Healthy Living

Syphilis Symptoms

Syphilis Symptoms

Key Takeaways

  • Syphilis symptoms follow a progression of four stages that can last for weeks, months, or even years.
  • Symptoms of syphilis can be hard to notice, so the disease can go untreated.
  • If syphilis is not treated, the bacteria can spread throughout the body and cause serious damage over time. 

Syphilis is a sexually transmitted disease (STD) that can cause serious health problems when left untreated. This is caused by a type of bacteria known as Treponema pallidum. This disease can be treated easily in its earlier stage with the right medication. Early diagnosis and knowing the early manifestations of syphilis symptoms is very important.

Syphilis is tricky; someone might have the disease without actually knowing about it. Some syphilis symptoms are so mild that it can be easily confused with other common diseases. It can also come and go, but that doesn’t mean the infection is gone for good. Syphilis is even referred to as “The great Imitator”. It is a name referring to medical conditions that have symptoms that could be accompanied with a wide variety of diseases.

All sexually active individuals can be infected with syphilis. This can happen through unprotected sex, either vaginal, anal, or oral sex. A blood test can be used to test for syphilis. Health care providers can diagnose it by testing fluid from a syphilis sore, and they should not solely base their diagnosis on syphilis symptoms.

Symptoms may vary in men and women, but generally common symptoms like sores and rashes are applicable to both genders.

Symptoms of syphilis

Syphilis symptoms follow a progression of four stages that can last for weeks, months, or even years. The severity of symptoms depends on every individual person and the level of exposure to the bacteria, but the symptoms may overlap and don’t always occur in their typical order for everyone.

Primary stage

During this stage, a sore or chancre develops at the area where the bacteria entered your body. This sore is usually painless, and commonly occurs within three weeks of exposure but occurrence can range from 10 to 90 days after contracting the bacteria. At the primary stage, the person infected is highly contagious. The infection can be transmitted by any skin contact with the ulcers or sores, which are carrying spirochetes.

The sores may be present in areas other than the genitals, at any location where contact was made with an infected sore. There is also a swelling of lymph nodes near these sores. This may last from up to three to six weeks and can heal without treatment. Furthermore, syphilis sores often leave a thin scar.

Secondary stage

During this stage, a rash is present that appears two to 12 weeks after the chancres or sores develop. This means that the infection has spread throughout the body. The rash is usually not itchy. It may begin on your torso then eventually spread throughout your entire body. The rash often occurs over the body and commonly includes the palm of the hands and the soles of the feet. At the secondary stage of syphilis, the person infected is highly contagious. 

When syphilis has spread throughout the body, the person can experience the following symptoms:

  • Fever usually less than 101 Fahrenheit
  • Sore throat
  • Feeling of weakness or discomfort throughout the body
  • Flu-like tiredness
  • Weight loss
  • Patchy hair loss in the eyebrows, eyelashes, and scalp
  • Swelling of the lymph nodes
  • White patches in the mouth

Latent stage

During this stage, an accurate diagnosis can only be made through blood testing. The latent stage is the result of an infected person being untreated. This is characterized as a year after the person became infected. There are no visible signs or symptoms, because this is where the infection lies inactive. At this stage, the infection is still contagious.

The latent period may begin one year after contraction of the bacteria and lasts for a range of 5 to 20 years.

A pregnant woman in the latent stage of syphilis can pass the infection to her baby. This case is called congenital syphilis.

Tertiary stage

During this stage, the infection has become severe. Without detection and proper treatment for many years from the prior stages, the syphilis infection develops into this stage. As time passed, the bacteria spread throughout the body, damaging important parts such as the brain and nerves.

Symptoms of this stage of syphilis can now be easily acknowledged. Resulting complications are very serious and include: paralysis, blindness, dementia, deafness, impotence which may not be curable, and this can eventually lead to death if the bacteria has caused severe damage to major organs.

Symptoms of syphilis in men

The following are syphilis symptoms in men:

  • Painless sores on the genital area, commonly on the penis
  • Small skin growths similar to genital warts around the anus
  • White patches in the mouth
  • Fever
  • Weight loss

Symptoms of syphilis in women

The following are syphilis symptoms in women:

  • Painless and not easily seen sores on the outer genital or in the inner part of the vagina or the cervix
  • Small skin growths similar to genital warts that often appear on the vulva and around the anus
  • White patches on the mouth
  • Fever
  • Weight loss

Oral symptoms of syphilis

Early oral symptoms, sores, can be found in the mouth, and because of their impermanent nature, the oral symptoms of primary syphilis often go unnoticed by most people. In addition, these lesions can be confused with other unrelated diseases like simple mouth sores.

Oral syphilis symptoms manifest as a solitary ulcer, usually found on the lower lip and sometimes on the tongue. In men, it is more prevalent in the upper lip, while it is the opposite for women. There are cases where tonsils are also affected by syphilis bacteria, but these cases are rare.  

The diagnosis of syphilis through oral symptoms can be aided by detailed information about the sexual and social life of the person infected. Also, testing can be done on the cells of the observable mouth sore.

In secondary syphilis, some patients may show signs of oral lesions. The most common oral manifestations during this stage are mucous patches and nodular lesions. Maculopapular lesions tend to arise on the hard palate and appear as flat-to-slightly raised, firm, and red lesions. A syphilis infection can be transmitted orally through kissing and oral sex.

What does syphilis look like?

As mentioned above, the development of syphilis is categorized into four stages (primary, secondary, latent, and tertiary). An infected person can show different signs and symptoms depending on what stage he or she is in. Syphilis may look different at every stage.

