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How To Recognize Early Symptoms Of Syphilis

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 07, 2018
Last Modified Date: Dec 07, 2018
Published Date: Aug 23, 2017

Early Recognition of Syphilis Symptoms: The Difference between Life and Death

Treponema pallidum bacteria causes syphilisSyphilis is a highly contagious sexually transmitted disease, usually caused by the bacteria Treponema pallidum. Carriers can be unaware they have the disease until the later stages. Thus, it is important to recognize early symptoms of syphilis, when it can be easily treated and infected persons can prevent its transmission to their sexual partners. Routine STD testing is the only way to know for sure whether an individual is carrying syphilis or not.

What Are the Early Symptoms of Syphilis?

Syphilis symptoms occur in a series of stages: Primary, Secondary, Latent and Tertiary. The earlier it is caught, the easier it is to treat and the less chances infected individuals have of spreading the disease to others via vaginal, anal, or oral sex.

Rate of Detection by Syphilis Stage

Primary Stage

Primary Stage Syphilis Mouth ChancrePrimary syphilis symptoms occur between 10 and 90 days after exposure. It usually begins with a single sore, called a chancre (SHANG-kur) most often located in the mouth, genitals or anus. These sores are the primary point of transmission from one body to another. Syphilis sores resemble bug bites, and are firm and round. They are painless, which is why they often go undetected by the patient. Syphilis sores will heal themselves within three to six weeks, although this does not mean that the patient is cured. Without treatment, an infected person will usually progress to the second stage of the disease.

Secondary Stage

The second stage of syphilis is evidenced by a rash that usually begins anywhere from six weeks to six months after initial exposure. The rash and sores, called mucous membrane lesions, erupt on various parts of the body and can appear differently, depending on the affected tissue(s). Again, these sores and rashes are transmission sites. Contact with these sores during vaginal, anal, or oral sex can pass the syphilis bacteria from one person to another. During the second stage, the chancres can erupt outside of the genital area:

Genitals: Soft mucous membranes of the vagina may have whitish sores. The rash can appear on the genitals or groin as wart-like lesions. They are rarely itchy or painful.

Mouth: The mouth may have lesions that appear as white patches on the soft mucous membranes of the inner cheeks, tongue, and Secondary Stage Syphilis Mouth Lesionlips.

Hands and feet. One unique characteristic of second sage syphilis is a rash referred to as a "copper penny rash," often appearing on the palms of the hands and/or the soles of the feet. The lesions can be reddish or brownish in color. They can have whitish centers.

Because these rashes and lesions often resemble sores and rashes caused by other diseases, they are often mistaken for something else. Some people with second stage syphilis are unaware of the lesions, which prevents early diagnosis and treatment.

Additional second stage syphilis symptoms include:

  • Swollen lymph nodes
  • Unexplained weight loss
  • Patchy hair loss
  • Sore throat
  • Headaches
  • Fever
  • Muscle aches
  • Fatigue

Similar to the primary stage, secondary stage syphilis symptoms will eventually fade on their own, although the person is still infected, contagious, and can progress to latent stage syphilis without adequate diagnosis and medical treatment.

If you are sexually active, do not use regular protection, and/or are sexually active with more than one partner, it is imperative that you are tested for STDs, such as syphilis, on a regular basis. Syphilis treatment must happen within these first two stages in order to prevent irreversible side effects, and to stop it from being spread.

Most cases of syphilis are now detected, diagnosed, and treated during these first and second stages. There are distinctive trends related to gender, race, and sexual orientation and first and second stage syphilis diagnosis:

According to CDC records from 2011:

  • Men are more likely than women to contract syphilis
  • African-Americans are the most likely to contract the disease, followed by: Whites, Hispanics, and American Indians/Alaskan Natives
  • The highest populations of individuals with syphilis are men who have sex with menSyphilis Rates by Ethnicity and Gender

Latent Stage

Left untreated, syphilis can remain latent, or dormant, which means there are no identifiable symptoms or side effects. The latent stage can last for decades. A person cannot transmit syphilis during the latent phase. However, since chancres can be small, painless, and visibly undetectable, an infected person can never be 100% certain when the latent stage begins or ends.

Tertiary Stage

Approximately 15% of latent stage syphilis patients will end up developing tertiary, or third stage syphilis, which can be devastating to the physical body and is often fatal. The tertiary stage often commences as late as 10 to 30 years after initial exposure. During this stage, the syphilis bacteria begins to compromise the body's organs and systems. Syphilis is contagious during the tertiary stage. Side effects can include:

  • Heart problems
  • Neurological damage
  • Blindness
  • Difficult with coordination
  • Paralysis
  • Impotence
  • Deafness
  • Death

Health Testing Centers incorporates syphilis screening in our Level I STD panel. Contact us to day to learn more about the panels we offer to screen for syphilis and other common STDs. Early detection and treatment are the greatest assets we have in preventing unnecessary illness and fatalities due to sexually transmitted diseases.

The media in this article come from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification numbers #1971, 12590 and 1971. Charts were compiled from STD Surveillance data compiled by the CDC.