Some people with syphilis have no symptoms at all, so you may not know you have it unless you get tested. There are four stages of syphilis infection: primary, secondary, latent and tertiary.
The signs and symptoms of syphilis depend on the stage of disease.
Primary syphilis occurs 10-90 days after infection. Symptoms may include a single painless sore usually about a centimetre big at the site where the infection entered the body - such as on the penis, vagina, cervix, mouth or anus. There may also be swollen lymph nodes.
The sore, or sometimes multiple sores, can go unnoticed because it is usually painless and may be hidden from view in areas like the back of the throat, vagina or anus. These sores usually go away by themselves after three to six weeks, even with no treatment. But, even though the sore heals, if you have not been treated, you still have the infection and can pass it on to others.
Secondary syphilis occurs seven to 10 weeks after the initial infection in about one in four people. A wide variety of symptoms can occur and these may include:
- a red rash on the palms, soles, chest or back
- enlarged glands in the armpits and groin
- hair loss
- ulcers in the mouth, nasal cavity or genitals
- neurological symptoms.
Latent syphilis generally has no symptoms and it is only picked up on blood tests. If syphilis is not treated at this stage it can remain latent (sleeping) or develop into tertiary syphilis.
Tertiary syphilis can appear anywhere from five to 20 years after primary infection. At this stage, the bacteria can damage almost any part of the body including the heart, brain, spinal cord, eyes and bones, resulting in heart disease, mental illness, blindness, deafness and neurological problems.
Last reviewed: June 2015