What is syphilis?

Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It’s spread through unprotected anal, oral and vaginal sex. It can also be transmitted through skin-to-skin contact with someone who has syphilis. One of the early symptoms of syphilis are lumps called chancres. Chancres are small ulcers that are typically hard and painless and found around the genitals or other body parts where you have sex. Contact with chancres can be a way to spread the infection. Not many people know about syphilis today or what to watch out for. Around 50% of cases have no symptoms and symptoms are often easily missed when they are there. This means many people don’t think they have syphilis when they really do. Over the last few years and especially since COVID, we have seen a massive increase in WA syphilis cases.  

What are the symptoms of syphilis?

Syphilis is broken down into different stages, each with their own set of symptoms. Not everyone experiences all the symptoms, and it’s very possible for someone to have syphilis and not experience any of them. This is why testing is super important.
Primary syphilis

The presence of a chancre (small, hard and painless ulcer) at the site of infection – this can be on the penis, on the vulva, inside the vagina, inside the anus, or mouth. Chancres are most commonly singular (only one). However, sometimes there can be multiple. They are typically painful and have pus in that case. A chancre typically appears 3 weeks after infection and will last between 2-12 weeks. Chancres can often be missed due to location (i.e. inside the vagina or anus) and because of the lack of pain.

Secondary syphilis

Secondary syphilis symptoms usually appear 6 weeks after the symptoms of primary syphilis and resolve within several weeks. But they can reoccur. Symptoms include:

    • Fever, headache, generally feeling unwell
    • Swollen lymph nodes
    • Red spotty rash that affects the palms, soles and/or trunk
    • Hair loss
    • Warty growths around the genitals and anus
Latent syphilis

Once the infection progresses past the secondary stage, it enters the latent stage which displays no symptoms. It can last anywhere between a few years and up to 30 years. Some people will spontaneously eliminate the infection and for others it will spread throughout the body and most to the tertiary stage.

Tertiary syphilis

Syphilis infection can progress to the heart, nervous system, eyes, ears and skin. It can lead to mild to severe damage in the areas it spreads to. Thankfully we have access to treatment and testing in Australia so we don’t see a huge amount of tertiary syphilis cases.


Syphilis and pregnancy

With syphilis on the rise in WA, one thing to be careful of is congenital syphilis. Congenital syphilis is when a pregnant person has syphilis and passes it onto the fetus. This can result in miscarriage, preterm birth, low birth weight, stillbirth or death soon after birth, as well as sepsis and physical malformations. We’re lucky here in Australia that syphilis is one of the routine tests done early in pregnancy, but it is still out there. GPs might not think to test for it and pregnant people might not know to ask for a test. Treatment during pregnancy is safe for the mother and baby, and seeking treatment as soon as possible leads to better outcomes.  

Getting tested for syphilis

You can’t always look at a symptom and go “oh yep, that’s syphilis.’ Often they are mild and may be confused for something else like the flu. The only way to know is by getting tested. Even if you don’t have symptoms, make sure syphilis is included when you get an STI screening. It’s usually just a blood test. If you have a chancre, you can also get that swabbed.  

Where can I get tested?

Check out the map below to find a sexual health clinic near you. Note: the clinics listed below are just recommendations, as they are either well known to us or are specifically sexual health clinics. Please let us know if any of the below details are incorrect and need updating. Similarly, please let us know if you have a bad experience with any of the clinics listed below, as we aim to only recommend friendly, non-judgemental and sex positive services.  

Treating syphilis

Treatment varies depending on what stage of a syphilis infection you are at, but most of the time it’s really simple. It’ll either be a few injections or oral antibiotics. Your healthcare provider (whether that’s us or someone else) will be able to discuss your treatment with you and answer any questions you may have. Are you a GP with a patient who is a syphilis contact? Check out our testing and treatment guide. Are you a contact of someone who has syphilis? Find out what you need to do here.  

Things to remember about syphilis

Syphilis is not like chickenpox. You can still get it again. Condoms are great for prevention, but they’re not always completely foolproof. WA is dealing with a syphilis outbreak at the moment. It doesn’t matter your gender, sexuality, race, culture or relationship status. We’ve seen syphilis cases connected between different groups so it’s important to use protection, get tested and get treatment if you need it.   Find out more about syphilis on WAAC’s syphilis page.