
You can NOT pass it by:
- Kissing / Hugging
- Swimming in a pool
- Using a public loo
- Sharing towels / cups / plates / cutlery
How can I prevent it?
You can lower the risk of syphilis spreading by using condoms correctly.
For more details on using condoms, please see our Safer Sex page.
For more details on using condoms, please see our Safer Sex page.
What might I notice?
You might not notice anything. Many people get no, or only mild, symptoms.
Symptoms of syphilis can also come and go. If your symptoms clear up, it doesn't mean you no longer have syphilis. You could still get other symptoms or pass it on to your partner(s).
Syphilis symptoms have three stages. These stages are similar, no matter what genitals you have.
Stage One
Stage one syphilis appears 9 to 90 days after you have unprotected sex.
During this stage, you might notice:
Some people don't notice or ignore the sore, because it is painless. But it is highly infectious. You can pass syphilis on in this stage.
The ulcer normally disappears without treatment, but you are still infectious.
Stage Two
Stage two happens when the bacteria spreads through your body via your blood. It normally appears two to three months after stage one. It can appear up to two years after you are infected.
During this stage, you might notice:
These symptoms can disappear after a few weeks or come and go. Often this happens over weeks or months.
Stage Three
Stage three syphilis only occurs once symptoms have stopped. This happens when you haven't had treatment for years or even decades.
This is the most dangerous stage for the person with syphilis.
Most people will not notice any symptoms during this stage. But stage three syphilis can cause a number of complications. For more information, please see the What If I Don't Get Treatment? section below.
Symptoms of syphilis can also come and go. If your symptoms clear up, it doesn't mean you no longer have syphilis. You could still get other symptoms or pass it on to your partner(s).
Syphilis symptoms have three stages. These stages are similar, no matter what genitals you have.
Stage One
Stage one syphilis appears 9 to 90 days after you have unprotected sex.
During this stage, you might notice:
- A sore or ulcer on your genitals or in your mouth
Some people don't notice or ignore the sore, because it is painless. But it is highly infectious. You can pass syphilis on in this stage.
The ulcer normally disappears without treatment, but you are still infectious.
Stage Two
Stage two happens when the bacteria spreads through your body via your blood. It normally appears two to three months after stage one. It can appear up to two years after you are infected.
During this stage, you might notice:
- Swollen glands in the neck, armpit, and/or groin
- A non-itchy rash. This is often on your palms or the soles of your feet
- Small, flat lumps near the vulva or anus
- White patches on your tongue or the roof of your mouth
- Flu-like symptoms, like tiredness, lack of appetite, being achy, headaches, joint pains, and fever
- Patchy hair loss
- Eye problems
- Hearing problems
- Brain problems
- Weight loss
These symptoms can disappear after a few weeks or come and go. Often this happens over weeks or months.
Stage Three
Stage three syphilis only occurs once symptoms have stopped. This happens when you haven't had treatment for years or even decades.
This is the most dangerous stage for the person with syphilis.
Most people will not notice any symptoms during this stage. But stage three syphilis can cause a number of complications. For more information, please see the What If I Don't Get Treatment? section below.
How do I get a test?
Testing for syphilis involves a blood test. We can do this in clinic. If you prefer you can order an at home test.
Syphilis can take up to three months (90 days) to show positive without symptoms. A test taken within 90 days might not be accurate. If you have tested negative in this window, we recommend you take another test. For more advice, please see Window Periods page.
In clinic, one of our team will do an exam. They will look at your genitals and anus. They might do an internal exam too. If you have oral symptoms, they will look at your mouth and throat.
If there are sores, they may swab them to send for testing.
An at home test is a finger-prick test. These are quick and easy to do. You can order one here. This test might not be accurate if you have had syphilis before. If you have, please get in touch for more advice.
The pre-natal team will offer all pregnant people a syphilis test. They will offer it between week 11 and week 20 of their pregnancy.
If you are unsure if you should test, please get in touch.
Syphilis can take up to three months (90 days) to show positive without symptoms. A test taken within 90 days might not be accurate. If you have tested negative in this window, we recommend you take another test. For more advice, please see Window Periods page.
In clinic, one of our team will do an exam. They will look at your genitals and anus. They might do an internal exam too. If you have oral symptoms, they will look at your mouth and throat.
If there are sores, they may swab them to send for testing.
An at home test is a finger-prick test. These are quick and easy to do. You can order one here. This test might not be accurate if you have had syphilis before. If you have, please get in touch for more advice.
The pre-natal team will offer all pregnant people a syphilis test. They will offer it between week 11 and week 20 of their pregnancy.
If you are unsure if you should test, please get in touch.
How do I get treatment?
If you have syphilis, the standard treatment is antibiotics. The antibiotic prescribed most often for this illness is penicillin. This is given as an injection. Some people are given doxycycline capsules instead.
The team might offer you treatment without a test, if:
If you need treatment for syphilis, please book an appointment.
If you are in stage three syphilis, treatment will not reverse the damage done.
You shouldn't have sex again until:
The team might offer you treatment without a test, if:
- You know you have been in contact with someone who has syphilis
- You have a rash typical to syphilis
If you need treatment for syphilis, please book an appointment.
If you are in stage three syphilis, treatment will not reverse the damage done.
You shouldn't have sex again until:
- Two weeks after you have finished treatment
- Any relevant partners have completed their courses of treatment
Do I need a follow up after treatment?
After your treatment for syphilis, you should take a follow-up test. This might be three, six, or twelve months after your treatment. The timeline depends on which stage of syphilis you were in before treatment.
Our team can help you figure out when to retest.
Our team can help you figure out when to retest.
What if I don't get treatment?
Syphilis is a treatable illness. If you find and treat it quickly, it doesn't cause long-term problems.
If it isn't treated, you can develop stage three Syphilis, which can cause:
Some of these are very rare. It is still important to know about them.
If it isn't treated, you can develop stage three Syphilis, which can cause:
- Tinnitus
- Numbness
- Paralysis
- Loss of Coordination
- Stroke
- Dementia
- Heart Disease
- Serious Damage to Eyes
- Death
Some of these are very rare. It is still important to know about them.
Should I tell my partners?
If you test positive for Syphilis, you should tell your partners. This is anyone you have had unprotected sex with in the last two years.
This is so they can test too and get treatment if they need it.
If you aren't sure, we can help you figure out who to contact. If you prefer, we can reach out on your behalf. We do this through a system called contact tracing.
You shouldn't have sex with your regular partners until:
It is possible that a partner who has been cured could catch syphilis again.
This is so they can test too and get treatment if they need it.
If you aren't sure, we can help you figure out who to contact. If you prefer, we can reach out on your behalf. We do this through a system called contact tracing.
You shouldn't have sex with your regular partners until:
- They have taken a test, and
- Two weeks after everyone who tested positive has completed their treatment
It is possible that a partner who has been cured could catch syphilis again.
Find out more about syphilis on the NHS Website.