Taking care of your sexual health is essential and being aware of syphilis symptoms can help you catch and treat it early.
Here we'll talk about syphilis and the typical signs you may experience in all four stages, with the tertiary stage being the most harmful. If you think you may have syphilis, don't worry as it's perfectly treatable if caught early.
Unfortunately, syphilis symptoms can be hard to notice and they can even come and go which is why it's even more important to get tested. We've also included an FAQ section that you can check out for more information including how to get tested and what the treatment is for syphilis infection.
So, if you think you may have syphilis or you just want to be educated on the signs, read along for more information.
Symptoms of Syphilis
So what is syphilis and what signs should you look for? Syphilis is a sexually transmitted disease (STD) and you can catch it by having sex (including oral sex) without a condom or by sharing sex toys, needles and other injecting equipment with an infected person.
The syphilis bacteria, treponema pallidum causes the infection and there are four stages: primary, secondary, latent, then tertiary.
Lots of people with syphilis don't even notice any signs for years. For this reason, if you think you have it get a syphilis test straight away - don't wait for the signs to start.
The first thing you may notice is a sore called a chancre. These are painless and can develop around the genitals or anus. These sores usually appear around 2-3 weeks after you become infected, but not everyone will get them.
Although chancres can heal by themselves, without treatment the infection can progress to a later stage of syphilis and cause more health problems.
Symptoms of Syphilis in Men
Over the past few years, more and more men who have had sex with men have reported being diagnosed with syphilis. Although the health issues from syphilis are harmful on their own, it's been discovered that the chancres caused by syphilis make it easier for HIV to be transmitted sexually.
In fact, there is a 2-5 fold increased chance of catching HIV if you have syphilis. This is because sexually transmitted infections that result in sores, such as syphilis, disrupt the barriers that give protection against bacteria and infections.
The skin growths caused by syphilis can easily bleed and if they make contact with rectal or oral mucous membranes during sexual activity, they increase the risk of transmitting HIV.
The initial symptom of syphilis is typically a single sore, although it can also be multiple sores. It starts as a pimple but will then ulcerate to form a small, round, and painless ulcer. This ulcer will appear at the sight where the syphilis bacteria entered the body.
Symptoms of Syphilis in Women
The primary symptom of syphilis in women is the same as for men, in the form of a painless ulcer. Just like in men, this ulcer will form where the bacteria entered and it's usually just a single sore.
If it's left untreated, the syphilis infection can progress through the four different stages, each with its own signs. Once a person is infected, it usually takes around 3 weeks for the first sores to appear. However, it can take anywhere from 10 to 90 days after being infected for the sores to develop.
With syphilis in females, there's also a danger that it could be passed on to an unborn baby during pregnancy, this is known as congenital syphilis. To avoid congenital syphilis, it's vital to be tested for syphilis during pregnancy.
If you do test positive while you're pregnant, you'll be given antibiotics that will cure the disease. You must take the antibiotics as congenital syphilis can be extremely dangerous for the baby.
Without treatment, congenital syphilis can result in adverse outcomes including stillbirth, low birth weight, and preterm birth. Babies born infected with congenital syphilis can suffer from the following:
- Slow development
Syphilis during pregnancy is easy to treat and potentially fatal if left, so you must seek medical help if you suspect you're infected.
Symptoms of Primary Syphilis
As we discussed earlier, the primary stage of syphilis consists of a sore, or chancre, forming where the infection happened. A chancre will be small, firm, and round and because it's painless, you may not even know it's there.
These chancres can develop around the anus, vagina, around the vulva or on the penis. They may also form inside the vagina or rectum, under the foreskin and other easy to miss places.
These sores are extremely contagious and it's very easy to transmit the disease to others during sex. Chancres can also easily be mistaken for ingrown hairs, pimples, or other benign bumps, so be extra cautious and get tested if you find one.
They typically last for around 3-6 weeks before they heal on their own, regardless of whether they're treated or not.
However, if you don't seek treatment, you'll still have the infection even if the sores aren't there anymore. To cure it completely, you'll need treatment to prevent it from moving onto the next stage.
