Syphilis Symptoms Explained As Infection Rates Soar Across England

Syphilis rates are at their highest level since World War II.

Syphilis rates are at their highest level since World War II, a report by the Terrence Higgins Trust and British Association for Sexual Health and HIV (BASHH) suggests.

Meanwhile, STIs are being diagnosed every 70 seconds in England – a figure that is “unacceptably high”, said the charity, and leaving already stretched sexual health services “struggling to cope”.

Cases of syphilis in England have more than doubled over the past decade – from 2,847 in 2009 to 7,541 in 2018. The rise is most notable among men who have sex with men – who accounted for 75% of cases in 2018.

The rise in STIs is likely to be due to people not using condoms correctly and consistently, according to Public Health England, as well as an increase in testing improving detection of the most common STIs.

Across all STIs, the highest rates of diagnoses continue to be seen in 16-24 year olds. If left untreated, syphilis can prove life-altering, resulting in serious damage to the heart, brain and nervous system. In some cases it can prove fatal.

Here we explain what the symptoms are and how to get tested.

Condoms are the best way to protect against STIs.
Image Source via Getty Images
Condoms are the best way to protect against STIs.


Syphilis has three stages according to sexual health charity BPAS. The first stage often presents itself as a painless sore (or multiple sores) around the vagina or penis. These sores might appear in the mouth or around the anus.

The second stage of the infection may appear as a rash or flu-like symptoms. Rashes are generally quite blotchy and red, affecting the palms of the hands or soles of the feet, according to the NHS. You might also experience tiredness, headaches, joint pain, a high temperature and swollen glands.

Some people might also experience small skin growths (like genital warts) that develop on the vulva in women or around the anus in both men and women, and white patches in the mouth.

If left untreated the infection can progress to third stage syphilis causing serious damage to the heart, brain, other internal organs, bones, eyes and nervous system. This can be deadly.


If you think you’ve slept with someone who has syphilis or you have any of the symptoms above, it’s important to get tested as soon as possible as the STI won’t go away on its own. You can do this at your GP or local sexual health clinic.

Syphilis is usually diagnosed through a blood test and possibly an examination of the genital area. If you have sores a medical professional might take a sample of the fluids from them using a swab.


Like other STIs, treatment for first and second stage syphilis involves a course of antibiotics or a single antibiotic injection.

People should avoid penetrative or oral sex until at least two weeks after the treatment has finished and it’s important to bear in mind that you can catch syphilis more than once, even if you’ve been treated for it before.


Public Health England (PHE) has urged people to increase condom use and encourage testing following changes in partners, in order to drive down the transmission of infections.