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Published on: 2/28/2026
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.
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.
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.
Understanding the stages helps explain why your body reacts differently over time.
This is the first stage and usually appears 10 to 90 days after exposure.
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.
If untreated, syphilis moves to the secondary stage weeks to months later.
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.
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:
Without treatment, some people remain in this stage. Others move to tertiary syphilis.
This stage can develop 10–30 years after infection if untreated.
It can damage:
At this stage, damage can be permanent and life-threatening.
This is why early diagnosis and treatment are critical.
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.
Syphilis is sometimes called "the great imitator" because its symptoms resemble many other conditions. That's why testing is so important.
You should speak to a doctor immediately if you experience:
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.
If you suspect syphilis symptoms, here's what to do:
A healthcare provider can diagnose syphilis with:
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.
Syphilis is treated with penicillin, usually given as an injection.
If you're allergic to penicillin, your doctor can recommend alternatives.
Treatment kills the bacteria. However:
To prevent spreading the infection:
Partner notification is important for public health and prevents reinfection.
After treatment:
Follow-up is essential, even if symptoms are gone.
Untreated syphilis during pregnancy can cause:
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.
Yes. Prevention steps include:
Routine screening is especially important because syphilis symptoms can be subtle or absent.
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:
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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