Syphilis - Symptoms of syphilis

The symptoms of syphilis are the same for men and women, and can be difficult to recognise. They are often mild, which means you can pass on the infection without knowing you have it.

The symptoms develop in three stages:

• primary syphilis
• secondary syphilis
• tertiary syphilis

Primary syphilis

The initial symptoms of syphilis can appear any time from 10 days to three months after you have been exposed to the infection.

The most common symptom is the appearance of a small, painless sore or ulcer called a chancre. The sore will appear on the part of your body where the infection was transmitted, typically the penis, vagina, or around the anus.

The sores can also appear in the mouth or on the lips, tonsils, fingers or buttocks. Most people only have one sore, but some people have more.

You may also experience swelling in your lymph glands (small organs found throughout the body, such as in the neck, groin or armpit).

The sore is painless and may be overlooked, so the condition can be spread without you realising you have an infection.

The sore will then disappear within two to six weeks. If the condition is not treated, syphilis will move into its second stage.

Secondary syphilis

The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore.

Symptoms can include:

• a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet
• small skin growths, often mistaken for genital warts – on women these appear on the vulva and for both men and women they appear around the anus
• flu-like symptoms – such as tiredness, headaches, joint pains and fever
• swollen lymph glands
• weight loss
• patchy hair loss

These symptoms may disappear within a few weeks, or come and go over a period of months.

Latent phase

Without treatment, syphilis will then move into its latent (hidden) phase, where you will experience no symptoms, even though you remain infected.

Latent syphilis can still be passed on during the first year of this stage of the condition, usually through sexual or close physical contact. However, after a couple of years, you cannot pass the infection to others, even though you remain infected.

The latent stage can continue for many years (even decades) after you first become infected.

Latent syphilis is rare in the UK. However, without treatment, there is a risk that latent syphilis will move on to the third, most dangerous stage – tertiary syphilis.

Tertiary syphilis

The symptoms of tertiary syphilis can begin years or even decades after initial infection. Around a third of people who are not treated for syphilis develop serious symptoms at this stage.

The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms:

• stroke 
• dementia 
• loss of co-ordination
• numbness
• paralysis 
• blindness 
• deafness 
• heart disease 
• skin rashes

At this stage, syphilis can be dangerous enough to cause death.