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Is syphilis making a comeback in Singapore?

Syphilis in men may look minor at first, but it progresses faster than you think.

It appears that syphilis is making a comeback according to the CDC (Centers for Disease Control). That's certainly not good news, right? The yearly statistics for Singapore is about 1500 cases per year. The numbers have been monitored by Singapore Health authorities for about 5 years. So, it's a pretty good gauge.

However, it is good to know that Syphilis is totally treatable!

How do I contract syphilis?

Treponema pallidum bacteria are responsible for this sexually transmitted disease. You contract syphilis when you come into contact with syphilis sore or ulcer during oral, vaginal, and or anal intercourse. Sores usually pop up on your penis, mouth, lips, or anus. There is no need to worry about whether you can catch syphilis at the pool. Toilet seats, bathtubs, and clothing are all totally safe when it comes to syphilis.

Who is most at risk of contracting syphilis?

Of course, there will always be people who are more at risk due to their behaviors. Here is a list of the vulnerable:

  • Pregnant women -if you have a female partner and she is pregnant, she needs to be protected, so if you suspect you may have syphilis, you should stop all sexual activity and get tested.
  • If your partner is most likely infected with syphilis.
  • If you have unprotected sex with multiple sexual partners 
  • If you have multiple male partners

What does syphilis look like on a man?

Okay, we are going to discuss symptoms. When syphilis first appears, it may start with one small painless sore that you may be tempted to ignore. It is called a chancre. Some people get a few at a time. You may also notice that the lymph nodes in the groin area are swollen.

Essentially, syphilis is a stage disease which looks different at each stage. There are four stages to be aware of: they are primary, secondary, latent, and tertiary. You are contagious at the primary and secondary stages.

Primary Stage Syphilis

  • One or more sores located around your genitals, mouth, and around your anus. The sores are certainly unpleasant. They are painful and are round and firm to the touch.
  • Primary stage sores usually show up between 10-90 days after you contract syphilis.
  • The sores may hang around for about 3-6 weeks. They may heal on their own, but this does not mean that you should not get treated. Treatment is non-negotiable if you want to prevent the disease from progressing to the next stage or developing serious health complications.

Secondary Stage Syphilis

Secondary symptoms look totally different from the primary symptoms. They take on an entirely new dynamic, such as: 

  • Fever
  • Swollen lymph nodes
  • Weight loss
  • Skin rash (red or brown spots on your palms or sole of your feet)
  • Patchy hair loss
  • Joint and muscle pain
  • Headaches
  • Lethargy

Secondary symptoms usually show 3 weeks- 6 months after you contract syphilis. They also subside on their own eventually but as mentioned before treatment keeps it from progressing. So again, get treated — I cannot stress this enough! 

Tertiary stage Syphilis

This phase brings serious health issues. The disease attacks the brain, nervous system, brain, and eyes. It can also fatally target your internal organs. The timespan for this stage can be anywhere between 1- 30 years later.

So, depending on the part of the body that the disease is targeting, your doctor may classify it according to that. When untreated, syphilis spreads to your nervous system and brain. We call it Neurosyphilis. Neurosyphilis symptoms are:

  • Severe headaches
  • Muscle paralysis and numbness
  • Memory impairment
  • Mental disorder
  • Poor coordination

When syphilis spreads to the eyes, it is called ocular syphilis.

Ocular symptoms are:

  • Blindness
  • Visual disturbances

You should also know that neurosyphilis and ocular syphilis can occur at any stage of the disease.

Latent Stage Syphilis

Even though this stage is pretty advanced, there are no visible symptoms. This stage occurs within one year of contracting syphilis. However, that time frame is flexible; it can extend for a longer period.

You may also feel totally healthy and have no visible symptoms. Early latent syphilis is when this symptomless state begins within a year of contracting syphilis. Late latent syphilis is when this occurs a year after infection.

 Should I get tested for syphilis?

You should get tested if you answer yes to any of the following questions:

  • Are you sexually active and don't know whether or not your partner/partners are infected?
  • Did your partner test positive for syphilis?
  • Do you have other STDs?
  • Do you think you may have contracted syphilis?

