The signs and symptoms can be difficult to recognise and you might not notice them.
Syphilis can develop in stages:
- the early stage (primary and secondary syphilis)
- the latent stage
- the late stage (also called tertiary syphilis)
Early and late syphilis may cause symptoms, while in latent syphilis there are no symptoms. Some people don’t get any symptoms at all.
If you do get symptoms, you might notice the following at different stages.
Primary syphilis
- One or more ulcers can appear, where the syphilis entered the body. These ulcers are called chancres (pronounced ‘shankers’) and are often painless. They may appear between 2 weeks and 3 months after coming into contact with syphilis but it can be sooner or later
- These ulcers can appear anywhere on the body
- Ulcers may appear on the vulva (external female genitals) or the cervix (entrance to the uterus – womb)
- Ulcers may appear on the penis or foreskin
- They may be around the opening of the urethra (tube where urine comes out) or around the anus
- Less commonly, ulcers may appear in the mouth, and on the lips, tonsils, fingers or buttocks
- The ulcers of primary syphilis are very infectious and may take 2 to 6 weeks to heal. By this time, if the syphilis hasn’t been treated, it will spread to other parts of the body
Secondary syphilis
If syphilis isn’t treated, some people will develop the secondary stage, usually around 4 to 10 weeks after any ulcers have appeared. Syphilis is still infectious at this stage and can be passed on to someone else.
Symptoms might include:
- a painless rash that’s not normally itchy; it can spread all over the body, or appear in patches and is often seen on the palms of the hands and soles of the feet
- flat, warty-looking growths on the vulva or around the anus (often mistaken for genital warts)
- a flu-like illness, tiredness and loss of appetite, with swollen glands (this can last for weeks or months)
- white patches on the tongue, cheeks, or roof of the mouth
- patchy hair loss
Latent syphilis
When syphilis remains untreated, without any signs or symptoms of infection, it’s known as latent syphilis. Diagnosis is made by a positive blood test. People with latent syphilis may still be infectious.
Tertiary or late syphilis
Untreated syphilis may, after many years, start to cause serious damage to the heart, brain, bones and nervous system.
Late syphilis is rare in the UK and this guide does not cover it.