Syphilis is a curable sexually transmitted infection, but delaying treatment can allow the infection to progress and cause serious complications. Here is what experts want you to know about its symptoms, treatment and prevention. Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. While the diagnosis can understandably cause concern, there is an important fact to remember: syphilis is curable with appropriate antibiotic treatment. However, getting treated does not necessarily mean that any damage caused by a long-standing infection can be reversed. The infection can progress through different stages, and symptoms may not always be obvious. This is one reason why people can have syphilis without realising they are infected and may unknowingly transmit it to sexual partners.

"Syphilis is curable with the right antibiotic treatment, particularly when it is diagnosed early. However, treatment cannot always reverse damage that has already occurred because of a long-standing infection," said Dr Sudeshna Saha, Consultant, Gynaecology, RG Hospitals, Kolkata.

What are the symptoms of syphilis?

Syphilis typically develops in stages, and the symptoms can vary depending on the stage of infection. During primary syphilis, a person may develop a painless sore, known as a chancre, usually at the site where the bacteria entered the body. It can occur around the genitals, anus or mouth. Because the sore may be painless and can disappear on its own, it may easily be overlooked. However, the disappearance of the sore does not mean the infection has been cured.

The infection can then progress to secondary syphilis. At this stage, a person may develop a rash, including on the palms of the hands and soles of the feet. Other symptoms can include fever, swollen lymph nodes, fatigue and general discomfort.

Syphilis may subsequently enter a latent stage, during which there may be no noticeable symptoms. Despite the absence of symptoms, the infection can remain in the body.

Is syphilis completely curable?

Syphilis can be cured with appropriate antibiotic treatment. Penicillin is the preferred treatment for syphilis, with the specific treatment regimen depending on the stage of infection and the individual's clinical circumstances. Early diagnosis and treatment are particularly important because untreated syphilis can progress and potentially affect several organs. Treatment should be taken exactly as prescribed, and people diagnosed with syphilis should attend the follow-up appointments and testing recommended by their healthcare professional.

An important distinction is that curing the infection does not necessarily undo damage that may already have occurred. This is why waiting for symptoms to disappear without seeking medical care is not a safe approach.

Can syphilis come back after treatment?

A person can get syphilis again even after successful treatment. "Being treated for syphilis does not provide immunity. A person can become infected again after successful treatment if they are exposed to the bacteria through sexual contact," explained Dr Saha.

This means that treatment alone does not protect a person from a future infection. Preventive sexual-health practices and appropriate evaluation of partners remain important.

Do sexual partners need treatment?

They may. Sexual partners of someone diagnosed with syphilis may need to be evaluated by a healthcare professional and, depending on their exposure and test results, may require treatment. This is important not only for the partner's health but also to reduce the possibility of passing the infection back and forth. Until treatment has been completed and a doctor advises that it is safe to resume sexual activity, avoiding sexual contact is an important precaution.

What happens if syphilis is left untreated?

Untreated syphilis can remain in the body for years and may eventually cause serious health problems. Depending on the infection and stage, complications can involve the brain and nervous system, heart, blood vessels, eyes and other organs. Some complications associated with late or untreated infection can be serious and may cause lasting damage. The absence of symptoms therefore does not necessarily mean that there is no infection or risk.

When should you get tested for syphilis?

Testing should be considered if you may have been exposed to syphilis, particularly after sexual contact with someone who has been diagnosed with the infection. You should also seek medical advice if you develop:

  • An unusual or painless sore around the genitals, anus or mouth
  • An unexplained rash, particularly involving the palms or soles
  • Swollen lymph nodes
  • Unexplained fever or fatigue
  • Other symptoms following a possible sexual exposure

Because syphilis can enter a stage without obvious symptoms, testing may also be important for people who have no noticeable signs but may have been exposed.

Syphilis is curable, and timely treatment can prevent the infection from progressing and reduce the risk of serious complications. But symptoms can be subtle, disappear temporarily or be absent altogether. If you think you may have been exposed, do not wait for symptoms to become severe. Speak to a healthcare professional about testing and treatment. Completing the prescribed treatment and following medical advice about follow-up and sexual activity are important parts of managing the infection.



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