What is Syphilis?

Syphilis is an STI caused by the bacterium Treponema pallidum. Syphilis is transmitted through blood, including the blood of an open sore caused by the infection. It is most commonly passed from one person to another during penetrative sex, oral sex, sharing sex toys, and sometimes through pregnancy and/or childbirth. Aside from the severe health outcomes that can occur when someone has untreated syphilis, part of what makes it so dangerous is that its symptoms are easily confused for other illnesses. This means that lots of people won’t realise they got syphilis even if they are showing symptoms.

Syphilis infections are understood in three stages: primary syphilis, secondary syphilis, latent syphilis, and tertiary syphilis.

Primary syphilis occurs right after infection enters the body and as it establishes itself. This stage is marked by the presence of an often painless hard round sore that appears on the spot where the bacteria entered the body – this sore is called a chancre. The chancre typically lasts 3 – 6 weeks regardless of if a person receives treatment. Since it is painless, it can often go unnoticed in places like your anus, vagina, or throat. It can be accompanied by other sores around it.

Secondary syphilis is marked by the onset of skin lesions and rashes. This can happen before, or weeks after, the chancre heals. They can appear on many areas of the body and are sometimes (but not always itchy). Some folks also get white raised sores known as Condyloma lata that are most commonly found in moist areas (like the genitals or under-arms), Lots of other symptoms can accompany this stage like fever, fatigue, hair loss, muscle aches, and sore throats.

Latent stage syphilis is often known as the silent stage of a syphilis infection. This is because the infection shows no symptoms during this period. Latent stage syphilis can last for many many years.

Not everyone who has latent stage syphilis will reach the tertiary stage of this infection, but for those who do it can be fatal. Syphilis can infect most major organs, and the symptoms of tertiary syphilis vary greatly depending on the affected organ.

How can I prevent transmitting Syphilis?

As with many STIs, the three main things you should do to lower your risk of getting or passing along STIs is to 1) use barrier protection, 2) getting tested, and 3) communicating with your sex partners.

Using barrier protection for penetrative sex, oral sex, and with sex toys is a super important way to reduce the risk of transmitting syphilis. Check out our barrier protection and contraception section to learn more.

As discussed in the last section, the long term effects of syphilis can be quite severe. Getting tested regularly allows you to treat the infection before it moves on to a more dangerous phase. BUT it also helps you avoid giving it to other people. Getting tested means that you can be more confident that you aren’t passing this STI on to sexual partners, and it means that if you do get syphilis you can pause the things you do that might pass the infection on to others until you are finished treating it. Check out the section below to learn more about where/how to get tested in Nova Scotia.

Lastly, talking to the people you are having sex with is a super important way to avoid getting syphilis. It can feel awkward to bring up, but having conversations about what preventative methods you both want to use, and what your risk is is a super important part of keeping everyone safe. You can start by offering up your own info – when were you last tested? What do you like to do to avoid getting STIs? And then encourage them to share too. This conversation also can make the experience of sex more comfortable, and less wrapped up in anxiety around the likelihood of contracting or passing along an STI.

How do I know if I have/get Syphilis?

While it is always great to keep an eye out for symptoms that might point to this infection, the only way to be confident in whether or not you have syphilis is to get tested.

In Nova Scotia, Syphilis testing is done through a blood sample. A health practitioner will give you a requisition to get blood taken, and this sample will be sent off to a lab to be tested. Sometimes, in the case of a positive result, a second sample will be asked for to confirm you have an active syphilis infection.

So, when do you get tested? It is a good idea to make syphilis testing a part of your STI testing routine. You can check out our checklist to learn more. If you had a recent exposure, or are worried you might have syphilis, the testing available in Nova Scotia often can’t detect the infection until 3-4 weeks after transmission. If you get tested and it comes back negative, it is a good idea to test again in 4 weeks to reduce your chances of getting a false negative.

You can get testing at your local sexual health centre (such as HSHC, the Red Door, or the Ally Centre of Cape Breton), from a family doctor, and from the infectious disease clinic in Halifax. If you are a student many universities and some high schools will have health clinics where you can get tested. Additionally, some walk-in clinics will offer STI testing, but it is a good idea to call ahead of time to confirm a specific walk-in clinic can offer that service. You can check out Sugar Health to find the testing site closest to you.

Can Syphilis be treated?

Yes, Syphilis can be treated! In Nova Scotia it is generally treated with either antibiotics or a Penicillin injection. It is important to continue to take this medication until the infection clears, and so it’s a good idea to discuss follow up, medication schedules, and future testing with your doctor as soon as you find out you have syphilis.

It is important to note that you can still be contagious while you are on syphilis treatment. Do your best to not engage in any activities / behaviours that might risk passing the infection on to someone else until you have gotten confirmation from your doctor that the infection is gone.

It is possible to get syphilis again, and so we recommend continuing to manage your own risk and get tested regularly even if you have had syphilis before.

You can learn more about where HEAL NS got this information from at:
https://www.canada.ca/en/public-health/services/diseases/syphilis.html
https://www.cdc.gov/std/treatment-guidelines/syphilis.htm
https://www.mayoclinic.org/diseases-conditions/syphilis/symptoms-causes/syc-20351756
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2023-49/issue-10-october-2023/infectious-congenital-syphilis-canada-2022.html
https://novascotia.ca/dhw/CDPC/syphilis.asp
*disclaimer: we do not necessarily endorse all of the information, content, or language used in these references.