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Syphilis Rates Are Soaring: What You Need To Know


  • Syphilis is a bacterial infection most commonly spread through sexual contact.
  • Syphilis develops in stages, with different signs and symptoms in each stage.
  • Syphilis can become debilitating and even deadly if it’s left untreated.
  • The only way to know if you have syphilis is to be tested, either through your provider or by using an at-home testing kit.
  • Syphilis is easily treated with the right dose of antibiotics. 
  • Stay on top of your sexual health with the resources and services available through eDrugstore.

Syphilis has been around for hundreds of years. Many people assume that syphilis infections are no longer common, thanks to the wide availability of antibiotics. Unfortunately, syphilis cases have surged in the past decade, and when not treated, this disease can have devastating consequences.            

What Is Syphilis?

Syphilis on a screen

Syphilis is a bacterial infection that can be spread through sexual contact. Syphilis develops in stages, with symptoms escalating over time. This infection is caused by the bacterium Treponema pallidum

Syphilis infections can become debilitating and even fatal if they are left untreated. Fortunately, syphilis is highly treatable when diagnosed in time. The earlier an infection is caught, the better the treatment outcome. 

Syphilis Transmission

Syphilis is most commonly spread through sexual contact. This includes direct contact with a syphilis sore during vaginal, anal, or oral sex. It can also spread from a pregnant person to their unborn baby. 

There are many myths surrounding syphilis transmission. The most popular myth is that you can get syphilis from casual contact with everyday objects. This is not the case, however. You can’t get syphilis from casual contact with objects, such as toilet seats, clothing, bathtubs, or hot tubs.

Syphilis Risk Factors

Anyone who is sexually active can get syphilis. Some people are at an increased risk of contracting the disease, including:

  • People who have sex without using a barrier method, such as a condom
  • People who have sex with multiple partners
  • Men who have sex with men
  • People with HIV

Syphilis Symptoms

There are four stages of syphilis. Each stage has different signs and symptoms, and your risk for serious complications rises as the stages progress. 

Despite well-established symptoms, syphilis can be tricky to diagnose. This is because some people can have syphilis without any symptoms. Syphilis has also been nicknamed the great imitator because its symptoms mimic other types of infections.

Primary Stage

During the primary stage, you may develop one or more sores on your body. These sores are often firm, round, and painless. The sores last around three to six weeks and heal on their own.

The sores typically appear where syphilis originally entered your body. They frequently show up on or near the:

  • Penis
  • Vagina
  • Anus
  • Rectum
  • Lips or mouth

You should still seek treatment if your sores have disappeared on their own. This is a sign that syphilis is progressing to the next stage (the secondary stage).

Secondary Stage

The next stage of syphilis is known as the secondary stage. During this stage, you may notice skin rashes and sores in your mouth, vagina, or anus. The rash may appear while your primary sores are healing, or it may appear several weeks after these sores have healed.

The rash can appear on more than one area of your body. It typically shows up on the palms of your hands or the soles of your feet. 

The rash might look and feel rough, red, or reddish brown. It isn’t usually itchy, and it may be barely noticeable. A rash can also appear with other symptoms.

Other symptoms during the secondary stage include:

  • Fatigue
  • Fever
  • Headaches
  • Muscle aches
  • Sore throat
  • Swollen lymph nodes
  • Weight loss

These symptoms will go away on their own, regardless of treatment. If you don’t seek treatment, syphilis will progress to the next stages.

Latent Stage

Once syphilis progresses past the second stage, it will enter the latent stage. This stage is characterized by a period of no visible signs or symptoms. This stage can last for years and lead to serious health complications, including death.

Tertiary Stage

The final stage of syphilis is the tertiary stage. Tertiary syphilis typically occurs 10-30 years after initial infection. Most people with untreated syphilis don’t reach this stage.

For those who do, tertiary syphilis can affect many systems of the body, including the heart and blood vessels, brain, and nervous system. This can cause seriously debilitating conditions and can become life-threatening. 

Complications include:

  • Blindness
  • Hearing problems or hearing loss
  • Heart disease
  • Memory loss
  • Mental health conditions
  • Neurological disorders
  • Neurosyphilis, an infection of the brain or spinal cord
  • Tissue damage or deterioration 

Surging Syphilis Rates

A total of 133,945 syphilis cases were reported in the United States in 2020. This reflects an increase of 52 percent since 2016. Primary and secondary syphilis, which are the most infectious stages of syphilis, accounted for 41,655 of these cases. 

Syphilis cases have risen in both men and women. However, cases seem to be rising more steadily in women. Preliminary data for 2021 suggests that these trends continued. 

The World Health Organization (WHO) has reported similar trends across the globe. Syphilis cases have soared, as have chlamydia and gonorrhea, in different regions of the world.

Factors Contributing to Increased Syphilis Cases

Syphilis rates have disproportionately affected men who have sex with men and people of color for many years. In the past few years, health officials have noticed a significant uptick in syphilis cases among women and in people who identify as heterosexual. 

The reasons for the rise in syphilis cases are complex. Researchers and health officials have proposed a combination of factors, including:

  • Limited access to care. Disparities in sexually transmitted infections, including syphilis, are strongly linked to limited access to insurance coverage, preventative care, screening, and treatment services.
  • Relaxed precautions. Modern HIV therapies and pre-exposure prophalaxis  (PrEP) have led to many people relaxing safer sex practices. For example, people may be less likely to use barrier methods while having sex. 
  • Substance use. Rates of substance use disorder and injection drug use have also risen. This is an established risk factor for risk-taking behaviors, such as unprotected sex with multiple partners.
  • Online dating. The past decade has seen a massive surge in online dating and “hookup” culture. People now have a wider pool of potential sexual partners to choose from. This can make it more challenging to follow up with recent sexual partners after an infection is discovered. 
  • The COVID-19 pandemic. Many people experienced reduced access to preventative, screening, and testing services during the COVID-19 pandemic. Health departments and community health centers were primarily focused on COVID-19 mitigation in recent years. This led to additional barriers to care for many people living in the United States.

Syphilis Treatment

Man holding up a pill

Once you’ve been diagnosed, treatment is relatively simple for primary and secondary syphilis. These stages of syphilis can be cleared up with the right antibiotic. Advanced stages of syphilis often require more intensive treatment. 

Primary and secondary syphilis are treated with a penicillin injection. People who are allergic to penicillin may be prescribed alternative antibiotics, such as ceftriaxone or doxycycline. After you’ve finished your antibiotics, you should be tested again to ensure the infection has been resolved.

Abstain from sex until you’ve finished your treatment. You should make sure your recent sexual partners have been tested and treated for syphilis as well. It’s possible to become infected with syphilis more than once.

Syphilis Prevention

Colorful condoms

Anyone who is sexually active can get syphilis. You can lower your risk by:

  • Using barrier methods, such as condoms and dental dams correctly and consistently every time you have sex
  • Knowing your sexual health status and your partner’s status 
  • Avoiding contact with any sores on a sexual partner’s body
  • Limiting your number of sexual partners or being in a long-term mutually monogamous relationship with someone who does not have syphilis
  • Practicing open and honest communication with your partner(s) about sexual health 

Know Your Status

Sexually transmitted infections (STIs) are increasingly common. The most common symptom of all STIs is not having any symptoms at all (being asymptomatic). The only way to confirm you have an STI, like syphilis, is to get tested. 

Men who are sexually active should plan routine STI testing based on their individual risk factors. For example, men who have multiple partners or men who have sex with men should be tested more frequently. 

Frequent testing is easier than ever thanks to at-home testing kits. Some at-home test kits can be delivered right to your front door. You can mail your sample and receive lab-certified results in just a few days. 

We offer the Uber Box, which tests for syphilis as well as chlamydia, gonorrhea, trichomoniasis, herpes, HIV and hepatitis C. If you receive a positive result, you can schedule a free consultation with a doctor to review your results and next steps. 

Stay on Top of Your Sexual Health with eDrugstore

The only way to know if you have an STI is to get tested. We make it easy to know your status and to access treatment at Take advantage of free consultations with a physician licensed to practice in your state by calling 1-800-467-5146.

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