How to Spot Syphilis Symptoms

Written by Kathleen Morrison
Medically Reviewed by Andrea Sleeth WHNP-BC, MSCP

When it comes to STIs, syphilis can be a bit of a trickster—it's often called the "great imitator" because its signs can pop up looking like so many other things. This can make it a little difficult to know what your body's trying to tell you.

So, how do you spot syphilis symptoms? Well, it often starts with a single, painless sore that might easily go unnoticed. Then, as it progresses, things can get a bit more varied, like rashes or other unexpected body changes.

Because these signs can be so subtle or confusing, having the right info is extra NB.

The good news, though, is that syphilis is completely curable, especially when it's found early! Knowing what to look for and understanding your body's signals is a huge step in taking charge of your sexual health journey.

What is Syphilis and how does it work?

Syphilis is a sexually transmitted infection (STI) caused by a tiny bacterium called Treponema pallidum. This little bug makes its journey through direct skin-to-skin contact with a syphilis sore—which can be anywhere on the body—during vaginal, anal, or oral sex.

The tricky part about syphilis is that it unfolds in different stages, each with its own set of signs. These can often be subtle or even mistaken for other common everyday things, making it a bit of a "great imitator." If syphilis isn't addressed, it can lead to more serious wellness challenges over time.

But here's the thing: syphilis is curable, especially when it's found and taken care of early. It's all about tuning into your body and taking action.

The stages of Syphilis symptoms

Syphilis is a bit of a chameleon, showing up differently depending on its stage. It's important to know what to look out for so you can catch it early and get treated before things get more serious than they need to.

Stage 1: Primary Syphilis

The very first sign of syphilis often shows up as a small, round sore called a chancre. Here's what you need to know about this initial... visitor:

• It usually appears at the spot where the bacteria entered your body—think genitals, rectum, lips, or mouth.
• It's typically firm and painless, which means it's super easy to miss, especially if it's hiding in a hard-to-see spot.
• Even if the chancre disappears on its own within 3 to 6 weeks (which can happen), that doesn't mean the infection has packed its bags. Syphilis is still very much present and just moving along to its next phase.
• Bottom line? If you notice one of these bad boys, get tested as soon as you can to get it sorted out.
  

Stage 2: Secondary Syphilis

If that initial chancre wasn't addressed, syphilis moves into its secondary stage, bringing more widespread signs. This is where the infection truly earns its "great imitator" nickname. You might notice:

• A skin rash—this is a classic. It often shows up on the palms of your hands and the soles of your feet (pretty weird, right?), but it can appear anywhere else on your body too. The rash might look rough, red, or reddish-brown, but it's usually not itchy.
• Other general wellness shifts that might feel like a common flu:
  • Fever
  • Swollen lymph glands
  • Sore throat
  • Patchy hair loss
  • Headaches
  • Weight changes
  • Muscle aches
  • Feeling super tired (fatigue)

Just like the chancre, these secondary symptoms can come and go with or without treatment. But remember, a lack of symptoms doesn't mean a lack of infection.

If you notice any of these symptoms, especially if you've had unprotected sex or think you might have been exposed to syphilis, it's a good idea to get tested ASAP. You're gonna need prescription antibiotics to kill it dead.

Stage 3: Latent Syphilis

After the primary and secondary stages' symptoms disappear, syphilis often enters a "latent" or hidden stage. During this time:

• All visible symptoms from the earlier stages are gone.
• However, the infection is absolutely still lurking quietly in your body.
• This stage can last for years, sometimes even decades, before potentially progressing further if left unaddressed.
  

Stage 4: Tertiary Syphilis

Tertiary syphilis is a rare but truly serious stage that can unfold if the infection remains unaddressed for a long, long time. At this point, the infection can impact multiple organ systems and lead to significant wellness challenges. This can include effects on your:

• Brain and nerves (potentially leading to issues like difficulty coordinating movements, paralysis, numbness, or even dementia)
• Eyes (sometimes causing gradual vision changes or even blindness, known as ocular syphilis)
• Heart and blood vessels
• Liver
• Bones and joints

The wellness impacts from tertiary syphilis can be substantial and, in very rare cases, can even be fatal. While addressing syphilis at this stage can help avoid further damage, it typically can't undo the changes that have already occurred. This is why early detection and consistent treatment are so incredibly vital!

