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Stages of Syphilis You Should Be Aware Of

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  • Syphilis usually develops in stages, with symptoms varying at each period. In some cases, however, these stages may overlap, and some indicators do not happen in the same order
  • Most people with untreated syphilis don't develop tertiary syphilis. Tertiary syphilis happens 10 to 30 years after the infection began

Syphilis progresses in stages, and infected people will notice various symptoms at each period. However, there may be instances when the disease may not manifest chronologically and some indicators can overlap. The Mayo Clinic also adds that some people may not be aware that they have the condition because symptoms can go unnoticed for years.1

Primary Stage

At this stage, you can see a single sore or multiple sores that are often (but not always) firm, round and painless, and may be hidden within the vagina or rectum. The sores, which are called chancres, develop nearly three weeks after exposure to the syphilis bacterium and are found at the exact location where the pathogen entered the body. Chancres can last for three to six weeks, and may heal on their own whether the person receives treatment or not.2,3

Secondary Stage

During the secondary stage of syphilis, you can develop skin rashes and mucous membrane lesions, or sores in the mouth, vagina or anus.4 The rashes can appear on the body two to eight weeks after the main sore appears, or before it completely heals.5

If the rashes are rough, red or reddish-brown and are located on the palms of your hands and the bottoms of the feet, they’re considered a syphilis rash. The rashes tend to be unnoticeable because they look faint on the skin6 and don’t itch. Sometimes, rashes may be accompanied by wart-like sores in the mouth or genital area7 or other indicators like:8

  • Fever
  • Swollen lymph nodes
  • Sore throat
  • Patchy hair loss
  • Headaches
  • Weight loss9
  • Muscle aches
  • Fatigue

Symptoms during this stage can resolve whether or not the person receives treatment,10 typically healing within a few weeks, or repeatedly appearing and disappearing within a year.11 If left unaddressed, symptoms can cause the infection to move to the latent and even tertiary stages of syphilis.

Latent Stage

People whose infections are in the latent stage may not notice symptoms after the skin rash has faded away. The University of Michigan Medicine adds that people may be “… contagious during the early part of the latent stage and may be contagious during the latent period when no symptoms are present.”12

Failure to address symptoms of syphilis in the latent stage may cause the infection to remain in your body for multiple years. Eventually, while some indicators may not return after their initial presentation, the infection can move toward the tertiary stage.13,14

Tertiary Stage

Around 15 to 30 percent of untreated syphilis cases may progress to tertiary syphilis.15 This final stage of syphilis typically happens 10 to 30 years after the initial infection,16 although it’s possible for someone to develop it within one year of diagnosis.17

Although it’s not contagious, syphilis at the tertiary stage can cause complications.18 Huge sores can appear within the body or on the skin (gummas), and affect various organ systems, such as the heart and blood vessels (cardiovascular syphilis), and the brain and the nervous system (neurosyphilis).19 Tertiary syphilis can also affect the eyes, liver, bones and joints, and may even lead to death.20,21,22


Syphilis: Introduction

What Is Syphilis?

Tuskegee Syphilis Study

Congenital Syphilis

Syphilis Stages

Syphilis Causes

Syphilis Transmission

Syphilis Symptoms

Syphilis Treatment

Syphilis Testing

Syphilis Prevention

Syphilis FAQ

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