Syphilis Symptoms

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.

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Syphilis symptoms for primary stage

Most common

  • Single, firm, round, painless sore (called chancre, pronounced SHANG-ker)
  • Can appear within 10 days to 3 months after exposure

Less common

  • Swollen lymph glands (neck, armpit, or groin)
  • No obvious symptom (painless sore could be small)

Least common

  • 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

Most common

  • Swollen lymph glands (neck, armpit, or groin)
  • Sore throat
  • Headaches
  • Feeling tired

Less common

  • 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

Least common

  • Fever
  • Lose weight
  • Muscle aches
  • Chills
  • Not feeling hungry
  • Runny nose

Syphilis symptoms for latent stage

Most common

  • No symptoms at all

Less common

  • Repeated symptoms from the secondary stage

Least common from complications due to latent stage syphilis

  • Muscle movement problems
  • Paralysis
  • Numbness
  • Losing sight
  • Dementia (loss of memory, concentration & judgment)

Pictures of syphilis symptoms

Syphilis Symptom 1
Syphilis Symptom 2
Syphilis Symptom 3
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 death.

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