Syphilis is a sexually transmitted bacterial infection that develops in stages, and symptoms vary depending on the stage of the disease you have.
There are four stages of syphilis: primary, secondary, latent, and tertiary.
But symptoms don't always occur in the same order, and they may overlap from stage to stage.
You can also be infected with syphilis for years and not notice any symptoms. But since syphilis doesn’t go away on its own, if you have signs or symptoms of syphilis, you should get tested for it, and treated if you have it.
Because symptoms of syphilis can look like many other diseases, it's often called "The Great Pretender.”
What Does Primary Syphilis Look Like?
The first sign of syphilis is usually the appearance of a small, painless sore that's called a chancre.
The chancre develops where the bacteria entered your body, typically within three weeks from the time you were exposed. In men, this is usually on the head or shaft of the penis, although it can be on the anus, in the rectum, or in the mouth.
In women, a chancre may develop on the vulva or anus or in the vagina, rectum, or mouth.
Most people with syphilis develop only one chancre, but it's possible to develop several of them.
It's also possible that you may not even notice the chancre — or know that you have syphilis — since it's painless and may be hidden inside your body. But if you see a sore that could be chancre, you should get tested for syphilis.
Chancres usually heal within a few weeks, even without treatment.
Syphilis Rash: A Sign of Secondary Syphilis
Soon after your chancre has healed, you may develop a rash.
The rash often appears first on your back or abdomen, but it may eventually cover your entire body, including the palms of your hands and soles of your feet.
You may also get wart-like sores in your mouth or genital area.
The rash caused by syphilis is usually not itchy, but it may be accompanied by other, flu-like, symptoms, such as:
- Muscle aches
- Sore throat
- Swollen lymph nodes
These signs and symptoms may disappear within a few weeks, but they can also return repeatedly for up to a year.
Latent Syphilis: A Time of No Symptoms
If left untreated, syphilis evolves from the secondary stage to the latent, or hidden, stage.
When the disease is latent, you will have no noticeable symptoms.
This stage can last for years. In fact, your symptoms may never return.
Tertiary Syphilis: Rare but Serious
Latent syphilis may also progress to the tertiary stage. This happens in about 15 to 30 percent of cases in which people don't get treatment.
During this stage, the infection can damage your brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This can occur many years after you got the original infection, if you don't have it treated.
Neurosyphilis: Infection of the Central Nervous System
Syphilis that affects the neurological system — the brain and spinal cord — is called neurosyphilis. While neurosyphilis can occur at any stage, it usually develops in people who have had untreated syphilis for many years.
Having both HIV and syphilis raises the risk of developing neurosyphilis.
Symptoms of neurosyphilis can include seizures, uncoordinated movement, an inability to speak or understand language, partial paralysis, personality changes, and confusion.
Congenital Syphilis and ‘Syphilis Nose'
Pregnant women can transmit syphilis to their unborn or newborn babies through the placenta or during childbirth, increasing the risk of miscarriage, stillbirth, or death of the child within a few days following birth.
The good news is that the antibiotic penicillin can be used to treat syphilis during pregnancy and prevent the passing of the disease to your baby — with an extremely good success rate of 98 percent.
If your baby does contract syphilis, most likely your newborn won't have visible symptoms, although some babies do develop a rash on the palms of their hands or the soles of their feet.
Babies born with syphilis may later develop hearing impairment, teeth deformities, and a deformity called "syphilis nose" or "saddle nose," in which the bridge of the nose collapses.
Editorial Sources and Fact-Checking
- Syphilis. Mayo Clinic.
- Syphilis — CDC Fact Sheet. Centers for Disease Control and Prevention.
- Where Can I Get Tested for STDs? Planned Parenthood.