You've probably heard the safe sex spiel dozens of times in your life. Truthfully, wrapping your tool isn't hard to do — and in a perfect world, you'd do it 100% of the time, every time. But things happen, mistakes get made, trust gets formed, things start to feel good and before you know it, that scary picture of what syphilis looks like that you saw back in your high school health class become a distant memory. That is, until it appears on your private parts some weeks later.
Think that syphilis can't happen to you? Think again. According to the CDC, the U.S. averages around 23,000 reported cases of syphilis per year. Of those that report being infected by the disease, cases among men were much higher — 13.7 cases per 100,000 males vs 1.4 cases per 100,000 females. Unlike most other STIs (Sexually Transmitted Infections), the age range of the most people affected skewed higher than the early 20s crowd — with 24- to 29-year-olds in the lead for having the most reported cases of syphilis in the U.S.
So, just what is syphilis, and how does it get contracted? Can syphilis be cured? What are the symptoms? And how can you prevent it? Here's everything you need to know about preventing and treating syphilis.
What Is Syphilis?
Yes, it's an STI. But the actual cause of the disease is a spiral-shaped bacteria (called Treponema pallidum) that can move (or uhh…swim) in fluids. And does it ever spread, if you leave it untreated. "Syphilis is a sexually transmitted infection caused by a bacteria," explains Dr. Amesh Adalja, MD, infectious disease physician at Johns Hopkins Center for Health Security. "It is an infection that has the ability to disseminate throughout the body and can affect every part of it causing widespread damage." In fact, depending on how long the disease is left untreated, syphilis morphs into three different types, or "stages," which vary in severity of symptoms.
Symptoms Of Syphilis
If you did contract syphilis, symptoms typically show up three weeks later in both men and women. "Men and women usually experience broadly similar symptoms of painless sores on and around the genitals around in the early stages followed by a period with no symptoms," says Dr. Sam Malik, GP at DrFelix. "Some people also see a red rash on their hands or feet, or whiteness around the mouth." Because the symptoms of syphilis clear up on their own over time, it makes it easy for the disease to go untreated — which can leave both men and women infected with the bacteria to face more extreme complications as time goes on.
Primary syphilis is the stage of the disease discussed previously, where painless sores present themselves depending where the point of contact is, explains Dr. Tanya Kormeili, MD, board-certified dermatologist in Santa Monica. "It can involve anus or in the rectum, or in or around the mouth in addition to the genitals. While the male genitals are easily visualized, female involvement of the vagina may go unnoticed." And when it does go unnoticed, or when left untreated after initial symptoms subside, primary syphilis morphs into the next, more painful phase.
"Secondary syphilis includes a diffuse skin rash that is very infectious (called the rosy 'copper penny' rash, and swollen lymph nodes," says Dr. Kormeili. "The patient might have cold like symptoms such as sore throat, headaches, weight loss, muscle aches and fatigue, and a special type of hair loss known as 'moth eaten alopecia.'" However, even these symptoms, when left untreated, can subside, leaving the person infected with the disease feeling better weeks later. This secondary stage of syphilis typically occurs anywhere from six weeks to six months after exposure.
If left untreated for years, the most lethal form of syphilis — tertiary syphilis — occurs. When the disease has been left untreated for this long of a time, it has the opportunity to spread to the entire body. According to Dr. Kormeili, this can affect both the heart and brain with severe and permanent damage, ranging from paralysis, blindness, dementia, deafness and impotence.
How Is Syphilis Spread?
Since syphilis is an STI, it's transmitted through intercourse — but it's really contact with the sores that result in the spreading of the infection from person to person. Which means that, yes, you can get syphilis from kissing. "You get syphilis by being exposed to someone who has open sores, as opposed to genital herpes which can be transmitted without any open sores," explains Dr. James Wantuck, MD of PlushCare. "This can occur through sex or even through kissing someone with an open sore."
So penetrative vaginal sex, anal, oral, kissing and even sharing sex toys that come in contact with an open sore can cause the disease to be passed from person to person.
How To Prevent Syphilis
Prevention methods for syphilis can depend on what type of syphilis your partner has. "Secondary syphilis is harder to avoid because the rash all over the body and hair of the infected patients can spread to anyone in contact with that person," explains Dr. Kormeili. In addition to practicing safe sex — using condoms for both anal and penetrative vaginal sex, as well as barriers for oral, it's smart to get tested with new partners so that you are both aware of any STIs each of you may be unknowingly carrying. If the person you're romantically involved with has visible sores or a rash on their body, wait until it clears up and they have been tested before being intimate with them.
Also, if you do decide to use sex toys, make sure you're washing them with an antibacterial cleanser (like this one) to kill any syphilis bacteria that may wind up getting transmitted that way.
How To Diagnose Syphilis
Because the symptoms of syphilis tend to clear up on their own after a few weeks, it can be a hard disease to diagnose. "Syphilis is known as the 'great imitator' because the symptoms can mimic that of many different diseases," Dr. Wantuck says. But if you notice sores in your genital or anal region, it's smart to get yourself to a doctor when they first appear to determine whether or not you have syphilis — since leaving it untreated can wind up having severe complications in the long run.
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"The infection is usually diagnosed by a sexual health expert on the appearance of the sore," says Dr. Malik. "Although if you are too embarrassed to get seen in person, you can also get tested by using a home test kit service, but the sample needs to be analyzed in a professional lab. It is a blood-borne STI so you need to provide a tiny blood sample using a fine needle to prick your finger which is analyzed in a laboratory for evidence for the infection." Also, the timing on these types of tests can often take a while. "Blood-borne STIs like syphilis, HIV and hepatitis can sometimes take up to 12 weeks to get detected," Dr. Malik explains.
AskMen Recommends: Concerned you may have picked up an unwanted infection from a recent sexual encounter? We're not here to shame you. But before you let things fester (or sleep with other people), you should find out what your STI status is, and, if you have one, take action immediately. If you don't have the opportunity to see a doctor or to go to a health clinic, consider getting ordering an at-home test kit. Check out our list of the best at-home STI kits so you can find out where you stand ASAP.
How to Treat Syphilis
The treatment of syphilis differs depending on what stage the disease is in. If caught early on, you're looking at a simple shot or round of antibiotics. "Syphilis is treat by using penicillin delivered as a shot," Dr. Wantuck explains. "This single shot lingers in your system, killing the syphilis organism in the vast majority of people. There are also oral medications which can be used to treat syphilis, used in people allergic to penicillin or those unable to come in for an injection."
But if the disease has progressed to the second or third stages, treatment to cure the disease can be more extensive. More frequent shots and higher dosages may be used when treating secondary syphilis, and tertiary syphilis can end up costing you a hospital stay in order to fully rid the disease from the system.
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Your doctor can advise you on the best practices to follow through with after your syphilis treatment has been administered, but Dr. Malik offers some general guidelines to follow after following the course of treatment for primary syphilis. "Once the treatment is finished you'll be cured of the infection, although you should wait two weeks before having sex again," he says. "You should not have any type of sex or close skin contact during the treatment."
It's easy to put off a trip to a doctor when you're experiencing symptoms that come and go. But if you do see any of the signs that are in line with how syphilis shows up, it's better to have wasted a trip to the doctor and find out you're in the clear than to find yourself seeking much more extensive treatment months or even years after the disease has gone untreated. One surefire way to detect syphilis and get treatment before it progresses? Get checked regularly for STIs. Most insurances cover STI testing at least once a year — and if you've already used yours up and think you may have contracted syphilis, there are facilities that offer STI testing at affordable costs where you can have it done. Remember, knowledge is power — especially when it comes to your sexual health.