What Does Syphilis Look Like

What does syphilis look like depends on the stage of the infection, because syphilis develops in distinct stages. The first sign is usually a single painless sore, called a chancre, at the site of infection. This sore can be easy to miss, especially if it is inside the body. Later stages can cause a rash, often on the palms of the hands or soles of the feet. Because the symptoms come and go and can be mild, syphilis is often called the great imitator, and testing is the only reliable way to know if you have it.

Primary Stage

The primary stage of syphilis begins with a single painless sore, called a chancre, at the site where the bacteria entered the body. This is usually the genitals, but it can also appear on the mouth, lips, or anus. The sore appears about three weeks after exposure.

If you notice a sore that you cannot explain, it is a good idea to get tested. Even if the sore heals on its own, the infection can still be present and can still be passed to a partner.

The chancre is firm, round, and painless, and it heals on its own within three to six weeks even without treatment. Because it is painless and may be hidden, many people do not notice it.

Secondary Stage

If syphilis is not treated, it moves to the secondary stage, which usually begins a few weeks after the sore heals. The most common sign is a rash, often on the palms of the hands and soles of the feet. The rash can look different on different people and may not itch.

Other symptoms can include fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, and fatigue. These symptoms can come and go over weeks or months.

Latent and Late Stages

After the secondary stage, syphilis enters a latent stage where there are no symptoms. This can last for years. Without treatment, some people develop late-stage syphilis, which can damage the heart, brain, and other organs.

Late-stage syphilis is serious but rare, because most people are treated before reaching this point. Testing and treatment at any stage prevent the most serious complications.

The Only Way to Know

Because syphilis symptoms come and go and can be mild, testing is the only reliable way to know your status. A blood test can detect syphilis, and it is curable with antibiotics, usually penicillin.

If you have questions about your symptoms or results, write them down and bring them to your follow-up appointment. Your provider can explain what your symptoms mean and what steps you should take next.

If you have had a possible exposure or notice any of these signs, testing is important. Early detection and treatment prevent complications and protect your partners.

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