What can I expect at my appointment?

Your doctor will ask you questions to get a sense of your medical history. He will also ask you about the symptoms that you have been experiencing thus far. Then he will examine you.Next, your doctor will take some blood samples for blood tests to check for syphilis and other STDs.

What are the syphilis tests that are available?

Blood test

A blood sample is taken and sent to the lab to be tested. You can expect your results back in a few working days.

Rapid syphilis test

This is a MOH-approved test kit that delivers results in 20 mins. Just takes that anxiety factor away.

Your doctor will be able to give you more information on the available tests.

How is syphilis treated?

The right antibiotics can do the trick!

As mentioned above if untreated syphilis takes hold of your brain, eyes, or nervous system. It basically can do immense damage. You should also know that treatment cannot reverse the damage already sustained by your body. That's why I always stress that you should not delay when it comes to treatment. 

Take advantage of early screening to avoid any severe injury to your body.

The antibiotics are administered via injections — hope you're not squeamish about needles. How much you are going to have to take depends on your stage of syphilis. If you are allergic to penicillin, talk to your doctor about safe treatment options.

Even after HPV vaccination, you will still be required to undergo Pap tests. This is primarily because the HPV vaccine doesn't act as a Pap test alternative. What's more, human papillomavirus doesn't offer protection against all strains of HPV. Regular screening for penile or anal cancers among men should remain an essential part of your preventive healthcare regardless of whether you've been HPV vaccinated or not.

Treatment is a process like anything else. 

There will be routine blood tests for a few months to see how you are responding to treatment. If it appears that the treatment regime is not working as well as it should, your doctor will extend your course of antibiotics.

There are also some ground rules during treatment. Sex, of any kind, is a definite "no" during treatment. This is to keep your partner or partners safe from infection. It's the responsible thing to do.

What can I do to avoid getting syphilis?

So, you should know right off the bat that being treated for syphilis does not make you immune to being infected again. As such, you should consider changing the way you operate in the bedroom. Now I am certainly not here to judge you, but if you may allow me, let me give you some pointers to help you dodge a syphilis infection.

  • Practise safe sex. Use condoms every time you have sex. Not sometimes, all the time. Condoms are only effective if they shield you from the sores. 
  • Consider having one faithful partner who has been tested. Syphilis sores can be hidden inside the mouth, the genitals, and under the foreskin. So, you need to be sure of your partner's status.

Can syphilis be totally cured?

Yes, if you are treated with the right antibiotics and your body responds positively, you can expect syphilis to be fully treated for good. However, if syphilis already caused damage within your body, treatment might not repair it.

Why is syphilis considered dangerous?

Untreated syphilis is dangerous because of the parts of the body it targets. It damages the heart, brain, nervous system, and sometimes internal organs. Depending on the extent of the damage, syphilis can be fatal.

There is no doubt that syphilis is a big deal. Just because it is curable does not mean that it should be taken lightly. The fact that symptoms are not always visible does not mean that it is not wreaking havoc within your body. This is one sexually transmitted disease that should not be ignored. I cannot stress enough the importance of early screening. It can literally save your life. So, if you suspect you may have been exposed, contact your doctor sooner rather than later.


  1. Dupin N. Rev Med Interne. 2016 Nov;37(11):735-742. doi: 10.1016/j.revmed.2016.05.010. Epub 2016 Oct 13. PMID: 27745937
  2. Lancet. 2017 Apr 15;389(10078):1550-1557. doi: 10.1016/S0140-6736(16)32411-4. Epub 2016 Dec 18. PMID: 27993382
  3.  Arando Lasagabaster M, Otero Guerra L. Enferm Infecc Microbiol Clin (Engl Ed). 2019 Jun-Jul;37(6):398-404. doi: 10.1016/j.eimc.2018.12.009. Epub 2019 Feb 7. PMID: 30738716

This article was written and medically reviewed by Dr Ben, M.D on 31/05/2021

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