What are the symptoms of syphilis?
What syphilis symptoms actually look like at each stage, how soon they appear, and why it's curable when caught early.
Syphilis is a bacterial sexually transmitted infection (STI). If it isn't treated, it can progress through four stages: primary, secondary, latent, and tertiary syphilis.
Symptoms can change depending on the stage, and they may appear, disappear, and reappear over time. This can make it seem like the infection has gone, but syphilis stays in the body until it's treated, and testing is the only way to know for sure. Syphilis can be treated and cured with antibiotics, particularly when it's diagnosed early.
Key takeaways
- Syphilis has four stages: primary, secondary, latent, and tertiary.
- Primary syphilis causes a single, often painless sore.
- Secondary syphilis can bring a rash, fever, and hair loss.
- Latent syphilis causes no symptoms, but the infection remains.
- Symptoms can fade between stages. That doesn't mean it's gone.
- Tertiary syphilis can damage the heart, brain, and nerves years later.
- Syphilis is curable with antibiotics, especially caught early.
- Syphilis diagnoses in England fell 13.5% in 2025, to 8,262 cases, though cases in heterosexual women rose.
How does syphilis progress through the four stages?
If syphilis isn't treated, it can progress through four stages: primary, secondary, latent, and tertiary syphilis. Each stage can cause different symptoms, and how soon each stage's symptoms appear can vary from person to person.
| Stage | What can happen | Typical timing |
|---|---|---|
| Primary syphilis | A painless sore, sometimes called a chancre, may appear on the penis, vagina, anus, or mouth | Usually around 3 weeks after infection |
| Secondary syphilis | A rash, flu-like symptoms, swollen glands, or patchy hair loss may develop | Up to 3 months after the first sore |
| Latent syphilis | No visible symptoms, but the infection is still in the body | Can last for years |
| Tertiary syphilis | Serious damage can affect the brain, nerves, heart, or other organs | Usually 10 to 30 years after infection |
The stages don't always follow a neat timeline. Symptoms can disappear between stages, but without treatment the infection can remain in the body and may cause serious complications later.
What is primary syphilis?
Primary syphilis is the first stage of the infection. The main sign is usually a sore where the infection entered the body, which may be on the penis, vagina, anus or mouth. The sore is usually painless, and you may only have one.
As it is painless, it can go completely unnoticed and it can take 3 weeks or more after exposure for this first sore to appear. Usually it will heal on its own within 3 to 6 weeks even if it's never treated. But the sore healing does not mean the infection has gone away. Syphilis can stay in the body and progress to the next stage.
This is why testing matters after a possible exposure, even if you feel well or any symptoms have already disappeared.
What is secondary syphilis?
Secondary syphilis is the stage that can follow the first syphilis sore. Syphilis is sometimes called "the great imitator" because its symptoms can be mild, hard to notice, or mimic other conditions.
A rash can appear on the hands and feet, particularly the palms and soles, and it can spread elsewhere on the body. It rarely itches, and can sometimes be too faint to notice.
Other symptoms can include:
- A high temperature, headaches and tiredness
- Swollen lymph glands
- A sore throat
- Patchy hair loss on the head, beard or eyebrows
- White patches inside the mouth
- White or grey wart-like growths around the genitals or anus
These later symptoms can appear up to 3 months after the first symptoms of syphilis. They may improve or disappear on their own, but that does not mean the infection has cleared. Without treatment, syphilis remains in the body and can move into the latent stage.
What is latent syphilis?
Latent syphilis is the stage where there's nothing outwardly visible, even though the infection is still active in the body. There is no rash, sore or other obvious sign, and this stage can last for years.
Because there are no symptoms to spot, latent syphilis is usually found through a blood test. Without treatment, the infection can remain in the body for years and may eventually progress to tertiary syphilis.
Sexual transmission is most likely in the earlier part of an infection, roughly the first two years after you were first infected, rather than later in the latent stage itself.
What is tertiary syphilis?
Tertiary syphilis is the final, most serious stage, and it can develop 10 to 30 years after the original infection began. Tertiary syphilis is actually uncommon, since most untreated cases never reach this stage.
