Syphilis: The Great Comeback

26 May 2022
Yoxly Awesome Contributors

Written by:

Yoxly Awesome Contributors

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Medically Reviewed by:

Dr Danae Maragouthakis

Everyone loves a good comeback story – unless that story is one of an STI previously on the decline throughout the world. Unfortunately, that’s precisely what this article discusses. Syphilis infections are on the rise and have been for nearly two decades.

And, while we may not want to celebrate this, we certainly need to be aware of it and do our part in helping people understand what syphilis is, the symptoms to look out for, and how to treat it.

What is Syphilis?

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems if it's not treated. It's caused by a bacteria called Treponema pallidum. Syphilis is usually passed from person to person through sexual contact, including oral, vaginal, and anal sex. It can also be passed from a pregnant woman to her unborn baby, causing congenital syphilis. Syphilis is the second most common infectious cause of stillbirth globally. It can also have severe developmental outcomes for children.

Syphilis can cause various symptoms, including sores on the genitals or mouth, rash, fever, and swollen lymph nodes. If not treated, syphilis can damage the brain, heart, and other organs. Thankfully, syphilis is easy to treat with antibiotics.

We’ll go into more detail later in the article.

A Quick History of Syphilis

Throughout the history of the world, syphilis has been stigmatised as a disgraceful disease brought on by a neighbouring country. Some blamed the French, Russia blamed Poland, and Muslims and Hindus blamed each other. Eventually, everyone blamed the Europeans.

Early forms of syphilis were mistaken for other conditions, like leprosy. The first well-recorded outbreak in Europe occurred in 1495. It was considered much more lethal back then than today, as the disease caused pustules from head to toe and led to flesh falling off people’s faces. Contracting syphilis often meant death within a few months. A bit gruesome, right?

A 2020 study estimated that more than 20% of individuals between 15 and 34 years old in 18th century London were treated for syphilis.

Though the true origin of syphilis – and whose “fault” it really was – remains a mystery, one thing is known; for the past 20 years, syphilis infections have been on the rise.

Why Is It on the Rise?

Global Data, Healthcare Intelligence Centre, has predicted that syphilis cases in males and females of all ages will grow from 990,051 to over 1.2 million by 2027. Some reports show that syphilis rates have risen 300% since 2000 in many Western countries.

Considering syphilis infections declined during the 1980s and 1990s, why is it becoming a concern now?


Perhaps to understand why it’s best to explore who it’s on the rise with, first. According to this BBC article, 78% of all cases in 2017 were among gay, bisexual, and other men who have sex with men (MSM). This rise is attributed to changes in sexual behaviour among populations and, particularly with the growing acceptance of homo- and bisexuality.


Use of PrEP (pre-exposure prophylaxis) medication, available free on the NHS to certain groups, to prevent HIV acquisition from sex has increased dramatically in recent years. With the threat of HIV transmission diminished, some people are more likely to engage in unprotected intercourse. This medicine however, does not stop transmission of other infections, such as syphilis. 

Polyamorous or Multiple-Partner Relationships

Across the US and Britain, there is a growing propensity for polyamorous relationships. Even if actual polyamory numbers are low (estimated around 5% in the US), younger generations are more likely to explore non-monogamous relationships than older generations were, and interest in polyamory is at an all time high. The Sun newspaper reports that the average number of sexual partners has increased with each generation, with those aged 38–53 already having more partners than those aged 54–72.

Dating Apps and Sex Trends

The availability of relationship apps like Tinder and Grindr, plus trends in “chemsex” – where people take drugs like crystal meth during sex, have also been attributed to the rise in unprotected sex, number of sexual partners and sexually transmitted infections, including syphilis.

Those Most Commonly Affected by Syphilis

Although it can affect anyone who is sexually active, certain groups of people are more at risk. The MSM community is disproportionately impacted by syphilis, HIV, and other sexually transmitted infections. Other high-risk groups include people who are HIV-positive, people who have multiple sexual partners, and sex workers. 

Symptoms of Syphilis

The initial symptoms of syphilis may include a small, painless sore called a chancre. This sore typically appears 3-4 weeks after exposure to the bacteria and can last for 6-8 weeks. Other early symptoms of syphilis include fever, fatigue, muscle aches, and headache. However there may be no noticeable symptoms. If left untreated, syphilis moves into a latent stage, where there is usually no sign of infection. Eventually it can progress and damage the brain, heart, and other organs, causing dementia, paralysis, and blindness.

Infographic showing the symptoms of syphillis

How Syphilis is Diagnosed

Syphilis can be diagnosed in two ways. If you have a chancre (painless genital ulcer) your doctor may take a swab of this to diagnose the infection. However syphilis is usually diagnosed using a blood test.

You can order comprehensive STI tests online to check for various infections, including syphilis from Yoxly. Why not try our window period calculator to help guide you on when to get tested?

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Treatment of Syphilis

The good news is that syphilis is highly treatable with antibiotics, and most people who are promptly treated will not have any long standing effects. Antibiotics are usually administered as an injection, and you may require multiple doses. Even if you have no symptoms, or if you start to feel better, you must complete any prescribed course of medication to ensure the infection is adequately treated. You may need to inform your recent sexual partners of any infection. 


No one wants to have syphilis – or any other STI for that matter. But it’s on the rise! If you’re worried you may have been exposed to someone with syphilis, it’s essential to get tested immediately and seek medical attention. As with any potential infection, the best course of action is to discover and deal with it early.


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Yoxly's Awesome Contributors (YACs) are a diverse group of individuals who are passionate about public health, and committed to furthering our mission. Yoxly provides a platform where a variety of sexual health topics (some more awkward than others!) can be explored, in an informative and non-judgmental way. If you'd like to become one of Yoxly's Awesome Contributors, contact us!