The signs and symptoms ofsyphilisvary based on the stage of the infection.
There are four stages in all, each with distinct features.
This accounts for why many cases are missed until the disease is advanced and symptoms turn severe.
Verywell / Joshua Seong
This can show up 10 to 90 days after exposure, though the average is 21 days.
Because the sores are painless, they can be missed if they are inside the rectum or vagina.
Lymph nodesnearest the chancre may also be swollen.
Reproduced with permission from © DermNet New Zealand and © Dr. Richard Ashtonwww.dermnetnz.org2023.
This is a sign that the body is fighting the infection.
Withouttreatment, a chancre will heal within three to six weeks.
Without treatment, the sore will heal in three to six weeks.
Secondary Syphilis
If left untreated, primary syphilis will progress to secondary syphilis.
Symptoms most often appear within four to 10 weeks after the primary infection.
Secondary syphilis typically starts with a non-itchy rash on one or more parts of the body.
This rash can start while the chancre is still healing or after it has healed.
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from DermNet New Zealand and Dr. Richard Ashtonwww.dermnetnz.org2023.
Another telltale sign is unexplained hair loss, referred to assyphilitic alopecia.
Secondary syphilis typically starts with a rash on one or more parts of the body.
Latent Syphilis
Latent syphilis is the third stage of infection.
This “hidden” stage is noted for having few or no signs or symptoms.
Tertiary Syphilis
Tertiary syphilis is the most serious stage, as it can affect multiple organs.
Gummas can grow to a considerable size, causing major damage to organs.
It can also cause open sores on the skin and mouth that resembletuberculosis.
Cardiovascular Syphilis
Cardiovascular syphilis is a complication that affects the heart and blood vessels.
This can result in anaortic aneurysmin which the aorta bulges to a point where it can spontaneously burst.
Neurosyphilis
Neurosyphilisaffects thecentral nervous system.
Summary
The signs and symptoms of syphilis vary by stage.
Frequently Asked Questions
Yes, syphilis can be treated and cured with antibiotics.
Syphilis is known to be contagious during the primary, secondary, and early part of the latent stages.
It is less contagious during the latter part of the latent stage or when in relapse.
Centers for Disease Control and Prevention.Syphilis - CDC fact sheet (detailed).
Klausner JD.The great imitator revealed: syphilis.Top Antivir Med.2019;27(2):7174.
Michigan Medicine.Stages of syphilis.
Tudor ME, Al Aboud AM, Gossman W.Syphilis.
In:StatPearls [Internet].
2010;21(8):537545. doi:10.1258/ijsa.2010.010243
O’Byrne P, MacPherson P.Syphilis.BMJ.
2019;28:365:l4159.
2017;3:17073. doi:10.1038/nrdp.2017.73
MedlinePlus.Gumma.
Murali MV, Nirmala C, Rao JV.Symptomatic early congenital syphilis: a common but forgotten disease.Case Rep Pediatr.
