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Reviewed by Frank Cockerill, MD, Mar. 28, 2017
Syphilis symptoms have multiple stages.
Syphilis symptoms develop in 3 main stages: primary,
secondary, and latent stage. Damage
from undiagnosed syphilis can lead to death. It's sometimes called the "Great Imitator" because
its early symptoms can be similar to many other diseases.
Single, firm, round, painless sore (called chancre, pronounced SHANG-ker)
Can appear within 10 days to 3 months after exposure
Swollen lymph glands (neck, armpit, or groin)
No obvious symptom (painless sore could be small)
Multiple firm, round, painless sores (chancres)
Skin rash with rough, red or reddish-brown spots (often on palms of hands and soles of feet)
Syphilis Symptoms for Secondary Stage
Swollen lymph glands (neck, armpit, or groin)
Mucous membrane lesions (patches) in mouth, vagina, anus or penis
Moist, wart-like patches on the genitals or skin folds (condylomata lata)
Patchy hair loss
Swollen eyes, spleen, bones, or joints
Not feeling hungry
Syphilis symptoms for latent stage
No symptoms at all
Repeated symptoms from the secondary stage
Least common from complications due to latent stage syphilis
Muscle movement problems
Dementia (loss of memory, concentration & judgment)
Pictures of syphilis symptoms
NOTE: These photos represent symptoms of advanced disease.
Symptoms for the primary stage of syphilis usually appear 10-90 days after infection.
Most people with syphilis get their first symptom anywhere from 10 to 90 days after
infection. This primary stage of infection is the first of three stages. The most obvious
symptom is usually a single, small, firm, round, painless sore called a chancre (pronounced
SHANG-ker). The chancre usually appears where the body was first infected, which for women is
usually the vulva, vagina and anus or rectum. But the sores can also show up on the cervix,
mouth, tongue, lips or anywhere other part of the body that touched an infected sore. For men
chancre most often appears on the penis and anus or rectum. But it too can form on the lips,
tongue, mouth or elsewhere. About 25% of people will have multiple chancres. The chancre is
usually firm, round, small, and painless. It appears at the spot where syphilis entered the
body. The time between infection with syphilis and the start of the first symptom can range from
10 to 90 days (average 21 days). The chancre lasts 3 to 6 weeks and it heals on its own.
However, just because the chancre heals, doesn't mean the infection goes away. 70% of people in
the primary stage of syphilis will also get swollen lymph glands in either the neck, armpits or
groin depending on where the chancre develops. Like the sores, the swollen glands are usually
firm and painless. Since a single sore is small, painless and often inside the body (like the
swollen lymph glands) many people never notice this first symptom of syphilis.
Symptoms for the secondary stage of syphilis usually appear 2-8 weeks after first sore.
Most people with syphilis get their second wave of symptoms anywhere from 2 to 8 weeks after
the first chancre forms. This secondary stage of infection is the second of four stages. 33% of
people who don't treat primary stage syphilis with antibiotics stay infected with secondary
stage for up to a year. It's at this point where the bacteria has spread into the bloodstream
and the symptoms can likewise spread from the initial infection. 75% to 100% of people at this
stage will get a rash of red or reddish-brown spots. While the rash often appears on the palms
of the hands or soles of the feet, it can appear anywhere. The rash is usually not itchy and
sometimes so faint that it's not noticed or confused for the symptom of another health problem.
People may still have the chancre when the rash arrives, or it could already be healed. 50% to
85% of people will also get swollen lymph glands in either the neck, armpits or groin depending
on where the chancre developed. Anywhere from 6% to 30% of people can get mucous membrane
lesions (called mucous patches) in or on the mouth, vagina or penis.
10% to 20% of people with secondary stage syphilis will develop
condylomata lata, which are moist, wart-like patches on their genitals or
within skin folds. There are some less common symptoms such as swollen eyes,
kidney, liver, spleen bones or joints which could lead to more serious complications if the STD
is not treated. And finally some people may feel feverish, lose weight, get muscle aches,
chills, a runny nose and not feel as hungry as normal. Just like with primary stage syphilis,
these symptoms can all go away on their own, but that doesn't mean that the infection has gone
away. Usually the infection goes to the next stage, which doesn't usually have symptoms, but can
lead to serious complications.
Most people with latent stage syphilis have no symptoms at all.
This third stage of syphilis gets its name from "latent", which also means hidden. This is
because there are usually no symptoms during the 1 to 30 years of this stage. For the 35% to 40%
of people who get to this stage of untreated syphilis, this is when serious complications can
begin. During the early part of this stage some people do get symptoms from the secondary stage,
but by the later stage of latent syphilis it is less likely that any symptoms will appear. If
symptoms do show up, they are usually from health complications that begin with internal organs
such as the brain, heart, eyes, nerves, blood vessels, liver, bones and joints. Signs and
symptoms of the latent stage of syphilis include difficulty coordinating muscle movements,
paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause