Sifilis (syphilis) is a bacterial sexually transmitted infection that often starts with a small, usually painless sore on the genitals, anus or mouth, followed weeks later by a non-itchy rash on the palms and soles, flu-like symptoms or patchy hair loss. Symptoms are often mild, can come and go, and may disappear even though the infection is still there. Syphilis is curable with antibiotics, usually a penicillin injection, but if left untreated it can damage the heart, brain, nerves and eyes, and can be passed to a baby during pregnancy. A test is the only way to know for sure.
What is penyakit sifilis?
According to the WHO, syphilis is a preventable and curable bacterial sexually transmitted infection (STI). The WHO estimates that 8 million adults aged 15 to 49 worldwide acquired syphilis in 2022.
According to the NHS, if it is not treated, syphilis can cause serious and potentially life-threatening problems. Having a test is the only way to confirm it.
How is syphilis spread?
According to the NHS, the most common way of getting syphilis is unprotected sex (vaginal, anal or oral sex without a condom) with someone who has it, through contact with a sore on their genitals, anus or inside their mouth. It can also be passed on:
- to an unborn baby during pregnancy (congenital syphilis);
- by injecting drugs with a needle used by an infected person;
- rarely, through a blood or organ transplant.
The WHO notes that syphilis is most easily passed on in the early stages, up to about 2 years after infection.
Tanda sifilis: symptoms by stage
According to the NHS, symptoms are often mild and hard to notice at first, and they tend to change over time and may come and go.
| Stage | Possible symptoms (NHS) | When |
|---|---|---|
| Early | Small sores (ulcers) on the penis, vagina or around the anus, usually painless, sometimes only one; sores can also appear in the mouth, on the lips, hands or bottom | 3 weeks or more after infection |
| Later | A rash on the palms and soles that can spread and is usually not itchy; white or grey warty growths on the genitals or around the anus; white patches in the mouth; flu-like symptoms (fever, headache, tiredness); swollen glands; patchy hair loss on the head, beard and eyebrows | Up to 3 months later |
Sores inside the vagina or anus may go unnoticed because they are not painful. Symptoms can improve or go away completely, but if you have not been treated, the infection is still in your body, you can still pass it on, and you are at risk of serious problems later.
Some signs can look like other conditions, such as mouth ulcers or genital warts, which is why a test matters.
Sifilis pada lelaki dan wanita
The symptoms are largely the same for everyone, but where they appear differs:
- Men (sifilis lelaki): a sore on the penis or around the anus is often the first sign, and it may be painless and heal on its own.
- Women (sifilis wanita): a sore on the vulva, inside the vagina or around the anus can be easy to miss. Unusual discharge or itching has many possible causes; see our guides to keputihan and vaginal thrush, but get an STI test if you may have been exposed.
- Anyone: sores can appear in the mouth or on the lips after oral sex.
When and where to get tested
According to the NHS, see a doctor or sexual health service if:
- you or a sexual partner have symptoms of syphilis;
- a sexual partner has told you they have syphilis or another STI;
- you have recently had sex with a new partner without a condom;
- you are pregnant or planning a pregnancy and think you might have syphilis;
- you have injected drugs with a needle that someone else used.
In Malaysia, you can ask for an STI test at a klinik kesihatan, a GP or a private clinic. A doctor or nurse may check for sores, take a swab from any sore, and take a blood sample. You may be tested for other STIs at the same time. Your current and recent sexual partners will also need to be tested and treated; the clinic can advise you about contacting them.
How is syphilis treated?
According to the NHS and WHO:
- syphilis is treated with antibiotics. The WHO says early syphilis is treated with a benzathine penicillin injection, which is also the only WHO-recommended treatment for pregnant women; other antibiotics can be used as alternatives;
- treatment may start before your test result is back, and its length depends on the stage of syphilis;
- some people get flu-like symptoms within the first 24 hours of treatment;
- you will need to go back several times in the first 12 months to be retested;
- do not have sex (vaginal, anal or oral) until 2 weeks after you and your partner have finished treatment.
Do not try to treat a possible STI yourself with leftover antibiotics or traditional remedies; the right medicine and follow-up tests are needed to make sure the infection has gone.
Syphilis in pregnancy
According to the NHS and WHO, syphilis in pregnancy can be passed to the baby (congenital syphilis), and untreated syphilis can lead to miscarriage, premature birth, stillbirth, newborn death and lifelong health problems for the baby. The WHO advises testing at the first antenatal visit and treating straight away with penicillin.
In 2018, the WHO certified Malaysia as the first country in the Western Pacific Region to eliminate mother-to-child transmission of both HIV and syphilis. The WHO notes that antenatal testing and treatment for HIV and syphilis are provided free of charge in Malaysia. Attending your antenatal check-ups protects your baby.
Complications if untreated
According to the NHS, untreated syphilis can cause serious problems, some of which may not appear for many years:
- heart problems, such as angina, aortic aneurysm and heart failure;
- brain problems, such as fits, memory problems, personality changes and dementia;
- nerve problems, such as shooting pains, pins and needles, and joint damage;
- problems with the skin, bones, testicles, liver and other organs;
- muscle weakness, and sight and hearing problems.
Gonorea (gonorrhoea): another common STI
Gonorrhoea (gonorea, sometimes called kencing nanah) is another bacterial STI passed on through unprotected sex. According to the NHS, not everyone gets symptoms; when they do, they usually start around 2 weeks after infection:
| Possible symptoms (NHS) | |
|---|---|
| Women | Yellow or greenish vaginal discharge, burning pain when peeing, lower tummy pain, and rarely bleeding between periods |
| Men | Burning pain when peeing, discharge from the penis, sore testicles |
| Other areas | Pain, itching or discharge from the anus; a sore throat; red, painful eyes with discharge |
Gonorrhoea is treated with antibiotics. Get an urgent appointment if you have it and develop a fever, joint pain or swelling, a rash, or red, painful eyes, as these can be signs of a more serious infection. Burning when peeing can also be a UTI, so a test is needed to tell them apart.
How to lower your risk
According to the NHS, you can lower your risk of syphilis and other STIs if you:
- use a condom for vaginal or anal sex, and a condom or dam for oral sex;
- wait 2 weeks after you or your partner finish treatment before any sexual contact;
- do not share sex toys, or wash them and cover them with a new condom;
- do not share needles.
Getting tested if you have a new partner, and making sure partners are treated, helps stop syphilis spreading.
Frequently asked questions (FAQ)
What is penyakit sifilis (syphilis)?
Syphilis is a sexually transmitted infection (STI) caused by bacteria. According to the WHO, it is preventable and curable, but if it is not treated it can cause serious, potentially life-threatening problems affecting the heart, brain, nerves and other organs. It can also be passed from a pregnant woman to her baby.
What are the signs of syphilis in men (sifilis lelaki)?
The first sign is often a small, usually painless sore on the penis, around the anus or in the mouth. Later signs can include a non-itchy rash on the palms and soles, white patches in the mouth, warty growths, flu-like symptoms, swollen glands and patchy hair loss. Symptoms are often mild and can come and go, so many men do not notice them.
What are the signs of syphilis in women (sifilis wanita)?
Women may have a small, usually painless sore on or inside the vagina or around the anus, which can be easy to miss. Later signs are the same as in men: a non-itchy rash on the palms and soles, white patches in the mouth, warty growths, flu-like symptoms, swollen glands and patchy hair loss. Syphilis in pregnancy can harm the baby, so testing during pregnancy is important.
Can syphilis be cured?
Yes. Syphilis is treated with antibiotics, usually a penicillin injection. According to the NHS, the length of treatment depends on the stage, and you will need repeat tests over the following year. Avoid sex until 2 weeks after you and your partner have finished treatment. Treatment cannot undo damage that has already happened, which is why early testing matters.
What does sifilis mulut (syphilis in the mouth) look like?
Syphilis can cause sores in the mouth or on the lips at first, and later, white patches in the mouth. These can look like other mouth problems, so if you have unexplained mouth sores and a possible risk of an STI, see a doctor for a test.
What is the difference between syphilis and gonorrhoea (gonorea)?
Both are bacterial STIs treated with antibiotics. Syphilis typically starts with a painless sore and can later cause a rash and serious long-term problems. Gonorrhoea more often causes discharge from the vagina or penis and burning pain when peeing, but many people have no symptoms. A sexual health test can check for both at the same time.
Where can I get tested for syphilis in Malaysia?
You can ask for an STI test at a klinik kesihatan, a GP or a private clinic. A doctor may examine you, take a swab from any sore and do a blood test. According to the WHO, antenatal testing and treatment for syphilis are provided free of charge in Malaysia. If you have syphilis, your partners will also need testing.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. See a doctor if you think you may have been exposed to an STI. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