Tertiary syphilis can damage different organs and parts of the body. Complications can include:
- Heart problems such as angina, aortic aneurysm, or heart failure
- Brain problems such as seizures, memory loss, personality changes, or dementia
- Nerve problems such as shooting pains, pins and needles, joint pain, or gradual joint damage
- Damage to the skin, bones, testicles, liver, or other organs
- Muscle weakness
- Problems with sight or hearing
Some complications of untreated syphilis may not appear for many years. Tertiary syphilis can be fatal in severe cases.
It is also important to know that syphilis can affect the brain, nerves, eyes or hearing before the tertiary stage. These complications can occur at any stage of the infection.
Can you have syphilis with no symptoms?
Yes, you can have syphilis with no symptoms at all. During latent syphilis, there are no visible signs at all. Even in the early stages, the first sore is usually painless and can be hidden inside the body, making it easy to miss.
This is why you should not rely on symptoms alone to know whether you have syphilis. Testing is the only way to confirm an infection, and you can be tested even if you feel completely well.
A syphilis test usually involves a blood sample. If you have a sore, a clinician may also take a swab. You can get tested alongside other STI checks at a sexual health clinic, or use a home self-sampling kit and send your sample to a lab.
Is syphilis curable?
Yes, syphilis is curable and treatment tends to be simpler the earlier it's caught.
Treatment can involve an antibiotic injection, or a course of tablets or capsules. How long treatment takes depends on which stage the infection has reached.
You'll be retested at 6 weeks and again at 12 weeks to confirm treatment has worked, and further follow-up visits may be needed over the coming months depending on your situation.
Frequently asked questions
How soon do syphilis symptoms appear after infection?
Syphilis symptoms usually appear around 3 weeks after infection, though timing varies. The earliest sign is usually a painless sore, followed by symptoms such as a rash, swollen glands, or hair loss up to about 3 months later.
Because the first sore can be painless or hidden, you may not notice it appearing. Testing is more reliable than judging by symptoms or timing alone.
Can syphilis go away on its own?
No. Syphilis symptoms can improve or disappear without treatment, but the infection itself does not go away. It remains in the body and can progress to later stages unless it is treated with antibiotics.
Is syphilis curable?
Yes. Syphilis can be cured with antibiotics, and it works best the earlier it's started. Follow-up blood tests are used afterwards to check that treatment has worked.
What does a syphilis rash look like?
A syphilis rash often appears on the palms of the hands and soles of the feet, although it can spread to other parts of the body. It usually is not itchy and can sometimes be faint enough to miss. White patches in the mouth can also appear during secondary syphilis.
Can you have syphilis with no symptoms?
Yes. You can have syphilis without any noticeable symptoms. During latent syphilis there are no visible signs, and an early syphilis sore can also be painless or hidden somewhere it is easy to miss. This is why testing is more reliable than waiting for symptoms to appear.
What happens if syphilis is left untreated?
Untreated syphilis can remain in the body for years and may eventually cause serious complications. In some people, late-stage syphilis can damage the heart, blood vessels, brain, nerves and other organs. Testing and treatment prevent the infection from progressing further.
References
- Centers for Disease Control and Prevention. "About Syphilis." CDC, 23 Feb. 2026, cdc.gov/syphilis/about/index.html.
- NHS. "Syphilis." NHS, 17 Mar. 2026, nhs.uk/conditions/syphilis.
- UK Health Security Agency. "STIs Fall with Syphilis among Gay and Bisexual Men Lowest in a Decade." GOV.UK, 2 June 2026, gov.uk/government/news/stis-fall-with-syphilis-among-gay-and-bisexual-men-lowest-in-a-decade.
Show all references
- UK Health Security Agency. "What Is Syphilis? A Quick Guide to Its Symptoms and Treatment." UKHSA Blog, 2 June 2026, ukhsa.blog.gov.uk/2026/06/02/what-is-syphilis-a-quick-guide-to-its-symptoms-and-treatment.
- World Health Organization. "Syphilis." WHO, 29 May 2025, who.int/news-room/fact-sheets/detail/syphilis.
