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Published on: 2/28/2026

Syphilis Symptoms? Why Your Body is Reacting & Medically Approved Steps

Syphilis symptoms vary by stage, from a painless sore where infection entered to a non-itchy rash on the palms and soles, fever, swollen lymph nodes, patchy hair loss, and, if untreated, potentially serious nerve, eye, or heart problems, while the latent stage may have no symptoms at all. These symptoms reflect your immune system reacting as the bacteria spread.

There are several factors to consider and medically approved steps, including prompt testing, penicillin treatment that cures the infection, avoiding sex until cleared, partner notification, and follow-up testing, with urgent care needed for vision, hearing, or neurologic changes and special precautions in pregnancy; see below for full details that can impact your next steps.

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Explanation

Syphilis Symptoms: Why Your Body Is Reacting & Medically Approved Steps to Take

Syphilis symptoms can vary widely depending on the stage of infection. Some signs are mild and easy to miss. Others can become serious if not treated. The good news is that syphilis is treatable and curable, especially when caught early.

Understanding why your body is reacting the way it is — and knowing what to do next — can protect your long-term health.


What Is Syphilis?

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It spreads through direct contact with a syphilis sore (called a chancre), typically during vaginal, anal, or oral sex. It can also pass from a pregnant person to their baby.

Syphilis develops in stages, and symptoms change at each stage. Because symptoms can disappear without treatment, some people mistakenly think the infection has gone away. It hasn't — it simply progresses internally.


Syphilis Symptoms by Stage

Understanding the stages helps explain why your body reacts differently over time.


1. Primary Syphilis Symptoms

This is the first stage and usually appears 10 to 90 days after exposure.

Common symptoms:

  • A single painless sore (chancre), though some people develop multiple sores
  • The sore usually appears on:
    • Genitals
    • Anus
    • Mouth or lips
  • Swollen lymph nodes near the sore

Why this happens:

The sore forms where the bacteria entered your body. Even though it's painless, it's highly contagious.

The sore usually heals within 3 to 6 weeks — even without treatment. However, the infection remains in your body.


2. Secondary Syphilis Symptoms

If untreated, syphilis moves to the secondary stage weeks to months later.

Common symptoms:

  • Skin rash (often on palms of hands or soles of feet)
  • Rough, reddish-brown spots
  • Fever
  • Fatigue
  • Sore throat
  • Swollen lymph nodes
  • Muscle aches
  • Patchy hair loss (syphilitic alopecia)
  • Wart-like sores in moist areas (genitals, mouth, anus)

Why your body reacts this way:

At this stage, the bacteria have spread through your bloodstream. Your immune system reacts, causing widespread symptoms like rash and fever.

The rash usually doesn't itch, which can make it harder to recognize.

If you're experiencing patchy hair loss alongside other concerning symptoms, get clarity fast with a free symptom checker for Syphilis (Including Syphilitic Alopecia) to understand what may be causing your symptoms.

Secondary symptoms may also disappear without treatment — but the infection progresses silently.


3. Latent Syphilis Symptoms

This stage has no visible symptoms.

It can last for years.

Even without symptoms, the bacteria remain in your body. Blood tests will still show infection.

There are two types:

  • Early latent: Infection occurred within the past year
  • Late latent: Infection occurred more than a year ago

Without treatment, some people remain in this stage. Others move to tertiary syphilis.


4. Tertiary (Late) Syphilis Symptoms

This stage can develop 10–30 years after infection if untreated.

It can damage:

  • Brain (neurosyphilis)
  • Nerves
  • Eyes (ocular syphilis)
  • Heart
  • Blood vessels
  • Liver
  • Bones and joints

Serious symptoms may include:

  • Severe headaches
  • Vision changes or blindness
  • Hearing loss
  • Memory problems
  • Personality changes
  • Difficulty coordinating muscle movements
  • Numbness
  • Heart complications

At this stage, damage can be permanent and life-threatening.

This is why early diagnosis and treatment are critical.


Why Your Body Is Reacting

Your immune system recognizes Treponema pallidum as a threat. The symptoms you experience are largely your immune system's response to the bacteria spreading in your body.

  • Sores form at the infection site.
  • Rashes and fevers occur as bacteria circulate in the bloodstream.
  • Hair loss can happen due to inflammation affecting hair follicles.
  • Neurological symptoms occur when bacteria invade the nervous system.

