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STD Glossary

Syphilis: Symptoms, Treatments, and Facts

The old-school STD syphilis is making a stealthy comeback.

Sarah Kasbeer

Sarah Kasbeer

Theresa Chromati

French novelist Guy de Maupassant was said to have written some of his most disturbing works while in the throes of syphilis that had gone to his brain. He also attempted suicide by ramming a paper knife into his throat, and then ended up in a mental institution.

For a disease often associated with male artists of 19th-century France, syphilis appears to be having a 21st century renaissance. An STD caused by the bacteria treponema pallidum, syphilis has recently been on the rise in the US—the incidence increased from 2.1 cases per every 100,000 of the population in 2001 (an all-time low since data collection began in 1941) to 7.5 in 2015. Around 90 percent of cases occur in men, and the largest increases have been found among men who have sex with men.

Women haven't been entirely spared. From 2014-2015, the rate of infection increased by 18.1 percent among men and 27.3 percent among women, which also increased the risk of congenital syphilis in babies. And while the country saw an overall increase that year, western and southern states were disproportionately affected, with Louisiana reporting the highest incidence rate (15 per 100,000), followed by Georgia (14), and then California (12.6).

Vintage Med Stock / Getty Images

How will I know if I have syphilis?
You might notice a single painless sore that lasts three to six weeks but doesn't hurt. The sore is a chancre, marking the primary stage of the disease. Not long after, more pesky sores begin to pile up like last month's bills—on your mouth, genitals, or anus. Now would be the time to seek treatment, if you haven't already. These indicate the secondary stage, and you may get a skin rash of rough, reddish-brown spots on the palms of your hands and bottoms of your feet as well. It doesn't itch and might be faint enough that you hardly notice. You could also experience other seemingly unrelated symptoms: swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue.

How is syphilis treated?
Syphilis is pretty easy to cure, if caught in the primary, secondary, or even early latent stages, with an intramuscular injection of Benzathine penicillin.

What's the worst case scenario?
Without treatment, your symptoms will go away. (Maupassant noted in a letter to his mother that his hair had stopped falling out.) In the latent stage, you will still have syphilis—you just won't hear from it again for another ten to 30 years, if ever. Only 15 to 30 percent of patients who go untreated develop tertiary syphilis, known to damage internal organs, brain, nerves, heart, blood vessels, liver, bones, and joints. Oh and it causes death too.

During any of the aforementioned stages, the disease can also spread to the central nervous system (known as neurosyphilis, as in Maupassant's case) or eye (ocular syphilis), causing paralysis, dementia, and blindness. A pregnant woman can also infect her unborn children, resulting in congenital syphilis, which may lead to dangerous complications, including stillbirth and infant death. Early prenatal care and treatment of the expectant mother lowers the risk of transmission.

How do I protect myself?
Wrap it up. Syphilis is spread via direct contact with sores, which can happen during vaginal, anal, and oral sex, so you can reduce your risk of contracting this and other STDs by using a latex condom—and making sure your partner has been recently screened. Syphilis also helps facilitate the transmission of HIV, so if you're sexually active with multiple partners, it's recommended that you get tested every three months. To find out your status, a doctor can test your blood or the fluid from a sore.

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