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For Teens: Understanding Syphilis

Syphilis is an infection caused by bacteria. It spreads through any kind of sexual contact. That is most often by vaginal sex, anal sex, or oral sex. This sexually transmitted infection (STI) has four stages. It gets worse with each stage. Syphilis can be cured. Early treatment is very important. If left untreated it can cause lasting heart or brain damage, dementia, or blindness. Syphilis can even cause death.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.

What to look for

First-stage symptoms often show up within a few weeks of becoming infected. It may take months for second-stage symptoms to appear.

During the first (primary) stage, you may have:

  • A painless sore in or on the mouth, genitals, or anus. Sometimes more than one sore appears. The sore often goes away on its own within a few weeks. You will still need treatment even if it goes away. You can still pass the infection on to others.

The second (secondary) stage can start as the sore is healing. This stage can last up to several weeks after the sore has healed. During the second stage, you may have:  

  • A body rash that includes the palms of the hands and the soles of the feet

  • Flulike symptoms such as a fever, sore throat, and headache

During the second stage, you can pass the infection to others if you have open sores. If the infection is not treated, it can move to an inactive (latent) stage and rarely to a late stage. In the latent stage, the infection is still in your body even though you don't have symptoms. Without treatment, the infection can move to the late stage. This can damage your organs, including your brain. This can cause blindness, deafness, and dementia. Late-stage syphilis can lead to death.

A blood test is often done to test for syphilis. Sometimes, fluid from a syphilis sore will also be tested.

Syphilis and pregnancy

During pregnancy, untreated syphilis can infect the developing fetus. It can cause a range of birth defects, some severe. This is called congenital syphilis. It's very important to be checked for syphilis before or during early pregnancy. The CDC advises that all pregnant women get tested for syphilis at their first prenatal visit. Congenital syphilis cases are increasing across the country. Many states now require syphilis testing during pregnancy and sometimes at birth.

Treatment

Syphilis is best treated with antibiotics. These medicines can also often cure it. These medicines may be given as a shot, by mouth (pill), or into a vein (IV). Syphilis can be treated in later stages, but the damage done to the heart and brain may not be reversed.

If you are told that you have syphilis, make sure your current and past partners get checked, if possible. And don’t have sex until your healthcare provider says it’s OK.

If you don’t get treated

Syphilis can stay in the body for years. During the third stage, syphilis can make you very sick. It can cause:

  • Damage to the brain, nerves, and heart. Some damage can’t be reversed, even with treatment.

  • Blindness

  • Death

Tell your partner

It’s important to talk with your partner about STIs and testing. If you don't feel safe talking face-to-face with your partner about testing, send a text or an email. Or make a phone call instead. Ask someone for help if you’re not safe.

Ask your partner if they have an STI or if they’ve been tested. Think about getting tested if one of you isn’t sure. If your partner does have an STI, encourage your partner to get treated. Otherwise they can pass the infection back to you or on to others.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 12/1/2022
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