• Infections
• STDs
• Sexual Health

How Long Does it Take to Cure Syphilis?

Medically reviewed and edited by Amy Dougherty, FNP-BC, AGAC

What is Syphilis?

Syphilis is a sexually transmitted infection caused by a spiral-shaped bacteria known as Treponema pallidum. Because syphilis is sexually transmitted, it can be spread from person to person via sexual acts involving vaginal, anal, and oral sex. It’s also transmissible through other bodily fluids, such as the exchange of saliva occurring during kissing. 

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There are different stages of syphilis infection, each with its own signs and symptoms.

Primary syphilis

This is early syphilis which is the most infectious stage. It is characterized by a chancre (a firm or rubbery painless sore) present in or around the mouth, anus, or vagina. 

This stage may not always be obvious as the chancre may be hidden inside the vagina, mouth, or anus. 

Secondary syphilis

This stage is characterized by a flat reddish-brown skin rash that may affect any part of the body. This rash is unique as syphilis is one of the few diseases that affects the palms and soles. 

Other symptoms include:

• Flat-topped wart-like sores around the genitals

• Patchy hair loss 

• Ulcers inside the mouth that have grayish-white mucous patches reminiscent of a snail’s slime trail (snail track ulcers)

• Enlarged lymph nodes 

• Flu-like symptoms 

Early latent syphilis (hidden or dormant syphilis)

This stage occurs when treatment for syphilis is not given and symptoms begin to resolve on their own. Those infected with syphilis show no symptoms but may still be infectious. 

This stage can span from the initial infection until a year thereafter.

Late latent syphilis

This period occurs around one year following the initial infection and persists either until treatment is sought or the symptoms reappear in the form of secondary or tertiary syphilis. 

Late latent syphilis is not transmissible through sexual contact. 

Patients may develop this stage of the disease and never show any signs or symptoms again, or they may progress to the most dangerous form of syphilis — tertiary syphilis.

Tertiary syphilis

The last stage of syphilis may occur many years or even decades after the initial infection. 

Tertiary syphilis may involve the brain, spinal cord, liver, heart, or skin. It can also affect sight and hearing. 

Treatment at this stage is aimed at minimizing complications of the disease and preventing mother-to-child transmission (congenital syphilis) rather than preventing sexual spread. 

If neurosyphilis is diagnosed, treatment may involve hospital admission and penicillin given intravenously. 

Treatment for Primary, Secondary, and Early Latent Syphilis

The first three stages of syphilis can all be treated with a single dose of penicillin injected directly into the muscle of the buttocks.

As for the later stages of syphilis, treatment differs slightly. 

Treatment for Late Latent and Tertiary Syphilis

In late latent syphilis and tertiary syphilis stages, treatment requires more time. Three doses of Penicillin G (Bicillin®) are typically needed. These are administered in the buttocks and are given one week apart. 

What are my options if I’m allergic to penicillin?

If you have a penicillin allergy, you’ll need to disclose this to your doctor before receiving treatment for syphilis.

Adoxa® (doxycycline) is often used to treat patients who are allergic to penicillin.

How Long Does it Take to Cure Syphilis?

You can get rid of syphilis for good depending on which stage you’re in when you start treatment — syphilis is easier to treat in the earlier stages.

The time it takes to cure syphilis varies from person to person. It is, however, advisable to wait seven days to four weeks after you’ve completed treatment and to visit your doctor for a test to make sure you’re cured before resuming sexual activities.

If syphilis is diagnosed before the onset of tertiary syphilis, the disease can be cured without any lingering symptoms. 

However, if tertiary syphilis — especially neurosyphilis — develops, complications of the disease are likely irreversible. It is therefore important to seek treatment as soon as possible if you suspect you have syphilis. 

Note: Even though syphilis is curable, it does not prevent reinfection after treatment is complete.

How can I protect myself from reinfection?

A few simple steps can be taken to ensure you and your partner remain free of syphilis.

• Use barrier protection, such as condoms

• Discuss testing and treatment with partner(s) 

• Attend all follow-up appointments with your health care practitioner 

• Avoid intravenous drug use and limit sexual partners

Where Can I Learn More About Syphilis Treatments?

Do you have a question about syphilis, but you’ve been putting off visiting your doctor? Get in touch with a virtual doctor at LifeMD.

Make an online appointment to get started.

Amy Dougherty, FNP-BC, AGAC

Amy is a board-certified FHNP with 13 years of experience in Hospital Medicine, Urgent Care, and Primary Care. Amy is an expert in acute/chronic disease management. She's been honored by the Elite American Nurses Association for her achievements.

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