References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Syphilis progresses through distinct stages, each with different symptoms. Recognising the signs at each stage helps with early diagnosis and treatment. The earlier syphilis is caught, the simpler the treatment. Left untreated, it can cause serious long-term damage.
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Symptoms by Stage
| Stage | Timing | Symptoms |
|---|---|---|
| Primary | 10-90 days | Single painless chancre at infection site |
| Secondary | Weeks to months later | Rash (palms/soles), fever, fatigue, swollen glands |
| Latent | Months to years | No symptoms — infection still present |
| Tertiary | Years to decades | Heart damage, neurological problems, organ damage |
Primary Syphilis
- Painless firm ulcer (chancre)
- Usually at site of sexual contact
- Heals on its own in 3-6 weeks
- Highly infectious
Secondary Syphilis
- Body rash, often on palms and soles
- Mucous patches in mouth
- Fever, fatigue, hair loss
- Swollen lymph nodes
- Highly infectious
Latent Syphilis
- No symptoms at all
- Only detectable by blood test
- Can last years
Tertiary Syphilis
- Cardiovascular damage
- Neurosyphilis (dementia, stroke)
- Gummatous lesions
- Rare with modern treatment
Treatment
- Early stages — single penicillin injection
- Late stages — longer course
- Curable at all stages, but damage may not reverse
Read more: What is syphilis? | 4 stages explained | Identifying syphilis sores
Frequently Asked Questions
Can syphilis be cured?
Yes — penicillin is highly effective.
Is syphilis common?
Rates are rising in the UK.
How is it tested?
Blood test for antibodies.
Related reading
- Cold Sores vs Syphilis Sores: How to Tell the Difference
- How to Identify Syphilis Sores (Chancres)
- Blood Test for Syphilis, Hepatitis B and Hepatitis C
- Can You Catch Syphilis Without Having Sex?
- Do STIs Always Have Symptoms?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
