Syphilis – what is it?

Syphilis is caused by bacteria which are passed on through unprotected oral, vaginal or anal sex. It can be present with hardly any symptoms but is still infectious.

The number of Syphilis cases among gay men in some areas is increasing rapidly so anyone who is having sex should be aware of their risk and the more partners you have the greater your risk of infection.

Symptoms

Only around a third of people with syphilis realise that they have it. The symptoms are generally painless and can easily go unrecognised.

The first stage of infection is usually a small, and painless, ulcer. The ulcer will be raised, red and usually has a hard edge. This might be on your dick, on your lip or at the edge of your arse, or even on your skin. It can even be inside your arse or your mouth like a mouth ulcer, where it can’t be seen. This makes it difficult to see and because it is painless people often don’t notice they have caught it.

After a week or two this small (but very infectious) ulcer goes away by itself so that even those people who have noticed the ulcer can think the infection has gone away.

The second stage of symptoms can affect people anywhere from one week up to six months after the end of the first stage.

The symptoms can be:
–  fevers
–  general tiredness
–  swollen glands
–  a painless rash, (often on the palms of the hand or soles of the feet)
–  sores and warts on the arse
–  and sometimes, patchy hair loss

There is a third stage to Syphilis and this can appear between 2–40 years later if the syphilis was left untreated. Third stage Syphilis is quite rare in the UK because most people go to the doctor during second stage symptoms, but it is worth knowing about.

The third stage of Syphilis can cause damage to your heart, brain and nervous system.

Transmission

Syphilis is very easy to pick-up and often difficult to recognise, so anyone who has sex could be at risk.

The Syphilis bacteria usually enter your body through soft skin – like in your mouth, your arse or on your cock. It is extremely powerful and can penetrate even ordinary skin where there are tiny cuts or grazes.

Sexual activities where transmission can occur include kissing, rimming, fingering, fucking or being fucked without condoms, sucking or being sucked without condoms.

You cannot get Syphilis from contact with towels, toilets or anything similar because the syphilis organism cannot live outside the body.

A Syphilis infection makes it easier to catch HIV (up to eleven times easier!), and being HIV positive makes it easier to catch Syphilis.

If you have HIV it’s important to realise that what’s safe for HIV is not necessarily safe for syphilis and so your usual prevention measures (e.g. condom use) won’t always save you from getting, or passing on, Syphilis.

For example, you may feel that oral sex is sufficiently low risk in terms of HIV for you not to use condoms, however the risk of catching or passing on syphilis would be much more significant.

Testing

The only way to know for sure if you have Syphilis is to get a blood test from your doctor or at a clinic.

The usual test is very simple – the doctor takes a small amount of blood from you. A swab can also be taken from a Syphilis ulcer if you have one.

It takes about a week for the results to come back from the clinic and the treatment is simple antibiotics.

Treatment

Syphilis is generally treated with a course of penicillin injections or doxycycline tablets over two or three weeks. The injections are given by your doctor or at a Sexual Health (STI) Clinic.

Once treated, it is important to make sure that the infection has been properly killed off – this is done by regular blood tests for three months after the treatment is finished.

Once you have been treated you are not immune to Syphilis. You can still get the infection again so it’s still a good idea to have regular check-ups –every six months or more often, depending on the risks you have taken.

Prevention

Syphilis is highly infectious so the more risks you take the likelier you are to become infected. Using condoms and other barrier methods for anal and oral sex will offer a degree of protection, however be aware of skin to skin transmission and ulcers not covered by condoms or dental dams.