Symptoms of Secondary Syphilis
Secondary stage syphilis is more severe than primary stage syphilis. A reddish-brown rash on the body is the initial sign of the second stage. This rash is usually found on the palms of the hands and the soles of the feet, but similar rashes and other inflammatory skin problems can appear elsewhere.
These skin rashes can be mistaken for other conditions including chickenpox, acne, and contact dermatitis. For this reason, syphilis has earned the nickname "The Great Imitator." Syphilis rashes aren't usually painful or itchy and can be so faint you can hardly see them.
According to the CDC fact sheet, other signs you may develop include:
- Sore throat
- Hair loss
- Weight loss
- Swollen lymph glands
- Muscle aches
The signs from this stage will disappear whether you seek treatment or not. However, if you leave it untreated, the disease can progress to the latent stage.
Symptoms of Latent Syphilis
After secondary syphilis, there's the latent stage. Not all syphilis sufferers will go through the latent stage and if you do, you won't experience any signs, possibly for years or never again. But the disease will still be there and it'll lie dormant in your body and may develop into tertiary syphilis.
If you've had syphilis for a long time and have not had any treatment, you could be at risk for many dangerous health problems. The later stages of syphilis can cause paralysis, blindness, and tumours. It can even turn into neurosyphilis which attacks your nervous system and can be fatal.
In the early stages, syphilis is easily curable with simple treatment. But the damage caused by late-stage syphilis is incurable. Complications from the later stages can happen decades after the first infection.
Symptoms of Tertiary Syphilis
Although most sufferers of untreated syphilis won't progress to the tertiary stage, when it does happen it can cause problems with various organs. These include the blood vessels, heart, nervous system, and brain.
Tertiary syphilis is life-threatening and can occur up to 30 years after the initial infection. In this stage, the disease causes damage to the internal organs and can be fatal. Other complications include:
Symptoms of Oral Syphilis
During the primary stages, syphilis may show up as an ulcer on your lips, gums, tongue or near your tonsils. At first, it will look like a small red patch and will progress into a large open sore.
This sore can be grey, red, or yellow as well as being painful and very contagious. Without treatment, the sore may disappear but the infection will still be in your body and you could still infect others.
Because syphilis is a bacterial infection, it's very easy to cure in the early stages. With oral syphilis, your dentist can perform a biopsy to make a diagnosis. If you test positive, you'll be referred to your doctor for more tests and treatment.
It's so important to understand that without treatment, syphilis can cause serious, and long-term, damage to your vital organs.
What treatments are available for syphilis?
In the early stage of syphilis, you'll be prescribed antibiotics to treat the infection, typically penicillin. If you have a penicillin allergy, you'll probably be given a different antibiotic such as doxycycline. If you're in a later stage, you'll need a higher dosage.
If you're being treated for syphilis, your sex partners need to be treated as well, otherwise, you'll just keep passing the infection to each other, or other partners.
If you're having treatment for syphilis:
- Take the medicine as your doctor tells you to, even if the symptoms go quickly.
- Your sexual partner(s) should get a test for syphilis too so you don't get re-infected.
- Refrain from having sexual activity, including anal, oral, or vaginal sex until the course of treatment has finished and all physical symptoms have healed.
- Remember, having syphilis once doesn't stop you from getting it again. Always use condoms and have tests done regularly.
How do I get a test for syphilis?
Getting tested for syphilis usually involves a simple blood test. During the blood test, a health care worker will draw a blood sample from your arm using a needle. Once the needle has been inserted, the blood will be collected using a vial or test tube.
Only a small amount will be needed and you may feel a slight sting or scratch as the needle goes in and out. Blood tests are relatively painless and take just a few minutes. If you're anxious about needles, be sure to tell the health care worker, and they can take steps to make you feel more at ease.
You can also order a home testing kit through iPlaySafe, to take a quick test in the comfort of your own home! We partner with Preventx, the UK's largest provider of remote sexual health testing, to make STI testing simple, fast, and efficient. Your results will be sent to you within 2-5 days of taking the test.
How regularly should I be tested for STIs?
When you're sexually active, you should ideally be tested for sexually transmitted infections (STIs) once a year, minimum. If you have more than one sexual partner, share needles, or don't always practice safe sex, then you should get tested every 3 months.