Explainer

Syphilis

Real talk:

Untreated syphilis can cause serious health issues over time, but early testing and treatment makes it easily curable with antibiotics.

Myth-busting:

Myth: “Syphilis is a thing of the past.”
Fact: Not at all. Syphilis was first documented a long time ago, but it’s still around today. In fact, syphilis rates are on the rise.

Myth: “Syphilis cannot be cured.”
Fact: False! Syphilis is treatable with antibiotic injections. The number of injections depends on the stage of syphilis – so make sure you test regularly.

Myth: “Syphilis goes away by itself.”
Fact: Don’t ignore syphilis! Even if the initial symptoms of syphilis disappear, the infection remains. Later stages of syphilis can cause serious health issues.

What is syphilis?

Syphilis is a bacterial infection passed through skin-to-skin contact.

Syphilis has become increasingly common in Australia. It’s ideal to test for syphilis during routine STI screenings, and at pre-natal check-ups for pregnant people.

Syphilis is curable with antibiotics, but if left untreated, it can cause serious health problems.

How do you get syphilis?

Syphilis can be passed:

through skin-to-skin contact during any kind of sex – with or without penetration.
from a pregnant person to their baby
through blood contact.

Syphilis is most contagious when symptoms like rashes or sores are present, but it can be passed even without visible symptoms.

What are the symptoms of syphilis?

Syphilis doesn’t always have symptoms. If symptoms do come up, they look different depending on the stage of infection: primary, secondary, latent or tertiary.

Primary syphilis is the first sign of infection, which often happens a few weeks after being exposed to syphilis. This can cause a painless sore that shows up around the affected area (such as the genitals, mouth or anus). The sore will usually heal on its own, but the infection continues to develop and remains contagious.

Secondary syphilis usually starts a couple of months after infection (if left untreated). Symptoms include a rash on the palms of your hands, soles of your feet, chest or back. You may also get flu-like symptoms and tiredness. These symptoms will go away eventually.

Latent syphilis is when there are no visible symptoms, but the infection can still be passed in the early part of this phase. Without treatment, a person can remain infectious for up to two years. After this, it is less likely to pass it on to sexual partners.

Tertiary syphilis can take five to twenty years to develop (if left untreated). Symptoms can affect all parts of the body, commonly causing problems in the heart, eyes, ears and brain.

How is syphilis prevented?

You can reduce the risk of syphilis by:

avoiding sex when a person has potential symptoms
using barriers like condoms, dams and gloves (but since transmission is skin-to-skin, these barriers aren’t 100% effective!)
using gloves and sterile sharps if your sex involves blood play
not sharing injecting equipment
avoiding tattoos or piercings outside of professional environments.

You can access free Needle and Syringe Programs (NSP) across Australia.

How do you test for syphilis?

A routine STI screening includes a syphilis test.

There are two screening options for syphilis: a blood test or a swab test if an active sore is present.

If you have symptoms or may have been in contact with syphilis, book in with your doctor and they’ll advise the best course of action.

Pregnant people should also test for syphilis during pregnancy. If diagnosed with syphilis, you can receive treatment immediately and prevent passing the infection to your baby. Congenital syphilis can lead to very serious consequences for the baby, including stillbirth.

Check out our STI testing guide on what to expect at a sexual health check.

How do you get treated for syphilis?

Syphilis is treated with antibiotic injections. The number of injections will depend on the stage of the infection.

If you’re diagnosed with syphilis, don’t forget to let your sexual partners know so they can also get treated.  Syphilis is so contagious that presumptive treatment (meaning, without waiting for a test result) is recommended for all sexual partners.

Check out our partner notification section for more information on navigating this part of the process.

When to see a healthcare professional

A healthcare professional can recommend the tests that are right for your body and your sexual practices. They can provide treatment straight away if you need it, check for any complications, and talk with you about re-testing or letting partners know. Regular checks are a simple way to look after yourself, your partners and your community.

See a healthcare provider if: