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Sexual Health • STI Care

Syphilis

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Its early signs — a painless sore and later a rash — are easy to miss and go away on their own, but the infection stays in the body and can damage the heart, brain, nerves and eyes years later. It can also pass to a baby during pregnancy. Syphilis is simple to test for and is cured with penicillin injections.

How it spreads

Syphilis spreads through direct contact with a syphilis sore or rash during vaginal, anal or oral sex, and from a mother to her baby during pregnancy. It is most infectious in the first two stages. It does not spread through toilet seats, shared utensils, swimming pools or clothing. Having had syphilis before does not protect you from getting it again.

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Sexually transmitted infections are cured or controlled with the right tests and prescribed treatment. Partners need testing too, and consultations are confidential.

The stages

The stages of untreated syphilis Primary syphilis: a painless sore about three weeks after infection, healing in three to six weeks. Secondary: a rash often on the palms and soles, with flu-like symptoms, weeks to months later. Latent: no symptoms, possibly for years. Tertiary: damage to the heart, brain, nerves or other organs, years to decades later in some untreated people. Nerve and eye involvement can happen at any stage. Primary ~3 weeks after Painless sore (chancre) where infection entered Heals in 3–6 weeks Secondary Weeks to months Rash, often on palms and soles; fever, sore throat Fades on its own Latent Can last years No symptoms, but still infected; found by blood test Still curable Tertiary Years to decades Damage to heart, brain, nerves, bones or skin Some untreated people Infection Nerves and eyes can be affected at any stage Time
Treatment works at every stage, but damage already done in the tertiary stage may not reverse — early testing matters.

When to seek urgent care

  • Changes in vision, eye pain or redness with a known or possible syphilis infection
  • Severe headache, confusion, hearing loss, weakness or numbness
  • A sore or rash in pregnancy — see a doctor promptly

See a doctor for any sore or ulcer on the genitals, anus or mouth, even if it is painless and heals, and for an unexplained rash on the palms or soles.

Syphilis in pregnancy

Untreated syphilis in pregnancy can cause miscarriage, stillbirth, early birth, or a baby born with congenital syphilis. Every pregnant woman should have a syphilis blood test at her first antenatal visit — it is part of routine antenatal care and free at government facilities. Treatment with penicillin during pregnancy protects the baby.

Testing & treatment

A blood test diagnoses syphilis; a swab from a sore can also be tested. Testing for HIV and other STIs is advised at the same time. Treatment is with benzathine penicillin injections — a single dose for early syphilis, or weekly doses for three weeks for later stages; other antibiotics are used if you are allergic to penicillin. Avoid sex until treatment is complete and any sores have healed, and have follow-up blood tests to confirm the treatment worked. Recent partners need testing and treatment too. Free, confidential testing and treatment are available at government hospitals and designated STI clinics.

Prevention

  • Use condoms every time; note they protect only the area they cover.
  • Test regularly if you have new or multiple partners.
  • Get tested in early pregnancy — and again later if at ongoing risk.
  • Talk openly with partners about testing; tell partners if you are diagnosed so they can be treated.

Ayurveda & history

Penicillin cures syphilis; no herbal treatment does. Never use mercury-containing preparations.

Syphilis is not in the ancient Ayurvedic classics. It is described in the 16th-century Bhavaprakasha as Phiranga roga — the “disease of the Firangis” — because it arrived with European traders. Historically it was treated with mercury compounds (such as Rasakarpura), as it was in Europe. Mercury is toxic to the kidneys, nerves and brain, and these preparations must not be used. Today, an Ayurvedic physician's role is limited to general supportive care after penicillin treatment. Anyone who offers to cure an STI with herbs or “special preparations” should be avoided.

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Dr. Anitha Reddy

General Medicine
📍 Hyderabad
Experience: 11 yrs
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Dr. Kavya Nair

Dermatology
📍 New Delhi
Experience: 9 yrs
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Dr. Vikram Desai

Neurology
📍 Bengaluru
Experience: 18 yrs

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