Sexually Transmitted Diseases: Syphilis

Date: 11 Nov 2025

Sexually transmitted diseases (STDs) remain a significant global public health concern, affecting millions each year. Among the most persistent and historically documented STDs is syphilis, a disease caused by the bacterium Treponema pallidum.

It progresses in stages, each presenting unique symptoms and requiring timely, guideline-directed treatment. The Centers for Disease Control and Prevention (CDC) provides comprehensive, regularly updated treatment protocols to manage this infection effectively.

 

What is Syphilis?

Syphilis is a chronic, potentially life-threatening bacterial infection typically transmitted through sexual contact, including oral, vaginal, or anal sex. It can also be transmitted congenitally—from an infected mother to her baby during pregnancy or delivery.

 

Stages of Syphilis and Their Treatments

1. Primary Syphilis

• Symptoms: The hallmark of primary syphilis is a chancre, a painless ulcer that appears at the site of infection, typically within 10–90 days after exposure. It usually heals on its own within a few weeks.
• CDC Treatment Recommendation:
  • Benzathine Penicillin G 2.4 million units IM in a single dose.
  • For those allergic to penicillin: Doxycycline 100 mg orally twice daily for 14 days (not recommended during pregnancy).

2. Secondary Syphilis

• Symptoms: Characterized by rash (often on the palms and soles), mucous membrane lesions, fever, lymphadenopathy, and patchy hair loss.
• CDC Treatment Recommendation:
  • Same as for primary syphilis: Benzathine Penicillin G 2.4 million units IM in a single dose.

3. Latent Syphilis

• Early Latent (within 1 year): Asymptomatic but infectious.
• Late Latent (after 1 year or unknown duration): No symptoms, less infectious but still dangerous.
• CDC Treatment Recommendation:
  • Early latent: Benzathine Penicillin G 2.4 million units IM once.
  • Late latent or unknown duration: Benzathine Penicillin G 2.4 million units IM weekly for 3 weeks (total of 7.2 million units).

4. Tertiary Syphilis

• Symptoms: Severe complications including gummatous lesions, cardiovascular syphilis, and possible organ failure.
• CDC Treatment Recommendation:
  • Same as late latent: Benzathine Penicillin G 2.4 million units IM weekly for 3 weeks.

5. Neurosyphilis & Ocular Syphilis

• Symptoms: Affects the nervous system—can cause headaches, altered behavior, dementia, visual disturbances, and more.
• CDC Treatment Recommendation:
  • Aqueous crystalline Penicillin G 18–24 million units per day, administered as 3–4 million units IV every 4 hours for 10–14 days.
  • Alternative (if penicillin not available): Procaine Penicillin G plus Probenecid for 10–14 days.

 

Importance of Early Testing and Diagnosis

Early detection of syphilis and other STDs is critical. Regular screening is recommended for sexually active individuals, especially those with multiple partners or who are pregnant. Untreated syphilis can lead to irreversible complications affecting the brain, heart, and other vital organs.

 

Pharmacy Support Products

While antibiotics are prescription-based and must be administered under medical supervision, pharmacies can support STD management with helpful products:

1. Condoms (Durex, Trust, Fiesta)

Available at Pharmily and other local pharmacies, condoms reduce the risk of syphilis transmission when used consistently and correctly.

2. Feminine Hygiene Products

Products like FemFresh Intimate Wash help maintain genital hygiene and reduce irritation, supporting a healthier environment that may deter infection.

3. STD Test Kits 

Home-use syphilis test kits (if approved by local regulatory bodies) offer a discreet method of initial screening and can prompt timely medical intervention.

 

Prevention: The First Line of Defense

• Use protection: Condoms remain the most reliable method for reducing STD risk.
• Get vaccinated: While there is no vaccine for syphilis, HPV and Hepatitis B vaccinations are important for broader sexual health.
• Communicate: Open, honest conversations with partners about sexual health and recent test results help reduce risk.
• Routine screening: Regular STD testing is essential, especially for high-risk individuals.

 

Syphilis continues to pose a serious health risk, but with early detection, appropriate treatment, and preventive strategies, its impact can be significantly minimized.

The CDC’s treatment guidelines provide a solid foundation for clinical care, while pharmacies offer essential support in prevention and post-treatment care.

Empowering individuals with knowledge, access to healthcare, and preventive tools is the most effective way to curb the spread of syphilis and other STDs.

 

FAQs

1. How is syphilis transmitted and who is most at risk?
Syphilis is primarily transmitted through sexual contact with an infected person, including vaginal, anal, or oral sex. It can also be passed from an infected mother to her baby during pregnancy or childbirth. 

2. Can syphilis be cured completely?
Yes. Syphilis can be completely cured with the correct antibiotics, most commonly Benzathine Penicillin G, as recommended by the CDC. However, while treatment eliminates the infection, it cannot reverse damage already caused in the late stages, underscoring the importance of early detection.

3. What are the early warning signs of syphilis?
The first sign of syphilis is typically a painless sore (chancre) on the genitals, anus, or mouth, followed by rashes on the palms or soles, fever, or swollen lymph nodes. These symptoms may disappear without treatment but the infection remains in the body, progressing silently.

4. How can syphilis and other STDs be prevented?
Prevention includes consistent condom use, routine STD testing, and honest communication with partners about sexual health.