The appearance of a single sore marks the first (primary) stage of syphilis symptoms, but there may be multiple sores. The sore appears at the location where syphilis entered the body. The sore is usually firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore lasts 3 to 6 weeks and heals regardless of whether or not a person is treated. However, if the infected person does not receive adequate treatment the infection progresses to the secondary stage.
Skin rashes and/or sores in the mouth, vagina, or anus (also called mucous membrane lesions ) mark the secondary stage of symptoms. This stage usually starts with a rash on one or more areas of the body. Rashes associated with secondary syphilis can appear from the time when the primary sore is healing to several weeks after the sore has healed. The rash usually does not cause itching. This rash may appear as rough, red, or reddish brown spots both on the palms of the hands and/or the bottoms of the feet. However, this rash may look different on other parts of the body and can look like rashes caused by other diseases.
Large, raised, gray or white lesions may develop in warm, moist areas such as the mouth, underarm or groin region. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Other symptoms of secondary syphilis include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms of secondary syphilis will go away with or without treatment. Without appropriate treatment, the infection will progress to the latent and possibly late stages of disease.
Late and Latent Stages
The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person can continue to have syphilis in their body even though there are no signs or symptoms. This latent stage can last for years.
About 15% of people who have not been treated for syphilis develop late stage syphilis, which can appear 10–30 years after infection began. Symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. In the late stages of syphilis, the disease damages the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can result in death.