Syphilis is the third most common bacterial STI in Canada. The bacteria is usually passed on during oral, genital, or anal sex. It can also be passed on through close skin-to-skin contact with a syphilis rash or sore. Someone who is pregnant can pass on syphilis to their baby, called congenital syphilis. Congenital syphilis often has no symptoms and might not be diagnosed until later in life. In Canada, the reported number of syphilis cases is increasing faster than any other STI, including cases of congenital syphilis.
Syphilis has 4 stages. Each stage has different symptoms. Even when there are no outward symptoms, syphilis can still be passed on, making regular testing important. 💪
The first stage usually occurs within 3 weeks. At this stage, you might see one or multiple sores where the bacteria first entered your body. These are known as chancres. Chancres look like pimples that open up and are usually found on or around the penis, vagina, front hole, rectum, lips, or mouth. They are usually firm and painless, and ooze fluid containing the syphilis bacteria. Syphilis is most contagious when there are sores and rashes present since the bacteria can be passed on through close skin-to-skin contact. Chancres usually disappear after 3 to 6 weeks moving on to the next stage.
This stage usually occurs within 2 to 12 weeks after exposure. You might develop rashes or sores. Typically, these appear on the palms of your hands or bottoms of your feet but can show up anywhere on the body. Rashes are generally red or reddish-brown and do not itch. The bacteria is still contagious at this stage and can be passed on through sex or close skin to skin contact with a rash. Other symptoms at this stage include swollen glands, a sore throat, patchy hair loss, headaches, muscle aches, and feeling tired. Symptoms of secondary syphilis will often disappear, moving on to the next stage.
This is a period after the secondary stage when there are no visible signs of syphilis. This makes routine testing important since untreated syphilis can live in the body for years without showing symptoms. During this stage, syphilis can spread to the brain and nervous system, causing damage to your heart, bones, nerves, and organs. Even though there are no outwardly visible symptoms, the bacteria can still be passed on during this stage.
The final stage of syphilis is very serious and typically occurs 10 to 30 years after initial exposure. At this stage, lesions can develop on the skin, bone, and organs. Not everyone with untreated syphilis will develop tertiary syphilis but it can permanently damage parts of the body, including blood vessels to your brain and spinal cord. Symptoms include slurred speech, changes in behavior, memory loss, difficulty with muscle movement, and paralysis.
The only way to know whether you have syphilis or not is to get tested. This is done through a blood test. Having syphilis once does not protect someone from getting it again. You can get tested and access treatment at health clinics, including walk-ins, hospitals, some community health centres, or your doctor. Check out your local public health website for more information.
Syphilis can be cured with an antibiotic called penicillin. The antibiotic is given as a shot in the thigh or buttocks. If you had syphilis for less than a year, you may only need one shot. If you had syphilis for more than a year, you will most likely need three shots—one shot per week for three weeks. Once you have been treated for syphilis, you'll need to go for follow-up blood tests to make sure the infection is gone.
The best way to prevent syphilis is by using condoms (including on shared sex toys) and using dental dams for oral sex. You can also wash your hands after removing condoms and avoid touching your eyes. If you shave or wax your pubes, using condoms and lube can help reduce the chances of syphilis and other bacteria or viruses from entering your body. Getting tested before or in-between new sexual partner(s) is also a great routine to have in your sexual health regimen.