What is Syphilis tongue?

When most people think about sexually transmitted diseases, they tend to think about symptoms that affect the genitals. Rarely do they think about the mouth.

But the mouth is one of the places where many people infected with STIs get their symptoms.

Syphilis is no exception.

Syphilis, known as the “great imitator”, can produce a wide range of symptoms. One potential indicator is the condition referred to as a “Syphilis tongue.” It’s one of the more unusual manifestations of Syphilis, and one you need to be aware of if you’re concerned about this infection.

In this guide, we’ll explore what causes Syphilis tongue, how to identify a Syphilis tongue, and why promptly recognising and receiving treatment for this symptom is crucial.

Keep reading to find out more.

Are you worried about Syphilis? Book a Syphilis test at a sexual health clinic near you.

What is Syphilis?

Syphilis is a sexually transmitted infection caused by a spirochete bacterium called Treponema pallidum.

This infectious disease primarily spreads through unprotected sexual contact, like vaginal, anal, or oral sex, often through direct physical contact with a Syphilitic sore called a “chancre”.

These chancres can appear on the genitals, anus, rectum, lips, or mouth. The bacteria can enter the body through microscopic breaks in the skin or mucous membranes during sexual activity involving these areas.

Chancres usually appear in the primary stage of a Syphilis infection, when most of the noticeable symptoms appear. For a more detailed breakdown of the infection and its progression, read our Syphilis infection page.

While clear data on the prevalence of Syphilis in the Middle East remains patchy, Syphilis infections globally have risen sharply in the last few years.

There is also data to show that, in the Middle East, infection rates among certain populations are prevalent, especially in men who have sex with men, female sex workers, and male sex workers. Tracking the infection remains difficult in the region because of a lack of research funding and social stigma.

Despite this, Better2Know sees high demand for Syphilis testing in the region. Around 62% of all tests and screens sold by Better2Know in 2023 included a test for Syphilis.

What does Syphilis tongue look like?

Syphilis tongue refers to the oral manifestations of a Syphilis infection. What it may look like will depend on which of the four stages of Syphilis you’re currently in.

During primary Syphilis, the initial symptom in the oral region is usually the appearance of a chancre. These chancres can appear inside the mouth, on the lip, or on the tongue.

Chancres are typically painless, firm, round, and sometimes red in colour. In about 30% of cases, an infected person may experience multiple chancres in the primary stage.

As the infection progresses to the secondary stage, lesions may develop on the inner lips and tongue. These lesions often appear as white patches and can develop into sores or ulcers within the mouth.

In tertiary Syphilis, the disease can manifest as inflammation sites called ‘gumma’. These are most commonly found on the tongue or palate. Sometimes, gumma on the tongue can cause luetic glossitis, which leads to a red, swollen tongue.

Why does Syphilis appear in the mouth?

When you’re infected with Syphilis, chancres appear at the initial site of infection, where the bacteria enter the body.

In all likelihood, if chancres appear in your mouth, the infection entered your body through the mouth. This usually happens when you perform oral sex on someone already infected with Syphilis.

However, this is not necessarily true in all cases. Since Syphilis is a blood-borne infection, the bacteria that cause the infection can spread through your body via the bloodstream. This means that even if you initially contracted the infection through your genitals, it is still possible to experience oral symptoms.

Indeed, oral symptoms are common in secondary Syphilis, even if it is contracted through the genitals. This phase of the infection occurs when the disease goes untreated, and the bacteria have time to infect other parts of your body through the blood.

It’s always Better2Know your sexual health status. Secure an appointment for a sexual health test today.

How is oral Syphilis treated?

Whether you contracted the infection through the mouth or through the genitals, Syphilis treatment is often the same.

Modern antibiotics can easily cure the infection and clear up any Syphilis symptoms if caught and treated early. A single dose is often sufficient to cure an infectious case of primary or secondary Syphilis and prevent further progression. Additional doses may be required for later or more complicated cases.

However, before you can get treated properly, you need to get tested for the infection. It’s important that people with STIs get properly tested in order to know their sexual health status. Proper treatment begins only once testing has been done and a diagnosis has been made.

What happens if I go too long without getting tested?

Without getting tested, you cannot know your sexual health status, and so proper treatment can’t be done.

Untreated Syphilis can have serious negative health outcomes in the long term. These can include:

• An increased risk of contracting other STIs like HIV
• Damage to various organ systems, including the brain, spinal cord, eyes, bones, heart, blood vessels, and bones
• An increased risk of pregnant women passing on the infection to their baby during pregnancy (congenital Syphilis), causing complications for the infant, including deformities, delays in development, seizures, rashes, fever, swollen liver, swollen spleen, anaemia, and jaundice
• An increased risk of miscarriage, premature birth or stillbirths in pregnant women

Final thoughts

Getting Syphilis tongue can cause some concern. After all, nobody wants to have an STI.

But even if you have a symptom of an STI, it’s important not to panic. Most STIs can either be cured completely or managed with effective care and treatment.

If you’ve had an unsafe sexual encounter, started a new sexual relationship, or are sexually active and simply concerned about STIs, you should get tested with Better2Know.

Better2Know provides a range of high-quality, affordable Syphilis tests that can give you accurate and reliable results.

Click the “Book Now” button to make an appointment at a sexual health clinic near you. If you need help with your booking or want to speak to someone, call the number at the top of this page to speak to one of our trained sexual health advisors.

Better2Know offers sexual health testing at many clinic locations across the Middle East.