• Infections
• STDs
• Sexual Health

All There is to Know About the Symptoms of Syphilis

Medically reviewed and edited by Jarrod Nero, MSN, APRN, FNP-C

What is Syphilis?

Syphilis is a common infectious disease caused by the bacterium T. pallidum. 

It’s generally spread via unprotected sexual contact and it is therefore considered a sexually transmitted infection or disease (STI/STD). 

The genitals, mouth, and anus are the most commonly affected areas, but it’s possible for the disease to later spread to other parts of the body. 

Current estimates show a rising number of cases across the U.S. Research from the Centers for Disease Control and Prevention (CDC) shows that around 133,945 cases were reported in 2020.

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Is syphilis an incurable STD?

Syphilis is not incurable. In fact, syphilis is quite treatable, especially in its early stages. If left untreated, syphilis may become a permanent sexually transmitted disease. Generally, people infected with syphilis go through various stages of the disease. 

After the early stages of untreated syphilis, an infected person will tend to feel better before they enter a latent period where the disease becomes dormant (hidden). 

During the latent stage, the person can no longer spread the disease and shows no symptoms, but the infection is still present in the body. 

Without treatment, the infection has the potential to turn into a severe disease that affects multiple body parts — this is known as tertiary syphilis. 

How is Syphilis Spread?

Because syphilis is a sexually transmitted infection, it’s spread primarily through unprotected sex. This may be in the form of vaginal, anal, or oral sex.

Below are some other ways syphilis bacteria can spread:

Contact with syphilis sores

Syphilis can spread through contact with affected areas of the skin or mucous membranes (moist parts of the mouth, nose, eyes, and genitals). 

Affected areas of the body – especially those with rashes or sores – can spread the disease to other people. 

From mother to child

This occurs when a woman has syphilis during pregnancy. The bacterium causing syphilis crosses the placenta (the organ that nourishes a baby) and can affect the developing fetus. 

When syphilis spreads to a child in this way, it is called congenital syphilis (CS).

What are the Stages of Syphilis?

There are four stages of syphilis, each with their own set of signs and symptoms. These phases include:

1. Primary 

2. Secondary 

3. Latent

4. Tertiary

Despite their names, the stages of syphilis don’t always occur in the above order. 

What are the Symptoms of Syphilis at Each Stage?

Many people infected with syphilis might not know they have the disease. 

While it’s important to seek medical attention if you experience any of the symptoms mentioned below, you’ll only know if you’re infected after you’ve done a blood test.

Primary

This primary syphilis stage starts as a painless, firm red blister on the genitals, anus, or mouth. This blister is called a chancre (not to be confused with Chancroid, another STD). 

It typically takes between three and six weeks for a syphilis sore to disappear, whether you receive treatment or not. However, the disease will still progress if you don’t get the required treatment.

Secondary 

Rashes on the skin and mucous membranes indicate the start of secondary syphilis. At this point, the chancre has usually healed. 

Types of rashes include:

• Skin: These are red or brown spots that can occur all over the body. The syphilis rash is unique because it is one of the few diseases affecting the palms and the soles of the feet. 

• Condylomata Lata: Gray, moist, flat-topped blisters that occur around the genitals and anus. 

• Snail track ulcers: These are irregular ulcers that appear in the mouth with a reddish-gray appearance. 

• Other symptoms: Moth-eaten alopecia (patchy hair loss), enlarged glands, and flu-like symptoms. 

Latent

This is the period during which a person who has not received treatment for syphilis becomes asymptomatic and not infectious. 

The latent syphilis stage may come before or after the secondary stage. At this point, the disease is dormant and can reactivate at any time, triggering the next stage of syphilis — which may be the secondary or tertiary phase.

Tertiary

This is the most severe form of a syphilis infection. It can cause crippling illness and even death. 

Symptoms of tertiary syphilis can appear 10-30 years after infection. These symptoms occur when different organs in the body are infected with T. pallidum. 

Parts of the body that can be infected during the tertiary phase include the: 

• Brain, spinal cord, or nerves (neurosyphilis) 

• Liver (syphilitic hepatitis) 

• Eyes (ocular syphilis)

• Ears (otosyphilis) 

• Heart and blood vessels (cardiovascular syphilis) 

• Bones and joints

Where Can I Learn More About Syphilis?

Sexually transmitted infections can be difficult to manage and getting tested is often a scary experience. If you’ve been putting off an STD screening, get in touch with one of our doctors who can help. 

To learn more about treatment options for syphilis, make an online appointment with LifeMD.

Jarrod Nero, MSN, APRN, FNP-C

Jarrod, a board-certified Family Nurse Practitioner, earned his B.S. in Nursing from William Carey University and an M. S. in Family Health Nursing from the Southern University of Baton Rouge. He lives in New Orleans with his partner and son.

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