Syphilis vs. Herpes: How to Tell the Difference

Updated on April 6, 2026 by Jordan Stachel, M.S., RDN, CPT. Last updated October 2, 2023. 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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Table of contents

• What Is Syphilis?
• What Is Herpes?
• Syphilis vs. Herpes: Telling Them Apart
• Treatment
• Preventing Syphilis and Herpes
• Related Content

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There are over 35 infectious organisms known to cause sexually transmitted diseases. While many STDs are largely preventable or treatable, they remain a huge burden and a significant health issue in the country. On top of medical costs and complications, many STDs can lead to serious, long-term health issues, including reproductive health problems, increased risk of certain cancers, and fetal and/or perinatal problems [1].

Syphilis and herpes are two of the most common STDs in the United States, but they can be easy to mistake or miss. While a herpes or syphilis test can help you know which STD you might have, it’s important to understand the differences between the two infections. Learn more about syphilis and herpes and how you can tell the difference.

What Is Syphilis?

Syphilis is a bacterial infection spread primarily via sexual skin-to-skin contact, though mothers can also pass the infection to a child during birth [2]. It is noted for the appearance of sores, known as chancres, and can be transmitted when skin or mucus membranes make contact with these sores. While early syphilis can be cured, this infection can stay in the body for decades following the initial infection.

So what does syphilis look like? There are four stages to a syphilis infection, often associated with distinct physical signs:

• Primary stage – The first stage of syphilis infection is often characterized by a small, painless sore, known as a chancre, where the infection entered your body.

• Secondary stage – Usually, the secondary stage of syphilis is accompanied by a red or reddish-brown rash, with or without the continued presence of geneital sores. The rash is usually not itchy, but it can be accompanied by the appearance of genital warts and canker sores in the mouth. You may also experience general flu-like symptoms, like fever, sore throat, muscle aches, and swollen lymph nodes. These symptoms can go away after a few weeks, but they can repeatedly come and go for up to two years.

• Latent stage – This stage is marked by the absence of noticeable symptoms. However, this doesn’t mean that the infection has gone away.

• Tertiary stage – Without treatment, the sexually transmitted infection will stay in the system and proceed to the final stage of syphilis. Late stages of syphilis can lead to serious health issues, such as organ damage, heart issues, and damage to the brain and nervous system.

What Is Herpes?

Herpes is an infection caused by two viruses: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2) [3]. The infections are differentiated as follows:

• HSV-1 – This strain of the herpes virus is responsible for oral herpes, such as fever blisters or cold sores in or near the mouth. Often, HSV-1 doesn’t present symptoms and is frequently transmitted via non-sexual contact with the saliva of a person with the herpes simplex virus.

• HSV-2 – Commonly known as genital herpes, you can only contract this strain of the herpes virus by direct contact with the genitals of someone infected.

It is possible to transmit HSV-1, oral herpes, to the genital region via oral sex. It’s also important to know that herpes can spread even in the absence of visible sores. Treatment can help minimize or in some cases prevent herpes outbreaks and can help reduce the risk of passing the virus along to sexual partners.

Herpes is extremely common. Estimates suggest that half of Americans have oral herpes, while roughly 1 out of every 6 Americans has genital herpes. Part of this comes from just how easily the virus spreads. While it is an STD, herpes does not require sex for transmission. Simply contacting an open sore is enough to transmit it from person to person. This becomes even easier given that many people don’t know that they have herpes, as sores can easily be mistaken for other skin conditions.

There is also no cure for herpes (though treatments exist for symptom management), meaning that you can have it for life and not know it. Herpes is thankfully not dangerous or life-threatening to the average, healthy individual, but sores can be uncomfortable and painful.

Syphilis vs. Herpes: Telling Them Apart

Category	Herpes	Syphilis
Incubation period	Symptoms typically appear within 2–4 days, but can take up to 12 days	Symptoms typically appear around 21 days, but may take up to 3 months
Sore size, texture, and pain	Small sores (1–3 mm), often blister-like and painful	Larger sores (up to 3 cm), painless and firm to the touch
Amount of sores	Often appears as clusters of small sores or blisters	Typically presents as a single sore
Time to heal	Usually heals within a couple of weeks, but may take up to a month	Can take up to 8 weeks; may leave scarring
Additional symptoms	Flu-like symptoms (in some cases); burning while peeing; difficulty urinating; itching; general genital discomfort	Flu-like symptoms (secondary stage); widespread rash across the body
Complications	Painful outbreaks; may impact quality of life; more severe in immunocompromised individuals; risk to newborns	Can damage nervous system, organs, bones, joints, and blood vessels if untreated; may cause vision loss; can be life-threatening
Treatment	No cure; antiviral medications can reduce severity, duration, and transmission risk [4]	Curable with antibiotics in early stages; later treatment stops progression but cannot reverse damage

Preventing Syphilis and Herpes

While syphilis and herpes are completely different STIs, they do share one significant thing: they are both easy to miss. Both STDs can present a few noticeable symptoms or symptoms that are easy to mistake for other skin conditions. This is partly why they spread so easily among sexual partners. A good way to prevent the spread of both STDs is to practice safe sex. Use condoms and other protective devices every time you have sex.

Along with safe sex, make sure you get tested for STDs. Testing allows you to catch infections before they become severe and allows for proactive management of personal health. If you don’t have access to a clinic or simply want to take a test in the comfort of your own home, Everlywell offers a convenient at-home STD Test. If your tests come back positive, we can connect you with a healthcare provider to determine the next steps for better health.

Related Content

Stages of Syphilis

Symptoms of Syphilis in Women

Signs of Syphilis in Men

Is Monkeypox an STD?

Common STDs That Cause Dry Skin in Some People

Living With Herpes: What You Need to Know About Dating and Treatment

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References

1. Sexually transmitted diseases (STDs) - Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.
2. Syphilis - Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.
3. Genital herpes - Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.
4. Herpes - STI Treatment Guidelines. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.