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Symptoms of syphilis

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Syphilis has three stages, each with distinct symptoms:

First stage (primary syphilis)

  • 10 days to three months after becoming infected, you may get a painless sore (known as a ‘chancre’) at the site of infection. This is usually on the penis or vagina, in the mouth or around the rectum.
  • This heals over around two to six weeks later. Glands near the sore may swell.

Second stage (secondary syphilis)

  • A few weeks after the sore disappears, you may get a rash on your body, often on the palms of your hands or soles of your feet. You might feel ill, with a fever or headache.
  • You may experience patchy hair loss, weight loss or growths similar to genital warts. These will appear around the anus in men and women and also around the vulva in women.
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Between the second and third stages, syphilis becomes latent. This means it shows no signs or symptoms. 

Third or late stage (tertiary syphilis)

  • Years later, syphilis can seriously damage your heart, brain and nervous system. The infection is usually detected by then.

How it's passed on

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Syphilis bacteria are spread during unprotected oral, vaginal or anal sex through contact with the sores of the first stage or the rash of the second stage.

It can also be passed on through sharing sex toys and from a mother to her baby.

Unless they are treated, someone can pass on syphilis for up to two years once it becomes latent (between the second and third stages).

Using a condom or a Femidom (the female condom) cuts the risk, but only if the condom covers the sores or rash. Avoid touching the sores or the rash.

Other types of contraception, such as the contraceptive pill, offer no protection against sexually transmitted infections such as syphilis.

Having syphilis could make it easier for someone to contract or pass on HIV. But if someone has HIV and their treatment has made their viral load undetectable, then syphilis and other infections don’t appear to make them more likely to pass on HIV.

Syphilis tests and treatment

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There is a blood test for syphilis, and if you have a sore the fluid inside it will also be tested.

Antibiotics given by injection or tablets will cure it. Don’t have sex until the treatment has finished or you could pass on the infection.

People you’ve had sex with also need to get checked – a clinic can let them know if you don’t want to. Untreated syphilis can cause serious heart, brain and nerve problems years later and can even lead to death.

Most people get tested and treated for infections like syphilis at sexual health (GUM) clinics. It's free and confidential and no-one else, including your GP, will be told about your visit.

Some GP surgeries also test for and treat these infections.

All pregnant women are offered a syphilis test because the infection could cause a miscarriage, a stillbirth, or a baby could be born with it. It's easy to treat syphilis in pregnancy and the treatment will not harm the baby.

The more people you have sex with, especially unprotected sex, the more chance you have of contracting infections like syphilis. You can have them without knowing, so regular check-ups are a good idea, especially if you're starting a new relationship and/or you want to stop using condoms with your partner.