Syphilis, a sexually transmitted disease (STD), can be frightening because if it goes untreated, it can lead to serious health problems and increase a person's risk for getting human immunodeficiency virus (HIV), the virus that causes AIDS.
A syphilis infection can be treated in its early stages with antibiotics, and can be prevented by avoiding sexual contact with someone who is infected. Unfortunately, people don't always know that they are infected, so anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.
Symptoms
Syphilis, which is caused by the bacteria Treponema pallidum, often doesn't cause any symptoms in the early stages. If the infection goes untreated, it can progress to affect the entire body.
Syphilis typically has three stages, and there can be different symptoms in each.
Primary Syphilis
The symptoms of the first stage of the infection, which is called primary syphilis, typically appear 2 to 12 weeks after sexual contact with an infected person. A painless red sore called a chancre can appear on the genitals, at the area where the infection occurred. Enlarged lymph nodes (swollen glands) also might be present in the area. Depending on the type of sexual contact, a chancre might also develop on the mouth or in the rectal area. Chancres are the primary way that syphilis is transmitted between people, but often are unrecognized. Even without treatment, chancres will heal after 3 to 6 weeks, but if the infection isn't treated the disease will progress to the second stage.
Secondary Syphilis
The secondary stage usually begins weeks to months after the chancre sore appears. Syphilis bacteria enter the blood and spread through the body, causing many different symptoms, including rash (small red spots), fever, headache, loss of appetite, weight loss, sore throat, muscle aches, joint pain, a generally ill feeling, and enlarged lymph nodes.
The rash of secondary syphilis can develop on the palms and on the soles, in addition to the trunk, arms, and legs. Gray or white wart-like patches of skin called condylomata can appear on the moist areas around the mouth, anus, and vagina. These lesions are full of bacteria and very contagious. In the secondary stage, syphilis may also affect the liver, kidneys, and eyes, or cause meningitis. The symptoms of secondary syphilis will eventually go away. But without treatment, the infection can advance to the third stage. This is true even if an infected person did not have symptoms of primary or secondary syphilis.
Late (Tertiary) Syphilis
After the secondary stage, some people with syphilis progress to the latent stage, where they have no more symptoms but are still infected. Some of them go on to have symptoms of late syphilis, which can appear even years later and can damage the eyes, large blood vessels, heart, bones, and central nervous system (called neurosyphilis). Symptoms of this late stage of syphilis may include memory loss, problems with mental function, walking, balance, bladder control, and vision, in addition to impotence and loss of feeling, particularly in the legs.
Treatment
A doctor can test for syphilis with a physical exam and blood tests and treat it with antibiotics. The doctor can also check for any other STDs, such as gonorrhea, chlamydia, and HIV.
Anyone who is sexually active should see the doctor to be screened for syphilis and other STDs. Someone who has had sexual contact with a person who has syphilis, or has any symptom of the illness, should be seen by a physician for testing and treatment as soon as possible.
Preventing STDs
Because syphilis is an STD, the best way to prevent getting it is to abstain from having sex. Sexual activity with more than one partner or with someone who has more than one sex partner also increases the risk of contracting an STD.
When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.
Using douche can actually increase a woman's risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.
Because many STDs often don't have obvious symptoms, often teens don't know when they're infected, so sexually active teens should get screened regularly for STDs so that they don't lead to other more serious health problems.
A teen who is being treated for syphilis also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it's important to encourage them to talk to a trusted adult who can provide the facts.
Getting Help
If your teen is thinking of becoming sexually active or already has started having sex, it's important to talk with him or her about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don't have symptoms, so a partner might have an STD without knowing it.
It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.
It's also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.
Reviewed by: Larissa Hirsch, MD
Date reviewed: August 2007