  • In the primary stage, syphilis can present either a single sore or multiple sores at the site of infection. These sores commonly occur on or around the sexual organs, around the anus or in the rectum. Sores can also show in or around the mouth. They are usually firm, round and painless, but not always. They last three to six weeks and can heal even if untreated. These sores often leave a scar.
  • In the secondary stage, aside from the sores, the symptoms of syphilis include skin rashes, swollen lymph nodes and fever. These signs and symptoms can be mild and might be unnoticeable. The signs usually come with flat or slightly raised sores that are reddish brown in color. These sores are also small and solid, and are usually less than 2 cm in size. Another symptom of this disease is the occurrence of rashes. These rashes may be scaly or smooth, and usually look like other skin problems. Small, open sores may be present on mucous membranes, and the sores frequently contain pus. Moist sores that look like warts may be present. In dark-skinned people, the sores can appear lighter in color than the surrounding skin.
  • In the latent stage, there can be no visible signs and symptoms. Still, if the bacteria has not been treated, it can continue for years without showing. In this stage, the bacteria lives inactive in the body.
  • In the tertiary stage, symptoms can be associated with severe medical problems and are usually diagnosed by a doctor and a laboratory test. A person infected at this stage will probably look sick and ill, and the bacterial infection has spread throughout the body to major organs and vital parts.

In the worst cases, untreated syphilis can spread to the brain; this is called neurosyphilis, or to the eyes, which is called ocular syphilis. These conditions can happen during any of the stages mentioned, if the bacteria spreads to the organs.

Early symptoms of syphilis

Since syphilis early symptoms can be hidden in genital parts like the vagina or below the foreskin of the penis, the person infected may not immediately notice and will be vulnerable to severe stages of the disease if it spreads.

The initial indication of syphilis is usually visible around two to three weeks after infection. The average time between exposure to the bacteria and the start of the first symptoms is 21 days, and this can range from 10 to 90 days. This stage of the infection is also known as “primary symptoms".

The showings of early symptoms of syphilis are an important indication of an essential time to get tested and treated. This disease is easily curable with just the right antibiotic treatment at its first stages. Early detection is also important, because hidden sores can heal on their own within six weeks, leaving no scars even without treatment. The disappearance of sores and scars doesn’t mean that your infection is healing or has healed too.

These are the early symptoms of syphilis that you should look for:

  • The main symptom is a small and painless sore or chancre that is sometimes unnoticeable.
  • The sore is typically found in the genital area or in the mouth.
  • There may be multiple sores or a single sore.
  • There may be swollen glands in the neck, groin, or armpits.

Syphilis rash symptoms

A rash will appear during the secondary stage of syphilis infection. This non painful rash can occur on the palms of the hands or all over the body. The transmission of syphilis can be through direct contact with this rash. These rashes may sometimes resemble rashes that are associated with other diseases; hence, the diagnosis can be tricky. The rash usually will not itch and can be hard to notice because of its faintness.

Tertiary syphilis symptoms

Most people infected with syphilis may go untreated for years and this would develop into tertiary syphilis. At this stage, important organs including the heart and the brain, as well as the blood vessels and nervous system, may be affected. Tertiary syphilis could occur 10 to 30 years after the infection started without treatment. It can damage your internal organs and lead to death.

Tertiary syphilis is rare, but does occur because syphilis is often not easily recognizable at an early onset. That is why; regular testing is required for those who have an active sex life. Tertiary syphilis symptoms have debilitating side effects and complications. 

Complications of tertiary syphilis symptoms may include:

  • Gummata – These are growths of pink and flesh-like tissue that are contaminated with syphilis bacteria. Gummata may look like nodules or become tumor-like masses.
  • Cardiovascular syphilis – This refers to the infection of the heart and other related blood vessels also caused by the spread of syphilis bacteria. Destruction of the infected person’s body caused by this condition can be life-threatening.
  • Neurosyphilis – This refers to the infection of the brain and spinal cord by the syphilis bacteria. This can lead to havoc in many areas of the nervous system, causing loss of function in an infected person’s arms and legs and some altered mental abilities. Recognizable symptoms may include headache, dizziness, and personality changes. Sometimes, due to this complication, syphilis may be a descent into a mental disease and will be followed by death.

Antibiotic treatment cures syphilis infections and stops the development of associated complications. However, scar tissues and skin damages caused by the infection will not always go away.

The tertiary stage is the most destructive stage of syphilis. An infected person will never experience this stage if the infection is detected and treated at an early stage.

Can syphilis show no symptoms?

Syphilis is a disease that is sometimes hard to diagnose. At an early stage, you can be infected with syphilis bacteria without finding any signs or symptoms.

A syphilis sore is painless, so it can easily go unnoticed. These sores can last three to six weeks and can heal on their own, regardless of whether or not the infected person receives treatment. This will lead to the development of the syphilis infection to the next stage, because while the sores heal, the bacteria is still spreading. This is what makes it possible to have syphilis without being aware of it.

There is a certain stage where syphilis can show no symptoms – the latent stage, also termed as the hidden stage. During this stage, an appropriate diagnosis can only be made through blood testing. This latent stage can last for years. During this time, the untreated syphilis bacteria can cause a lot of irreversible damage to the infected body. Because syphilis can be hard to diagnose, a person infected can innocently spread the bacteria to other people.

People with an active sex life should have regular check-ups to monitor any sex-related diseases such as syphilis. Moreover, proper awareness like knowing the symptoms of the disease will certainly make a difference; hence, reading informational content from reliable sources is highly recommended. If you suspect you may have syphilis, don't wait to take action. As early as the first symptom appears, visit your doctor immediately.