What Does Syphilis Look Like?
Medically reviewed on March 8, 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.
Table of contents
- Syphilis: What It Is and How It Spreads
- The Signs and Symptoms of Syphilis
- Syphilis Signs and Symptoms by Stage
- Is Syphilis Treatable?
- When You Need to Know, Choose Everlywell
- Related Content
Syphilis can look like small sores, a rash, or, in some cases and stages, nothing at all—making the question “What does syphilis look like?” difficult to answer.
Even though syphilis has a set of specific signs and symptoms, they can easily be confused with symptoms of a variety of other diseases and health conditions.
That said, knowing the various ways that syphilis can show up in the body is not impossible (but an at-home Syphilis Test can give you clearer answers). Here’s what to know.
Syphilis: What It Is and How It Spreads
Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. Although curable with antibiotics, untreated syphilis can pose serious health risks [1].
How common is syphilis? In the United States, the incidence rate was 9.5 cases per 100,000 people in 2017 [2]; it’s estimated that in 2019 there were 129,813 new cases of syphilis [1].
Syphilis spreads by direct contact with a syphilitic sore, known as a chancre, during sexual activity. Vaginal sex, anal sex, and/or oral sex can all transmit the sexually transmitted infection.
The syphilis infection can also be transmitted from mother to child during pregnancy. Healthcare professionals refer to this occurrence as “congenital syphilis.” Congenital syphilis can be dangerous for the child, both during pregnancy and after birth. Spontaneous abortion, late-term stillbirth [3], low birth weight, and high cholesterol levels in the newborn are possible consequences—as well as jaundice (a yellowish tint to the skin), pneumonia, negative effects on mental development, and more [4].
The Signs and Symptoms of Syphilis
When it comes to the signs and symptoms of syphilis, the infection can be very good at masquerading as other diseases, such as herpes (Related: Syphilis vs. Herpes: How to Tell the Difference). Depending on the stage of the infection, the symptoms of syphilis may be confused with other conditions like [5]:
- Herpes sores
- Rashes caused by HIV infection
- Skin swelling or inflammation known as lichen planus
- Psoriasis
- Rosacea
That said, you can spot the signs and symptoms of syphilis (with a little help from a healthcare provider). However, what those signs look like and how they manifest—if they manifest at all—will depend upon the stage of the infection.
Syphilis Signs and Symptoms by Stage
There are four potential stages to a syphilis infection, depending on how long the infection persists without treatment. Each stage is characterized by its own set of syphilis symptoms [6].
1. Primary Stage
In the initial stage of a syphilis infection, you may notice a small sore or chancre. Typically, there will be only one sore, although in some cases multiple sores may appear, according to the CDC [6]. Syphilitic sores are round, painless, and firm to the touch. They are also deeply rooted in the skin.
Syphilis sores will generally heal within 3 to 6 weeks, even without treatment. However, the syphilis infection will remain in the body until treated with antibiotics.
2. Secondary Stage
During the second stage, syphilis may present as a skin rash. Like syphilis sores, a syphilis rash can be easily confused with rashes caused by other illnesses.
Generally, a syphilis rash may:
- Appear on the palms of the hands, soles of the feet, or on the chest, arms, or back.
- Appear pale in color or in round, red patches.
- Be accompanied by small, raised bumps at the rash site.
A syphilis rash may also be accompanied by large gray or white lesions known as condyloma lata. These lesions may appear in the mouth, groin, and/or underarm areas, as well as other moist, warm locations on the body.
Additionally, secondary stage syphilis can present an array of other lesions on the palms of the hands and soles of the feet [7]. Types of lesions that may develop include:
- Macular
- Maculopapular
- Papular
- Pustular
- Annular
According to the National Institutes for Health, these lesions are typically darkly colored. A syphilis rash is not usually itchy, although it may also appear so faintly that it may not be noticed.
3. Latent Stage
As its name suggests, the third stage of syphilis is characterized by a lack of symptoms. The latent period can last anywhere between one year or can last anywhere from 5–20 years [8].
Despite the lack of symptoms, an individual who has contracted syphilis is still contagious during the early part of this stage—they may continue to be contagious throughout the stage.
4. Tertiary Stage
The final stage of syphilis can occur between 10 and 30 years from the initial infection. This stage is very serious and can cause severe damage to the brain, bodily organs, nervous system, and other parts of the body.
Most of the symptoms associated with this stage are internal. However, certain symptoms may present in directly observable ways, such as hair loss.
Is Syphilis Treatable?
The good news is that syphilis is more than treatable: it’s usually curable.
When a test confirms the presence of the infection, a healthcare provider may prescribe antibiotics to treat the syphilis infection.
When You Need to Know, Choose Everlywell
The first step to treating and curing a syphilis infection is to get tested. In many cases, the signs and symptoms of syphilis can be so subtle that those who are infected might not even know it. Testing is the only way to confirm—and to keep from spreading the infection to others.
The Everlywell at-home Syphilis Test includes everything you need to conduct a safe and accurate STD test sample collection on your own. Simply collect the necessary sample, send it off to the lab, and securely access your results online. Order your test today with Everlywell.
Related Content
Symptoms of Syphilis in Females
Ingrown Hair vs. Herpes: What Are the Differences?
References
1. STD Facts—Syphilis. Centers for Disease Control and Prevention. URL. Accessed March 8, 2022.
2. Schmidt R, Carson PJ, Jansen RJ. Resurgence of Syphilis in the United States: An Assessment of Contributing Factors. Infect Dis (Auckl). 2019 Oct 16. PMID: 31666795; PMCID: PMC6798162.
3. De Santis M, De Luca C, Mappa I, Spagnuolo T, Licameli A, Straface G, Scambia G. Syphilis Infection during pregnancy: fetal risks and clinical management. Infect Dis Obstet Gynecol. 2012;2012:430585.
4. Congenital Syphilis. National Organization for Rare Disorders. URL. Accessed March 8, 2022.
5. Klausner JD. The great imitator revealed: syphilis. Top Antivir Med. 2019;27(2):71-74.
6. STD Facts—Syphilis. Centers for Disease Control and Prevention. URL. Accessed March 8, 2022.
7. Usatine RP. The palms and soles. West J Med. 2000;173(3):160-161.
8. Stages of Syphilis. University of Michigan. URL. Accessed March 8, 2022.