Syphilis: Symptoms and treatment

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Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. If left untreated, it can cause serious health problems. Cases of syphilis are on the rise in Canada.

Syphilis can be transmitted through:

  • vaginal, anal or oral sex
  • sharing sex toys
  • the placenta to a developing fetus
  • blood transfusions in places where blood is not screened
    • In Canada, all donated blood is screened for syphilis.
  • skin contact with a syphilis sore (known as a chancre) or rash
  • childbirth, when the baby comes in direct contact with lesions or fluids

Using condoms correctly or dental dams can lower the likelihood of passing syphilis.


You may not notice that you have any symptoms of syphilis. However, you can pass syphilis even if you show no visible symptoms.

If left untreated, syphilis can move through 4 stages, which have different signs and symptoms.

Some symptoms or effects can occur at any stage of infection, such as syphilis of the brain and nervous system (neurosyphilis). These can include:

  • headaches
  • dizziness (vertigo)
  • vision changes (ocular syphilis)
  • coordination or balance problems (ataxia)
  • hearing loss, ringing in the ears (otic syphilis)
  • memory problems, personality changes (dementia)

Primary syphilis

Symptoms of primary syphilis can include:

  • swollen glands in the groin or neck
  • a sore or ulcer that's firm, round and painless (a chancre)

The chancre occurs where syphilis entered the body, which can be:

  • on the lips
  • in the mouth or throat
  • in the genital or anal area

Since a chancre may not be visible and is usually painless, many people with syphilis don't recall having had one.

Secondary syphilis

Symptoms of secondary syphilis can develop between 2 to 12 weeks after exposure. These can include:

  • fever
  • headache
  • patchy hair loss
  • swollen glands in the groin or neck
  • white, wart-like sores (condylomata lata)
  • a rash, often including the palms of the hands and soles of the feet

These symptoms may be mild and you might not notice them. They may also be confused with other conditions.

Latent syphilis

Untreated secondary syphilis will progress to a latent stage. During this stage, you may not notice symptoms for up to 20 years.

Someone without symptoms who has syphilis for less than 12 months is in the early latent stage. Even without symptoms, you can pass early latent syphilis to others. Someone without symptoms who has symptoms for more than 12 month is in the late latent stage. Late latent syphilis is typically not transmissible to others.

Tertiary syphilis

  • the brain
  • the heart
  • blood vessels
  • the nervous system

Untreated tertiary syphilis can eventually lead to death.


You can get tested for syphilis with a blood test. You may also have a swab taken of your sores or rash if you have any.

If you have questions or want to be tested for syphilis and other sexually transmitted infections (STI), you can contact your:

  • health care provider
  • sexual health clinic
  • local public health unit

Find a testing location near you (

Treating syphilis

Syphilis can be cured with antibiotics, usually given by injection (shot). The earlier you start treatment, the better your health outcomes.

Even if you're treated, you can get syphilis again if you have sex with someone who has the infection and:

  • has not been treated or
  • has not finished treatment

If you're diagnosed and treated for syphilis, be sure to:

  • follow your health care provider's treatment and follow-up advice
  • avoid contact with sores or sexual activities with your sexual partner(s) until you and your partner(s) have:
    • completed your antibiotic treatment and
    • been told by your health care provider that the infection is gone

Once you have been treated for syphilis, you'll need to go for follow-up blood tests to make sure the infection is gone. It's important that you attend all of the scheduled visits.

Notify all of your sexual partners about their risk of infection. This is so they can be tested and treated.

If you're uncomfortable notifying your partner(s), ask your health care provider or local public health unit for support.

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