Syphilis symptoms: When to visit the doctor

Syphilis is a sexually transmitted disease (STD). The infectious agent responsible is Treponema pallidum, a type of bacterium. Anyone who comes into direct contact with the bacteria via an open sore, typically during sexual contact, can become infected. Syphilis symptoms can be broken down into four stages; in the first two stages, the disease is most contagious. In the later stages it is not as easy to pass on but this is when it causes the most damage to your body.

Syphilis symptoms are wide ranging, and many of them imitate other diseases. It’s also possible that you may not experience any syphilis symptoms at all, or you may only notice some of them. Even if you don’t display any syphilis symptoms, this doesn’t mean that your infection is not contagious and won’t progress to later stages. If you experience any of the syphilis symptoms outlined in the four stages below, or you think you may have been in close and intimate contact with someone who has syphilis, you should visit your doctor without delay.

This article on syphilis symptoms is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites. 

Primary stage syphilis symptoms

One of the first primary syphilis symptoms is an open sore or ulcer, known as a chancre that can appear on the cervix, genitals, tongue, lips, fingertips or throat. This sore can appear anywhere from 10 and 90 days after infection but usually appears around three weeks afterwards. The chancre may also appear inside the body and may not cause any pain, so you may not notice it at all.

Although the sore usually heals in a few weeks, this doesn’t mean you’re no longer infectious and so you should still seek treatment even if it heals on its own. In addition to a chancre, another one of the most common primary syphilis symptoms is enlarged lymph nodes in your groin. If you don’t seek treatment during this primary stage of the disease, there is around a 30% chance that it will progress to the secondary stage.  

Secondary stage syphilis symptoms

Secondary syphilis symptoms usually occur around three months after you’ve been infected with the disease. In the secondary stage, the main syphilis symptoms include a skin rash consisting of small brown sores together with flu-like symptoms. The rash usually appears on the palms of the hands and soles of the feet, but can also appear anywhere else on your body. The flu-like secondary syphilis symptoms you may experience can include:

• Muscle and joint pain

• Fever

• Headache

• Fatigue

• Sore throat

• Swollen lymph glands

You may also experience hair loss or weight loss. As with primary syphilis, these syphilis symptoms may disappear without treatment and your rash may heal within three to twelve weeks, but, again, this doesn’t mean you aren’t still infected. In some people, secondary syphilis symptoms can last for years. If and when these symptoms disappear, you will enter the latent stage of syphilis as described below. If you progress to this latent stage, you may still relapse back to the previous stage when secondary syphilis symptoms reappear.

Latent stage syphilis symptoms

If your syphilis infection is left untreated in the primary and secondary stages, the disease may move to the latent stage where you don’t experience any syphilis symptoms at all. When you reach this stage, you are not contagious and your syphilis symptoms may never return. However, this doesn’t mean you don’t still have the disease, and the bacteria may multiply in your body and progress to the tertiary stage of the disease. The latent stage of syphilis can last for any amount of time, from one year to 30 years.

Tertiary stage syphilis symptoms

Around 40% of people who are in the latent stage of syphilis will progress to tertiary stage of the disease, which can last from a year to several decades. In this tertiary stage, syphilis symptoms are most pronounced and the disease causes the most damage to your body. At this stage, the bacteria starts affecting your major organs such as your heart, brain and liver as well as other body parts such as your eyes, bones, blood vessels, joints and nervous system. In tertiary syphilis, symptoms can become so severe that they can result in death. Common tertiary stage syphilis symptoms include:

• Blindness

• Paralysis

• Numbness

• Uncoordinated muscle movements

• Heart problems

• Neurological problems

• Dementia and other mental disorders

• Lesions on various parts of your body including your skin, bones, cardiovascular system

All syphilis symptoms are a cause for concern

Many people think that syphilis is a disease of history, or that only affects people in far off countries, but there are about 12 million people living with syphilis and there are around 100 000 new cases every year in Western Europe. Syphilis can be treated effectively but any delays in consulting a doctor can mean that the disease progresses and becomes much more serious. The later the treatment, the more the long-term damage to the body can be. If you experience any syphilis symptoms or are worried that you may be infected, get it checked out.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors.

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