Our services launch is planned soon
Syphilis Symptoms: How to Recognize Early Signs
syphilis symptoms
Evelyn stared at the tiny copper-red spots on her soles, recalling the painless sore she’d brushed off weeks ago, and a knot of dread tightened in her stomach; by morning she’d booked a clinic visit, learned it was early syphilis, and got a single penicillin shot that same day — now, as her rash fades and tests confirm she’s cured, she knows first hand how crucial it is to recognize those subtle signs and act fast.
Early detection of syphilis can mean the difference between a quick cure and serious complications. In this guide, we’ll walk you through the hallmark symptoms of primary and secondary syphilis, explain when to seek testing, and offer practical tips to stay informed and protected.
Why Early Recognition Matters
Effective Treatment: A single injection of penicillin can cure primary syphilis, whereas later stages may require prolonged therapy.
Preventing Spread: Recognizing symptoms early helps you avoid passing the infection to sexual partners.
Avoiding Complications: Untreated syphilis can damage the heart, brain, nerves, eyes, and other organs.
Professional GP advice, anytime, anywhere
Primary Syphilis Symptoms
Primary syphilis typically appears 3–6 weeks after exposure, though the chancre can show up anywhere from 10 to 90 days post-infection.
Painless Chancre
Description: A firm, round sore (chancre) at the site where the bacteria entered the body
Characteristics:
Usually single, but can be multiple
Clean base with raised edges
Painless, so often goes unnoticed
Tip: Check the genitals, anus, mouth, and even fingers if you suspect contact with infected fluids.
Local Swelling and Tenderness
Swollen Lymph Nodes: Nearby lymph glands may become firm and slightly painful.
Duration: Chancre and swelling typically heal on their own after 3–6 weeks—but the infection remains active.
Secondary Syphilis Symptoms
If untreated, the infection enters the secondary stage 4–10 weeks after the chancre appears. Symptoms can overlap with other conditions, making awareness crucial.
Non-itchy Skin Rash
Location: Trunk, palms of the hands, soles of the feet
Appearance:
Flat or slightly raised red or brownish spots
May resemble psoriasis or pityriasis rosea
Duration: Can last 2–6 weeks, with periods of flare-up and remission
Mucous Membrane Lesions
Mucous Patches: Grayish-white lesions on the tongue, inside the mouth, or genital area
Condylomata Lata: Moist, wart-like growths in warm, damp areas such as the groin or underarms
Flu-like Symptoms
Low-grade fever
Fatigue and malaise
Sore throat
Muscle aches
Patchy Hair Loss
“Moth-eaten” Alopecia: Thinning patches of hair on the scalp, eyebrows, or beard
Reversible: Hair typically grows back after treatment.
When to Get Tested
After Unprotected Sex: Especially with a new or multiple partners.
If You Notice Any Sores or Rashes: Even if they’re painless or non-itchy.
Routine STI Screening: At least once a year if you’re sexually active.
Partner Notification: If a partner tests positive, get tested immediately.
Testing methods include blood tests (nontreponemal and treponemal) and direct sampling of chancre fluid.
Diagnosis and Next Steps
Visit a Sexual Health Clinic or GP: Free, confidential testing is widely available across the UK.
Blood Tests:
Rapid Plasma Reagin (RPR): Screens for antibodies.
TPHA/FTA-ABS: Confirms infection.
Treatment:
First-line: Single dose of intramuscular benzathine penicillin G.
Alternatives: Doxycycline or azithromycin for penicillin-allergic patients.
Follow-Up: Repeat blood tests at 3, 6, and 12 months to ensure treatment success.
Partner Treatment: All recent sexual partners should be notified, tested, and treated if necessary.
Key Takeaways
Look for chancres: Painless sores appear at the infection site.
Watch for rashes on palms and soles in secondary syphilis.
Flu-like symptoms can accompany the rash stage.
Early testing and treatment prevent serious health problems and onward transmission.
Stay informed: Regular STI screening is essential if you’re sexually active.
Frequently Asked Questions
Q1: Can syphilis be transmitted through kissing?
A: Yes, if there are open sores in the mouth or on the lips.
Q2: Will I test positive immediately after infection?
A: No. Antibody tests typically become positive 2–6 weeks after infection. If you test too early, you may need a repeat test.
Q3: Is it safe to have sex after treatment?
A: You should avoid sexual activity until your doctor confirms the infection is fully cleared, usually after follow-up blood tests.
Staying vigilant about early syphilis symptoms can protect your health and that of your partners. If you notice anything unusual, don’t hesitate — get tested without delay.
