What you need to know about each stage of syphilis

Medically reviewed on February 15, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Syphilis is one of the most common sexually transmitted infections in the United States [1]. It is a bacterial infection, and if left untreated, syphilis can lead to some severe problems for the infected person.

Syphilis infections progress over a series of stages that can come with different symptoms and severity. These infection stages can overlap, or the infection can even go latent and present no syphilis symptoms at all. When exhibiting no symptoms, taking a syphilis test is one way to tell if you have it; however, it’s important to be able to identify the symptoms of each stage of the infection too. Learn more about the stages of syphilis below.

Primary Stage

Primary syphilis is the initial stage of the infection. The first sign of syphilis infection is the appearance of a small sore, called a chancre, that appears where the bacteria initially entered the body. This includes the genitals, anus, lips and/or mouth area (oral syphilis). Chancres are typically firm, round, and solitary, though they can sometimes be open and wet. Chancres are also painless, and they can often appear in places that are hard to see, like deep inside the vagina or rectum.

Despite being painless, syphilis sores are highly contagious, allowing the bacteria to easily pass during sex. Chancres usually show up about three weeks after the initial exposure to the bacteria, and they can last up to six weeks before going away on their own. If you haven’t been treated, chancres going away are not a sign that the infection is gone.

Secondary Stage

A few weeks after the chancre has healed, you may experience a rash. This is a sign that the syphilis infection has progressed to its second stage. Secondary syphilis is characterized by a large rash that starts at the trunk (chest or back) and can spread to the rest of the body, even covering the palms of the hands and/or soles of the feet. This skin rash typically isn’t itchy, but it can hang around for up to six weeks. The rash may also come with wart-like sores in the genitals or around the mouth.

Related: Syphilis vs Herpes: How to Tell The Difference

Along with a rash, you may experience flu-like symptoms, including [2]:

• Fever
• Muscle aches
• A sore throat
• Swollen lymph nodes

During the secondary stage, symptoms can come and go for up to two years without treatment.

Latent Stage

If you still aren’t treated for syphilis, the infection may progress to a latent syphilis stage between the secondary and tertiary stages. During the latent stage, you may experience no symptoms at all. This can last for months or even years, and signs and symptoms may stop entirely. For many people, the infection will progress to a late or tertiary stage.

Tertiary Stage

About 15 to 30 percent of syphilis cases will progress to a tertiary syphilis stage [3]. This late-stage syphilis can cause some severe health problems. The infection can cause damage to the brain and nervous system, resulting in paralysis and nerve issues. It can damage the eyes and lead to vision loss. An untreated syphilis infection can continue to damage major organs and organ systems, including the heart, liver, blood vessels, joints, and bones. Complications from tertiary stage syphilis can occur up to 20 years after the initial infection. The effects can be deadly.

The good news is that syphilis is easy to treat and can be cured with a round of antibiotics. Even in later stages, you can still cure the infection and mitigate any future damage to the body. However, antibiotics won’t heal or reverse the damage that has already been caused by a late-stage infection, which is why it’s important to identify syphilis as soon as possible.

The best way to stay on top of a syphilis infection before it gets to later stages is to get tested regularly. Everlywell offers an easy and accurate test kit for syphilis that provides everything you need to collect a blood sample that can be sent to a lab. You can receive your results within days, and if you test positive, we can connect you with our healthcare provider network to determine the right next steps for your health.

Related content

Symptoms of syphilis in females

Signs of syphilis in men

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References

1. Syphilis - Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.

2. STD Facts - Syphilis. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.

3. Tertiary Syphilis - STI Treatment Guidelines. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.