How is syphilis treated?

Syphilis is a highly contagious sexually transmitted infection (STI). The preferred treatment is pharmacotherapy, primarily with penicillin—such as aqueous crystalline penicillin and procaine penicillin. In its late stage, syphilis can threaten the patient’s life; surgical excision is often indicated, although intramuscular injection therapy may also be used to control disease progression. Importantly, high-risk sexual contact with syphilis-infected individuals must be avoided to prevent transmission.

How Is Syphilis Treated?

1. Pharmacotherapy

Penicillin is the most commonly used drug for syphilis treatment. Common formulations include aqueous crystalline penicillin, procaine penicillin, and benzathine penicillin. However, some patients are allergic to penicillin. For these individuals, alternative antibiotics such as tetracycline or erythromycin may be prescribed. Benzathine penicillin G (long-acting penicillin) is administered via deep intramuscular injection into both buttocks.

2. Traditional Chinese Medicine (TCM) Therapy

TCM may also be employed in syphilis management. Rooted in syndrome differentiation, TCM tailors treatment according to individual symptom patterns. For patients presenting with damp-heat syndromes—characterized by skin rashes or indurated plaques near the genitalia or anus, and aversion to greasy foods—the herbal formula Long Dan Xie Gan Tang (“Gentiana Liver-Draining Decoction”) is commonly prescribed to clear damp-heat.

3. Treatment of Late-Stage (Tertiary) Syphilis

For non-penicillin-allergic patients: benzathine penicillin G, 2.4 million units per dose, administered once weekly for three consecutive weeks. Alternatively, procaine penicillin G, 800,000–1,200,000 units daily via intramuscular injection for 20 consecutive days. For penicillin-allergic patients: tetracycline, 500 mg per dose, four times daily orally for 30 days; or doxycycline, 100 mg per dose, twice daily orally for 30 days.

4. Surgical Treatment

Surgical excision may be performed directly at the affected site. Currently considered one of the most authoritative approaches, this procedure begins with local anesthesia followed by complete removal of necrotic tissue at the lesion site in a single session. This method facilitates rapid recovery and represents one of the most effective therapeutic options available.

The above outlines current approaches to syphilis treatment. We hope this information is helpful to you.