Signs and Symptoms of Syphilis

Syphilis prevention is extremely important. Syphilis is divided into three stages: primary, secondary, and latent or tertiary syphilis. These stages are determined by clinical findings, such as tests and physical exams, which are used to guide correct treatment and follow-up.

Syphilis symptoms in Women can be different from the Syphilis symptoms in Men. However, Syphilis is a curable condition and can be treated with antibiotics, especially in the early stages. But without treatment, it can lead to disability, neurological disorders, and even death.

Syphilis causes an effect on the central nervous system and this can occur at ANY Syphilis stage. (Neurosyphilis)

If you have syphilis or think you may have syphilis, you should not have sex
until ALL sex partners have been tested and treated to prevent Syphilis Transmission. (Including yourself)

Ending HIV Oklahoma aims to eradicate the transmission of Syphilis once and for all! Join the initiative today,

Primary Stage - HIGHLY INFECTIOUS

Ulcers or Chancres at the infection site

  • Are usually firm, round and painless (DO NOT IGNORE THIS!)
  • Appear within 10-90 days, with an average of 21 days, after exposure to syphilis
  • May persist for three to six weeks, then go away (on their own)

If you do NOT receive treatment and the chancre goes away, it does not mean syphilis is gone. WITHOUT treatment, syphilis will move to the next stage.

Click here to see pictures of primary syphilis >> (warning* images of genitals included*)

Secondary Stage - HIGHLY INFECTIOUS

Symptoms typically occur six weeks to six months after the the chancre (lesion), and clears up in two to ten weeks WITHOUT treatment; however, syphilis is still there.

  • Rash often on the palms of the hands, bottom of feet and on the torso or other parts of the body
  • Sores in the mouth, vagina or anus
  • Flat wart-like growths, condylomata lata, in the perianal/genital area and other moist body sites
  • Generalized enlarged lymph nodes (lymphadenopathy) and sore throat
  • Alopecia (patchy hair loss)
  • Headaches
  • Weight Loss
  • Muscle Aches
  • Fatigue

People with primary and secondary syphilis are very infectious!!!

If you have syphilis, you should not have sex until all sex partners have been tested and treated!!

Click here to see pictures of secondary syphilis >> (warning* images of genitals included*)

Early Latent and Latent Syphilis / Syphilis of Unknown Duration

Latent syphilis is defined as a positive syphilis infection without proof of primary or secondary symptoms. Early latent and late syphilis can overlap the primary, secondary stages of syphilis based on length of time of infection and visible symptoms.

Measures for early latent syphilis include:

  • Documentation of a negative blood test within the past year,
  • Documented exposure to early syphilis in the past year, and
  • Symptoms of syphilis that have cleared up within the past year.

Non symptomatic syphilis acquired more than one year ago is classified as late syphilis or syphilis of unknown duration. Most people with late syphilis may have no symptoms for many years.

Neurosyphilis is a syphilis infection of the brain and spinal cord which can occur at any stage of syphilis.

Neurosyphilis sometimes has no symptoms; however, symptoms can include:

  • Abnormal walk (gait), or unable to walk, weakness
  • Numbness in the toes, feet or legs
  • Problems with thinking, such as confusion or poor concentration
  • Problems with memory or dementia
  • Mental Problems, such as depression or irritability
  • Headache, seizure, or stiff neck
  • Loss of bladder control (incontinence)
  • Tremors or weakness
  • Eye pain
  • Visual problems, even blindness
  • Hearing problems, even hearing loss
  • Syphilitic Meningitis (inflammation of the membranes surrounding the brain and spinal cord)
  • Meningovascular Syphilis (caused by injury to the blood vessels and can result in a stroke)
  • General Paresis (slight or partial paralysis)
  • Tabes Dorasalis (slow degeneration of the nerve cells and nerve fibers that carry sensory information to the brain)

Neurosyphilis is a critical condition.

If you have symptoms of neurosyphilis, contact your healthcare provider or go to an emergency room immediately for testing.

Click here to see pictures of neurosyphilis >> (warning* images of genitals included*)

Tertiary syphilis is defined as symptomatic late latent syphilis, gummi and cardiovasculat syphilis, but not neurosyphilis. Late symptoms of syphilis usually develop of a period of 15-30 years of untreated infection.

Conditions which develop as a result of long term untreated syphilis cannot be reversed.

  • Damage to the heart, blood vessels, liver, bones and joints
  • Gummatous, soft noncancerous wounds (a wound that has a gummy or rubbery consistency)
  • Uvetitis (inflammation of the middle part of the eye) or Other Ocular Manifestations (an eye condition that directly or indirectly results from a disease process in another part of the body)
  • Death

Congenital syphilis is spread to an unborn baby from a mother who has NOT been treated or has gotten syphilis again.

Babies born to untreated mothers are at extreme risk for side effects, which can include:

  • Premature birth
  • Anemia
  • Enlarged Liver
  • Developmental delays (can be described as an impairment in physical, learning, language, or behavior areas)
  • Blindness or Deafness
  • Deformed teeth, bones and joints
  • Stillbirth (birth of dead fetus)

All women should be screened at their first prenatal visit. For clients who belong to communities and populations with a high prevalence of syphilis and for patients at high risk, blood tests should also be performed during the third trimester (at 28–32 weeks) and at delivery. For further information on screening guidelines, please refer to the CDC's 2021 STD Treatment Guidelines.