Syphilis is sometimes called "the great imitator" because its symptoms resemble many other conditions. That's why testing is so important.


When to Seek Medical Care

You should speak to a doctor immediately if you experience:

  • A painless sore on your genitals, mouth, or anus
  • A rash on your palms or soles
  • Sudden vision or hearing changes
  • Severe headaches or confusion
  • Any unexplained neurological symptoms

If something feels serious or life-threatening, seek urgent medical care.

Even if symptoms seem mild, testing is simple and can prevent long-term damage.


Medically Approved Steps to Take

If you suspect syphilis symptoms, here's what to do:

1. Get Tested

A healthcare provider can diagnose syphilis with:

  • Blood tests
  • Examination of sores (if present)

Testing is straightforward and widely available.

If you're unsure whether your symptoms match syphilis, you may consider starting with a free online symptom check for Syphilis (Including Syphilitic Alopecia) before seeing a clinician.


2. Start Treatment Promptly

Syphilis is treated with penicillin, usually given as an injection.

  • Early-stage syphilis may require just one dose.
  • Later stages may require multiple doses over several weeks.

If you're allergic to penicillin, your doctor can recommend alternatives.

Treatment kills the bacteria. However:

  • It does not reverse permanent organ damage
  • It does prevent further progression

3. Avoid Sexual Activity Until Cleared

To prevent spreading the infection:

  • Avoid sexual contact until treatment is complete
  • Inform recent sexual partners so they can be tested

Partner notification is important for public health and prevents reinfection.


4. Follow-Up Testing

After treatment:

  • Your doctor will recommend repeat blood tests
  • This confirms the infection has cleared

Follow-up is essential, even if symptoms are gone.


Syphilis and Pregnancy

Untreated syphilis during pregnancy can cause:

  • Miscarriage
  • Stillbirth
  • Premature birth
  • Severe infection in newborns (congenital syphilis)

Routine prenatal screening is standard and highly effective at preventing complications when treated early.

If you are pregnant and notice possible syphilis symptoms, contact a doctor immediately.


Can Syphilis Be Prevented?

Yes. Prevention steps include:

  • Using condoms consistently and correctly
  • Regular STI testing if sexually active
  • Limiting number of sexual partners
  • Open communication with partners about STI status

Routine screening is especially important because syphilis symptoms can be subtle or absent.


The Bottom Line

Syphilis symptoms can range from mild sores to serious neurological problems. Early signs may disappear on their own, but the infection does not.

Here's what matters most:

  • Syphilis is curable
  • Early treatment prevents long-term damage
  • Untreated infection can become life-threatening
  • Testing is simple and widely available

If you're noticing symptoms like painless sores, unusual rashes, unexplained hair loss, or neurological changes, do not ignore them. Consider using a symptom checker as a starting point, but always speak to a doctor for proper diagnosis and treatment.

Your health is too important to wait.

(References)

  • * Ghanem KG, Hook EW 3rd. Syphilis: a re-emerging infection. Infect Dis Clin North Am. 2018 Sep;32(3):477-491. doi: 10.1016/j.idc.2018.04.004. PMID: 30122289.

  • * Lukehart SA, Hook EW 3rd, Marra CM. Syphilis: epidemiology, pathophysiology, clinical manifestations, and management. Clin Infect Dis. 2020 Dec 17;71(Supplement_2):S89-S96. doi: 10.1093/cid/ciaa1532. PMID: 33331908.

  • * Kimball A, Stempel C, Ghanem KG. Syphilis: an update for the internist. J Gen Intern Med. 2023 Jul;38(Suppl 3):825-832. doi: 10.1007/s11606-023-08249-1. Epub 2023 Jun 2. PMID: 37266496.

  • * Liang SY, Hu SY, Li W, Xu M, Zhu YF, Li LJ, Zhang CC, Wang SM, Yu YS, Li ZJ, Wang Q, Li C. Neurosyphilis: A Comprehensive Review. Microbiol Spectr. 2023 Aug 16;11(4):e0050723. doi: 10.1128/spectrum.00507-23. Epub 2023 Jul 11. PMID: 37432570.

  • * Schmidt R, Zawar V, Kulkarni A. Syphilis: Laboratory and Clinical Aspects. Indian J Dermatol. 2017 Jan-Feb;62(1):4-11. doi: 10.4103/0019-5154.198394. PMID: 28216656.

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