The symptoms of syphilis are similar for men and women. They're often mild and difficult to recognise, and you may pass on the infection without knowing you have it.

The symptoms tend to change over time and may come and go.

Even if the symptoms do improve, there's still a risk you could pass the infection on or develop serious problems if you don't get treatment.

Early symptoms of syphilis

The first symptoms of syphilis usually develop around 2 or 3 weeks after infection, although they can start later than this.

This stage of the infection is known as "primary syphilis".

• the main symptom is a small, painless sore or ulcer called a chancre that you might not notice
• the sore will typically be on the penis, vagina, or around the anus, although it can sometimes appear in the mouth or on the lips, fingers or buttocks
• most people only have one sore, but some people have several
• you may also have swollen glands in your neck, groin or armpits

These symptoms usually pass within 2 to 8 weeks. But if the infection isn't treated, it may progress to a second stage.

Later symptoms of syphilis

Further symptoms may develop a few weeks after the initial symptoms have passed. This is known as "secondary syphilis".

Symptoms of secondary syphilis include:

• a blotchy red rash that can appear anywhere on the body, but often develops on the palms of the hands or soles of the feet
• small skin growths (similar to genital warts) – on women these often appear on the vulva and for both men and women they may appear around the anus
• white patches in the mouth
• flu-like symptoms, such as tiredness, headaches, joint pains and a high temperature (fever)
• swollen glands
• occasionally, patchy hair loss

These symptoms usually pass within a few weeks, although they may come and go over several months before they disappear.

You'll still be infected even if you don't have symptoms. This is known as "latent syphilis" and it can last for decades and lead to serious problems if not treated.

It's still possible to pass on the infection during this stage, although this usually only happens within 2 years of becoming infected.

Serious problems if left untreated

Without treatment, a syphilis infection can last for years or decades without causing any symptoms.

Eventually, it can spread to parts of the body such as the brain or nerves and cause serious and potentially life-threatening problems. This is known as "tertiary syphilis".

People with tertiary syphilis may experience:

• meningitis
• strokes
• dementia symptoms
• loss of co-ordination
• numbness
• vision problems or blindness 
• heart problems

Syphilis is still treatable at this stage, but it's sometimes not possible to reverse any damage that's already been done.

The only way to find out if you have syphilis is to get tested.

Syphilis won't normally go away on its own and can cause serious problems if left undiagnosed and untreated.

Who should get tested for syphilis

You should get tested for syphilis if:

• you're worried you might have it
• a sexual partner has been diagnosed with syphilis
• you have symptoms of syphilis

It's particularly important to get tested in these cases if you've had sex without a condom (unprotected sex), you have multiple sexual partners, you're a man who has sex with men, or you've had sexually transmitted infections (STIs) in the past.

Where to get a syphilis test

The best place to get tested for syphilis is a sexual health clinic (sometimes called a genitourinary medicine (GUM) clinic).

Find a sexual health clinic.

These clinics are staffed by healthcare professionals with special expertise in STIs. They tend to have easier access to the tests and treatments for syphilis than your local GP surgery.

You also don't have to pay for treatment if you go to a sexual health or GUM clinic. If you go to your GP surgery for treatment, you may have to pay a prescription charge.

You can go to your GP if you prefer, although they may refer you to a sexual health or GUM clinic if they suspect you might have an STI.

What the test for syphilis involves

You'll be asked about your sexual history, and whether you're experiencing any symptoms.

To diagnose syphilis, you'll usually have a:

• physical examination – a doctor or nurse will ask to examine your genitals (and inside the vagina for women) or other parts of your body to look for growths or rashes that may be caused by syphilis
• blood test – this can show whether you have syphilis or have had it in the past; repeating the test a few weeks later may be recommended if it's negative, in case it was too early to give an accurate result
• swab test – a swab (similar to a cotton bud) is used to take a small sample of fluid from any sores, so it can be checked for syphilis

You should also be tested for other STIs, such as chlamydia and gonorrhoea, as it's possible to have more than one STI at a time. Some results may be available the same day, while others may take a week or two to come back.

You should avoid having sex or close sexual contact with anyone else until you get your test results.

Read more about what happens at a sexual health clinic.

Screening for syphilis in pregnancy

All pregnant women are offered a blood test to check for syphilis, usually at around 8-12 weeks of pregnancy.

A syphilis infection during pregnancy can be very dangerous for the baby, but the screening test can help ensure it's detected and treated as soon as possible.

The test can be repeated if there's a risk you may have been exposed to syphilis later in your pregnancy.

Read more about screening for syphilis during pregnancy.

Syphilis can usually be treated with a short course of antibiotics.

It's important to get it treated because syphilis won't normally go away on its own and it can cause serious problems if left untreated.

Antibiotics for syphilis

A short course of antibiotics can usually cure syphilis. These are only available on prescription, so you'll need to be tested for syphilis to get them.

The type of treatment you need depends on how long you've had syphilis.

Syphilis that has lasted less than 2 years is usually treated with an injection of penicillin into your buttocks, or a 10-14 day course of antibiotic tablets if you can't have penicillin.

Syphilis that has lasted more than 2 years is usually treated with 3 penicillin injections into your buttocks given at weekly intervals, or a 28 day course of antibiotic tablets if you can't have penicillin.

More serious cases that affect the brain are usually treated with daily penicillin injections given into your buttocks or a vein for 2 weeks, or a 28 day course of antibiotic tablets if you can't have penicillin.

Follow-up blood tests will be recommended once treatment finishes to check that it has worked.

Side effects of treatment

You may experience some side effects shortly after treatment.

Around 2 in every 5 people experience short-lived flu-like symptoms, such as:

• a high temperature (fever)
• headaches
• muscle and joint pain

These symptoms usually only last 24 hours and can often be treated with paracetamol. Get advice from your doctor if they're severe or don't settle down.

There's also a risk of having an allergic reaction shortly after a penicillin injection. You'll be monitored after treatment to check for this and will be treated if it occurs.

Avoiding sex during treatment

Avoid any kind of sexual activity or close sexual contact with another person until at least 2 weeks after your treatment finishes.

This includes vaginal, anal and oral sex, as well as close skin contact.

If you have sex during treatment, you could become infected again or pass the infection on to someone else.

Notifying and treating sexual partners

Your current and previous sexual partners should be tested and treated for syphilis as well, as leaving the infection untreated can lead to serious problems.

How far back you need to go depends on how long you had syphilis before it was diagnosed and treated.

You can choose to either notify your previous sexual partners yourself, with support from clinic staff, or the clinic can contact them by letter or phone and advise them to go for a check-up.

If the clinic contacts your previous sexual partners for you, your details will remain totally confidential and no information about you will be given out without your consent.

Treating syphilis during pregnancy

Pregnant women with syphilis can be safely treated with antibiotics.

The treatment you need depends on how long you've had syphilis and how far along in your pregnancy you are.

Pregnant women who've had syphilis for less than 2 years are usually treated with an injection of penicillin into the buttocks (if treated during the first or second trimester) or 2 injections given a week apart (if treated during the third trimester).

Pregnant women who've had syphilis for more than 2 years are usually treated with 3 penicillin injections into the buttocks given at weekly intervals.

A short course of antibiotic tablets may be needed if you can't have penicillin.