Syphilis

Syphilis is a bacterial STI that progresses through stages if it's not treated. In the early stages, it causes a painless sore (called a chancre) where the infection entered the body, followed later by a rash and flu-like symptoms. If caught early, it's easily cured with antibiotics — usually a single injection of penicillin. If left untreated for years, it can cause serious damage to the heart, brain, and other organs. Syphilis rates have been rising in the UK in recent years. [CHECK: current UK syphilis trends]

• Syphilis is a bacterial STI that progresses through stages.
• The first sign is usually a painless sore at the site of infection (genitals, anus, mouth, or throat).
• It's curable with antibiotics — a penicillin injection is the standard treatment.
• It's spread through direct contact with a syphilis sore during vaginal, anal, or oral sex.
• Rates have been increasing in the UK, particularly among gay and bisexual men. [CHECK]
• It's tested for with a blood test.

The stages

Primary syphilis — a painless sore (chancre) appears where the bacteria entered the body, usually 10-90 days after infection. It might be on the genitals, anus, lips, or throat. Because it's painless, people often don't notice it. It heals on its own within a few weeks — but the infection hasn't gone.

Secondary syphilis — weeks to months later, a rash can develop (often on the palms of the hands and soles of the feet), along with flu-like symptoms: tiredness, headaches, swollen glands, hair loss, and weight loss. These also go away without treatment — but again, the infection is still there.

Latent syphilis — after the secondary stage, syphilis goes quiet. No symptoms, but the bacteria are still in the body. This stage can last years.

Tertiary syphilis — if still untreated after years, syphilis can cause serious damage to the heart, blood vessels, brain, and nervous system. This stage is rare now because most people are diagnosed and treated earlier, but it's why syphilis was historically so feared.

How it spreads

Syphilis is passed on through direct contact with a syphilis sore — during vaginal, anal, or oral sex. The sore doesn't have to be visible for the infection to be passed on. Condoms reduce the risk but don't eliminate it, because sores can be in areas the condom doesn't cover.

Things people get wrong

"Syphilis is an old disease that doesn't exist anymore." It very much does. Cases have been rising significantly in the UK, especially among men who have sex with men.

"You'd notice a syphilis sore." Not necessarily. The primary chancre is painless and can be hidden inside the vagina, anus, or throat. Many people miss it completely.

"Once the sore goes away, you're fine." The sore healing doesn't mean the infection is gone. Without treatment, syphilis progresses through further stages.

Things people ask about syphilis

How is it tested for?

A blood test. It can take a few weeks after infection for the test to be accurate, so timing matters. A sexual health clinic can advise on when to test.

Is it really just one injection to cure it?

For early-stage syphilis, yes — a single injection of penicillin is the standard treatment and is highly effective. Later stages may need a longer course. [CHECK: current treatment protocol]

Can you get syphilis from oral sex?

Yes. If there's a sore on or near the mouth, genitals, or anus, contact during oral sex can transmit it.

Where to get help

• Sexual health clinics (GUM clinics) — blood testing and treatment, free and confidential.
• Your GP — can arrange a blood test.
• Brook — sexual health services for under-25s.

Syphilis is an infection caused by bacteria. You catch it through sex — vaginal, anal, or oral — by touching a sore on the infected person's body.

The first sign is usually a painless sore where the infection got in. It might be on the private parts, bum, lips, or throat. Because it doesn't hurt, lots of people don't notice it. The sore goes away on its own after a few weeks, but that doesn't mean the infection is gone.

If it's not treated, the next stage can cause a rash (often on the palms of the hands or soles of the feet), feeling tired, headaches, and other flu-like signs. These also go away on their own, but the infection is still in the body.

If it's left for years without treatment, syphilis can cause serious damage to the heart, brain, and other parts of the body. This is rare now because most people get treated before it gets that far.

The good news is that syphilis is easy to cure when caught early. The usual treatment is a single injection. It's tested for with a blood test at a sexual health clinic.

Condoms help lower the risk but can't fully prevent it, because the sore might be on skin the condom doesn't cover.

Syphilis is becoming more common in the UK, so knowing about it matters.