Medically reviewed on July 19, 2023 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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In 2021, more than 2.5 million cases of sexually transmitted diseases (STDs) were reported in the United States. Instances of syphilis, specifically, have risen significantly in recent years. 
Syphilis is characterized by sores, skin rashes, and even organ failure in later stages. And in some cases, syphilis symptoms can develop orally, affecting the lips, tongue, and skin around the mouth.2 That said, the tongue is the most commonly affected site in instances of oral syphilis, with syphilis tongue being present in 33.9 percent of cases. 
So, what exactly does syphilis tongue look like, and what are the signs of oral syphilis? It is explored further below.
Syphilis is a sexually transmitted disease that’s contracted through vaginal, anal, or oral intercourse.  Following relations with an infected person, a bacteria known as Treponema pallidum (T. Pallidum) can cause an infection, which develops in stages, including :
Symptoms of oral syphilis can occur in the primary, secondary, and tertiary stages of syphilis. It’s spread through oral sex when T. Pallidum bacteria infect a cut in the lips or mouth. Fortunately, syphilis cannot spread through contact with objects, such as eating utensils. 
Oral syphilis manifests in the form of an oral lesion and/or syphilitic chancre, which can be found on the :
Most people with primary oral syphilis will also experience lymphadenopathy, or the swelling of the lymph nodes, which may feel tender to the touch. White mucous patches can develop on moist tissue, such as the tongue, during the secondary stage. This can mimic a condition called ‘leukoplakias’, in which white tissue develops in the mouth as a result of chewing tobacco, frequent smoking, or drinking excessive amounts of alcohol. 
The symptoms of oral syphilis can often mimic other diseases and inflammatory responses, making it more difficult to diagnose the infection properly. 
However, it's important to note that syphilis can also affect other parts of the body, including the eyes. In some cases, syphilis can manifest as ocular syphilis, which involves the infection spreading to the eyes and causing symptoms such as blurred vision, redness, and eye pain.
During the tertiary stage, oral syphilis can manifest as inflammation sites called ‘gumma’, which are most commonly found on the tongue or palate. Sometimes, gumma on the tongue can cause luetic glossitis, leading to a red, swollen tongue. The papillae, raised protrusions that contain the taste buds, may also disappear, giving the tongue a smooth appearance.
See related: Can You Get Syphilis Without Having Sex?
If you’re experiencing sores or rashes following sexual contact, speak with your healthcare provider. They’ll meet with you to discuss your sexual history and order a blood test to identify possible infections. 
In the case of oral syphilis, a healthcare provider may also extract a fluid sample from the syphilis sore or conduct a tissue biopsy to rule out other causes of symptoms.
In all stages, oral syphilis can be treated with an antibiotic like penicillin. After completing your treatment plan, your healthcare provider will order another blood test to ensure the syphilis infection is no longer in your body. 
While syphilis is curable, damage done to organs in the later stages cannot be undone.
Abstaining from sex is the only way to fully prevent oral syphilis; however, you can significantly reduce your chances of contracting the infection by practicing safe sex, such as :
Oral manifestations of syphilis can often occur after partaking in oral sex with a partner who is infected with the syphilis bacteria, Treponema pallidum. Accordingly, those with oral syphilis often experience sores and rashes in or around the mouth, including on the tongue.
To stay on top of your sexual health, regular testing for STDs is essential. If you're pregnant, it's crucial to be aware of the potential risks associated with syphilis. Syphilis in pregnancy can lead to severe complications, including transmission of the infection to the fetus.
Everlywell offers an at-home Syphilis Test that will measure a sample of blood for Treponema pallidum antibodies to identify whether you’ve been infected. If your test results are abnormal, Everlywell can help you connect with a healthcare provider to discuss treatment options and follow-up testing.
Online STD treatment services are also offered to address concerns about your sexual health. You can meet with a licensed clinician online for recommendations and treatment advice.
Take control of your health with Everlywell.