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Syphilis Symptoms

Primary stage syphilis symptoms can appear 10-90 days after infection

Most individuals who contract syphilis experience their first symptom 10 to 90 days (average time is 21 days) after the initial infection. The most common symptom is a firm, round, painless sore called a chancre (pronounced SHANG-ker). The chancre typically appears at the original site of infection.

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For women, chancres are typically found on the vulva, vagina, cervix, anus or rectum, while for men they may appear on the penis, anus or rectum. Chancres can also develop on the mouth, tongue, lips or any other body part that has come into direct contact with an infected sore. The chancre usually lasts between 3-6 weeks and heals on its own. However, this does not mean that the infection itself has left your system and treatment is still required to kill the Treponema pallidum bacterium that causes syphilis.

In addition to chancres, many people may experience swollen lymph nodes depending upon where the chancre develops. The most commonly affected lymph nodes are located in the neck, armpit and groin.

Secondary stage syphilis symptoms can appear 2-8 weeks after first chancre

The secondary stage of syphilis lasts between one and three months and usually begins between six weeks and six months after exposure to the bacteria. Secondary syphilis is characterized by a flat rosy-colored, non-itchy rash that usually covers the palms of the hands and soles of the feet. In some cases, the rashes may occur on other parts of the body or resemble rashes caused by other ailments. Additional signs of secondary syphilis include hair loss, white patches inside the mouth, genital warts, and flu-like symptoms such as fever and swollen lymph glands that last for weeks or even months.

Other symptoms that some people may experience include swollen eyes, kidney, liver, spleen bones or joints, fever, weight loss, muscle ache and loss of appetite. Although symptoms disappear after the primary and secondary stages, the latent (hidden) and late stages are more severe.

Latent stage syphilis begins when primary and secondary symptoms disappear

During the latent stage, the syphilis infection remains in the body even though it is not displaying obvious symptoms. During the latent stage, the syphilis infection becomes dormant and does not cause symptoms for an extended period of time, up to 20 years.

During the latent stage, the infection is still detectable by blood testing, despite the lack of symptoms. A syphilis infection can be treated and cured at this stage, but any damage done to internal organs is irreversible. If the syphilis infection progresses through the latent stage without treatment, it enters the terminal tertiary stage.

Tertiary syphilis

The terminal tertiary stage of syphilis typically occurs between 10 and 30 years after the initial infection. At this time, entirely new and life-threatening symptoms occur. Debilitating side-effects include, but are not limited to blindness, loss of motor skills, dementia, and damage to the central nervous system and internal organs, such as the heart, brain, eyes, kidneys and bones. In most cases, tertiary stage syphilis is distinguished by a descent into mental illness, followed by death.

Syphilis Symptoms - Primary Stage

Most Common
  • Single firm, round, painless sore (chancre)
Less Common
  • Swollen lymph glands in neck, armpit or groin
  • No obvious symptom (painless sore could be small or inside genital opening)
Least Common
  • Multiple firm, round, painless sores (chancres)

Syphilis Symptoms - Secondary Stage

Most Common
  • Flu-like symptoms
  • Swollen lymph glands in neck, armpit or groin
  • Sore throat
  • Headaches
  • Fatigue
Less Common
  • Sores in mouth, vagina, anus and penis (mucous membrane lesions)
  • Moist, wart-like patches on the genitals or skin folds (condylomata lata)
  • Patchy hair loss
  • Swollen eyes, kidney, liver, spleen bones or joints
Least Common
  • Fever
  • Weight loss
  • Muscle aches
  • Loss of appetite

Syphilis Symptoms - Latent Stage

  • No symptoms are caused as syphilis lies dormant during this stage

Syphilis Symptoms -Tertiary Stage

Most Common (Tertiary Stage Complications)
  • Internal organ damage (brain, nerves, eyes, heart, blood vessels, liver, bones and joints)
  • Loss of motor skills
  • Paralysis
  • Numbness
  • Gradual blindness
  • Dementia
  • Mental illness
  1. "Syphilis - CDC Fact Sheet." Centers for Disease Control and Prevention. https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
  2. Lafond, Rebecca E., and Sheila A. Lukehart. "Biological Basis for Syphilis." Clinical Microbiology Reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360276/
  3. "Indiana University Bloomington." Syphilis: IU Health Center. https://healthcenter.indiana.edu/answers/syphilis.shtml
  4. "Syphilis - CDC Fact Sheet" Centers for Disease Control and Prevention. https://swc.osu.edu/posts/documents/syphilis-june-2017.pdf

Medically Reviewed by on Jun 18, 2019

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