Stages of Syphilis - Topic Overview
Syphilis is described in terms of its four stages: primary,
secondary, latent (hidden), and tertiary (late).
During the primary stage, a sore (chancre) that is
usually painless develops at the site where the bacteria entered the body. This
commonly occurs within 3 weeks of exposure but can range from 10 to 90 days. A
person is highly contagious during the primary stage.
- In men, a chancre often appears in the genital
area, usually (but not always) on the penis. These sores are often
- In women, chancres can develop on the outer genitals or
on the inner part of the vagina. A chancre may go unnoticed if it occurs inside
the vagina or at the opening to the uterus (cervix), because the sores are
usually painless and are not easily visible.
- Swelling of the
lymph nodes may occur near the area of the
chancre may also occur in an area of the body other
than the genitals.
- The chancre lasts for 3 to 6 weeks, heals
without treatment, and may leave a thin scar. But even though the chancre has healed, syphilis is still present and a person can still pass the infection to others.1
Secondary syphilis is characterized by a rash that appears from 2
to 8 weeks after the chancre develops and sometimes before it heals. Other
symptoms may also occur, which means that the infection has spread throughout
the body. A person is highly contagious during the secondary stage.
A rash often develops over the body and commonly includes the palms
of the hands and the soles of the feet.
- The rash usually consists of a reddish brown,
small, solid, flat or raised skin sore or sores that are less than
2 cm (0.8 in.) across. The rash may look like other more common skin problems.
- Small, open
sores may be present on mucous membranes. The sores may contain pus, or moist
sores that look like warts may be present (condyloma lata).
dark-skinned people the sores may be a lighter color than the surrounding
The skin rash usually heals without scarring within 2 months. After
healing, skin discoloration may develop. But even though the skin rash has healed, syphilis is still present and a person can still pass the infection to others. 1
When syphilis has spread throughout the body, the person may
- A fever of usually less than
- A vague feeling of weakness or discomfort throughout
- Patchy hair loss, especially in
the eyebrows, eyelashes, and scalp hair.
- Swelling of the
Nervous system symptoms of
secondary syphilis, which can include neck stiffness, headaches, irritability,
paralysis, unequal reflexes, and irregular pupils.