Where Syphilis shows up

Here's a breakdown of common areas where syphilis symptoms—especially those initial sores or later rashes—might appear:

• Mouth and lips: In the primary stage, you might find a chancre right on your lips or inside your mouth. Later, in the secondary stage, you could experience sores or a sore throat.
• Genitals: This is a common spot for chancres during the primary stage—think on the penis, vulva, or inside the vagina. Secondary stage rashes can also show up here.
• Rectum and anus: Chancres can form around or inside the anus or rectum in the primary stage. This is important to remember for everyone, regardless of gender.
• Hands and feet: Weird, but a hallmark of secondary syphilis is a rough, reddish-brown rash that loves to appear on the palms of your hands and the soles of your feet.
• Anywhere else: Secondary syphilis rashes aren't shy and can pretty much show up anywhere else on your body! And as we touched on earlier, if syphilis progresses to its tertiary stage, it can impact internal organs like your brain, eyes, heart, and bones.

It's super important to know that any syphilis sore is highly capable of passing the infection along. Direct contact with a sore—whether during vaginal, anal, or oral sex—is how syphilis typically makes its journey to a new person.

When will I start to notice symptoms?

Another big question that often pops up: when can you actually expect to notice these things? The timing can shift a bit from person to person, but here's a general timeline of how syphilis tends to unfold:

• Primary stage symptoms:
  • The first sign, a chancre, typically makes its appearance about three weeks after exposure. But remember, this can happen anywhere from 10 to 90 days post-exposure.
  • This initial sore usually heals on its own within 3 to 6 weeks. But here's the super important part: just because the chancre vanishes doesn't mean the infection has left your body!
• Secondary stage symptoms:
  • If syphilis isn't addressed in its primary phase, secondary symptoms generally pop up 2 to 8 weeks after the chancre goes away.
  • These symptoms can be a bit fleeting—they might come and go for up to a year. Again, their disappearance isn't a sign that the infection is gone.
• Latent stage:
  • If syphilis is still unaddressed, it slips into its latent, or "stealth," mode. During this stage, there are no noticeable symptoms at all.
  • This hidden phase can last for years, quietly lurking in your body before potentially moving to its final stage.
• Tertiary stage symptoms:
  • This is a less common but very serious stage. About 25% to 40% of people with unaddressed syphilis might experience wellness challenges known as tertiary syphilis.
  • These serious signs can emerge years or even decades after the initial infection. This truly highlights the importance of early detection and care!

It's so crucial to remember this: even if all symptoms disappear, the infection is still very much present and can be passed on to your sexual partners. No visible signs definitely does not mean no infection when it comes to syphilis!

Testing for Syphilis

Knowing your status is a huge part of being proactive about your sexual health, and the process is often way simpler than you might think.

When to consider a Syphilis test

• After a known exposure: If you've had sexual contact with someone who has syphilis, getting tested is a super smart move. It's truly taking charge of the situation!
• Regular check-ins: Even if you're not seeing any symptoms, it's a fantastic idea to get regularly tested for STIs, including syphilis. This is especially true if you have new or multiple sexual partners. Think of it as a routine check-up for your sexual wellness—it’s just a part of good self-care!
• Any unusual symptoms: If you're noticing any of the potential syphilis clues we've talked about—like an unexplained sore or rash—it’s always wise to reach out for a test and a professional chat.
  

How Syphilis testing works

Testing for syphilis is usually done with a simple blood test. Easy peasy. This test looks for the antibodies your body makes in response to the syphilis bacteria. It's a straightforward process, and often, you can get your results fairly quickly.

Just like with other STIs, there's a "window period" for syphilis testing. This is the time between a potential exposure and when a test can reliably detect the infection. For syphilis, it generally takes 3 to 6 weeks after contact for a blood test to show accurate results, though sometimes it can take a little longer. If you test too early after an exposure, your healthcare provider might recommend a retest later to make sure you get an accurate result.

And here's some extra awesome news: you can even test for syphilis from the comfort of your own space! Many folks find at-home syphilis testing kits to be the most convenient (and private) way to get insights into their sexual health.

What happens if Syphilis is left untreated?

If syphilis isn't treated, it can lead to some truly serious health problems down the road. This isn't to scare you, but just to let you know why taking action matters! Some potential complications of untreated syphilis include:

• Brain and nervous system: Syphilis can sometimes make its way into your nervous system (often called neurosyphilis). This can bring about things like ongoing headaches, challenges with coordinating muscle movements, feelings of numbness or even paralysis, and in some cases, memory changes or other cognitive shifts.
• Vision wellness: Unaddressed syphilis can also impact your eyes (known as ocular syphilis). This might show up as changes in your vision, and in serious situations, it could even lead to blindness.
• Heart and circulation: Your cardiovascular system—that's your heart and blood vessels—can also face challenges. This could include issues with major blood vessels or the heart itself, impacting its optimal function.
• Pregnancy and baby's well-being: If a pregnant woman has unaddressed syphilis during pregnancy, they can pass the infection to their baby. This could potentially lead to serious outcomes like a miscarriage, stillbirth, or even infant death. Babies born with syphilis (congenital syphilis) can face a range of wellness challenges, including:
  • Bone or joint differences
  • Significant anemia
  • Enlarged liver and spleen
  • Jaundice (yellowing of skin/eyes)
  • Nerve issues that could cause vision or hearing challenges
  • Meningitis (inflammation around the brain and spinal cord)
  • Skin rashes

The great news is that syphilis is absolutely curable with the right prescription treatment! However, it's really important to know that while treatment can help avoid any further challenges from the infection, it might not be able to undo any wellness impacts that have already occurred

Syphilis doesn't need to be scary (when you've got facts)

Syphilis might not be the hottest topic at brunch, but it’s something you deserve to be clued up on. This STI is way more common than people think—and yep, it’s absolutely treatable. The key is knowing what to look out for and getting care early.

That means tuning into your body and not brushing off things like weird rashes, painless sores (especially on your genitals, mouth, or booty), or feeling super run down for no clear reason. Syphilis doesn’t always come with loud, dramatic symptoms—sometimes it’s sneaky. But that doesn’t mean you should just wait it out.

If you think something’s off, go ahead and get tested. You can totally handle this—and you don’t have to do it alone.

Plus, Wisp has your back with things like easy at-home STI test kits that make knowing what’s up really easy and accessible. Your sexual health is a huge part of your overall wellness, so take care of it like you would anything else that matters.

Frequently Asked Questions (FAQ):

What is usually the first symptom of syphilis?

Most folks notice a painless sore, called a chancre, where the bacteria first entered the body. It usually shows up on the genitals, mouth, or rectum. It’s easy to miss, which is why regular STI check-ins are a great move.

What are the warning signs of syphilis?

Keep an eye out for painless sores, body rashes (especially on your hands or feet), swollen glands, fever, or just feeling really blah. The symptoms can change depending on the stage, so if anything feels off, get checked.

Is syphilis 100% curable?

Yes! Syphilis is totally curable with antibiotics, especially when it’s caught early. Penicillin is the go-to treatment, and it works really well. The sooner you start treatment, the better—so don’t wait.

How would I feel if I had syphilis?

It depends. You might get flu-like symptoms, strange rashes, or painless sores—or you might not feel anything at all. That’s why regular testing is such a power move.

This blog post is for informational and educational purposes only and should not be taken as professional advice. Always consult with a qualified professional before making any decisions based on the information provided here.