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Syphilis Symptoms

On This Page: Symptoms | Primary Stage | Secondary Stage | Latent PeriodTertiary | Complications

Syphilis is a bacterial STD that has four stages (primary, secondary, latent, and tertiary). The symptoms that a person may have depend on which stage they are in. However, syphilis can be very tricky: its stages can overlap, and the signs don’t always develop in the same order. There are times when a person with syphilis can have no symptoms at all, even for years.

Syphilis symptoms are often mild, painless, or even hidden inside of the body, where they can’t be seen. This means they may be overlooked or brushed off as something less serious. Syphilis has been called the “great imitator” because its symptoms are so similar to other infections and diseases.

Left untreated, syphilis can be very destructive to several body systems, causing serious or even life-threatening health issues such as heart disease, mental disorders, nervous system disorders, blindness, and aortic aneurysms.

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Syphilis is a common STD that can be easily treated and cured with only one round of antibiotics when detected early. Order our confidential syphilis test then walk right into the lab nearest you. No appointment necessary.

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Syphilis Signs and Symptoms

Many people with syphilis don’t know they have it. You or your sexual partner may not see or feel symptoms, so you may not realize anything is wrong. Syphilitic sores can be sneaky, hiding in hard-to-see areas like under your foreskin, inside your vagina, or on your rectum. Signs can be mild and easily mistaken for other conditions like pimples or common rashes.

Syphilis is categorized into stages, which are each associated with different symptoms. Syphilis is the most contagious during the early (primary and secondary) stages.

Syphilis Symptoms – Primary Stage

The first symptom of syphilis is typically a painless sore called a chancre, which usually shows up on the genitals, anus, lips, or mouth, where syphilis entered the body. Chancres are usually firm and round but can be open and wet. Often, only a single sore appears, but there may be more. Chancres are very contagious to other people on contact, and this allows the syphilis bacteria Treponema pallidum to be spread during sexual activity.

A chancre lasts between 3 to 5 weeks before healing on its own.1 Even when the sore is gone, syphilis remains unless you take medication to cure it and prevent primary syphilis from moving to the next stage.

Secondary Stage of Syphilis

During the secondary stage, you may have skin rashes and/or lesions in mucous membranes (the mouth, vagina, or anus). Rashes can appear on one or more areas of your body when your chancre is healing or several weeks after the sore has healed. Usually, rashes aren’t itchy, and they can be so mild that they go unnoticed. These rashes and lesions are highly infectious if touched.

Secondary syphilis symptoms include:

  • Rough, red, or reddish-brown spots on the palms of the hand and/or bottoms of the feet
  • Sores in the mouth, vagina, and/or anus
  • Swollen lymph glands
  • Sore throat
  • Fever
  • Fatigue
  • Hair loss
  • Weight loss
  • Headaches
  • Muscle aches

Symptoms eventually go away, whether you do or don’t receive treatment, but the syphilis infection will progress to the latent or potentially the tertiary stage without the right treatment.

Syphilis Latent Period

After the secondary-stage rash goes away, there will be a latent stage when there are no symptoms. Even though signs are gone, syphilis is still present in your body. The latent stage can be as brief as 1 year or it can last 5-20 years.2 Without a blood test, people with latent syphilis may be unaware they are infected.

About 20 to 30% of people with syphilis have a relapse of secondary stage syphilis during the latent stage. A relapse means that you went through secondary stage syphilis, began not having symptoms for a while, then started to experience secondary stage symptoms again. Relapses can occur multiple times.3

Late Stage (Tertiary Stage)

About one-third of untreated people with syphilis will develop tertiary syphilis, the most severe and destructive stage.4 Tertiary syphilis invades and damages your internal organs and can be fatal. This stage happens around 10-30 years after infection, and people who have it can experience debilitating health problems like destructive tumors and nerve and brain damage.

Tertiary stage syphilis symptoms include:

  • Organ damage (brain, nerves, eyes, heart, blood vessels, liver, bones, and joints)
  • Chest pain or breathing difficulties
  • Changes in behavior
  • Dementia (mental disorder)
  • Vision problems/blindness
  • Loss of muscle movement coordination
  • Joint pain
  • Numbness

What Happens if Syphilis Is Left Untreated?

Without treatment, syphilis can eventually spread to several of your body’s organ systems and cause potentially life-threatening problems. These organs include the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. The issues you experience depend on which organs are affected.

Syphilis is easily curable with antibiotics if detected in the early stage. If you get treatment late, it can still cure syphilis, but the treatment can only stop future damage to your body. The damage that has already happened may not be reversible. This is why getting tested for syphilis is important for protecting your health.

Neurosyphilis and Ocular Syphilis

When syphilis invades the brain and nervous system, it’s called neurosyphilis. When it affects the eyes, it’s called ocular syphilis. Neurosyphilis and ocular syphilis can happen at any stage of the infection. Neurosyphilis can cause a wide range of symptoms, including headache, difficulty controlling muscle movements, paralysis, changed behavior, loss of senses, and dementia. Ocular syphilis can cause partial or complete vision loss.

Syphilis and HIV Risk

Having open syphilis sores increases your risk of getting or transmitting HIV and other STIs. This is because broken skin allows the infections to more easily enter or spread from the body. In 2016, approximately half of American men who have sex with men who had primary and secondary syphilis were also living with HIV.5

Syphilis and Pregnancy

If you are pregnant and have syphilis, it can spread to your baby during pregnancy or delivery, which can cause issues during fetus or newborn. Depending on how long you had syphilis, your baby’s health may be severely impacted.

Congenital syphilis can cause miscarriage, stillbirth, or death shortly after birth. Babies born with congenital syphilis can suffer from deformed bones, severe anemia (low blood count), brain and nerve problems, an enlarged liver and spleen, and skin rashes. If there is a syphilis sore on the breast or nipple, mothers shouldn’t breastfeed since contact with the sore can spread syphilis to your baby.

Syphilis can be treated with antibiotics during pregnancy to both decrease the risk of spreading it to the baby and stop the infection’s progression in the mother.

What Can You Do?

If you think you have syphilis or believe you may have been exposed, it’s important to get tested to check your sexual health. Quick detection and treatment are crucial to avoiding the serious repercussions that syphilis can cause.

  1. “Syphilis - CDC Fact Sheet (Detailed).” Centers for Disease Control and Prevention https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm
  2. “Stages of Syphilis.” Michigan Medicine. https://www.uofmhealth.org/health-library/tm6404
  3. Hook EW (2016). Syphilis. In L Goldman, A Shafer, eds., Goldman-Cecil Medicine, 25th ed., vol. 2, pp. 2013–2020. Philadelphia: Saunders.
  4. “Syphilis.” Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-diseases-stds/syphilis.
  5. “Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/std/syphilis/stdfact-msm-syphilis.htm

Medically Reviewed by on February 4, 2020


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