Syphilis Rash on the Body: Appearance, Diagnosis, Treatment - Verywell Health

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. At times, it is passed on by nonsexual intimate contact, such as kissing or food handling, as well. Sexually active people between the ages 20 and 35 are most at risk of getting syphilis.

People who have syphilis can be unaware of carrying the infection since it can take weeks for symptoms to appear. Syphilis symptoms develop in four stages: primary, secondary, latent, and tertiary.

This article will provide an overview of the stages, rashes that can look like syphilis, when to see a healthcare provider, and how syphilis is diagnosed and treated.

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Early Symptoms of Syphilis


The primary stage of syphilis can take about two to three weeks to develop. During the primary stage, symptoms include:

  • A painless sore on or in the mouth, genitals, rectum, or skin
  • Swelling of the lymph nodes (bean-shaped structures that help fight infections) near the sore

The primary stage of syphilis can seem harmless, but bacteria continue to grow in the body. Most symptoms emerge in the secondary stage of syphilis.

Secondary Syphilis Symptoms

The secondary stage of syphilis can appear four to eight weeks after the primary stage. Symptoms of secondary syphilis include:

  • Skin rash (rough red or brown spots usually on the palms or soles of the feet that can be faint)
  • Warts around the genitals, mouth, vagina, penis, or skinfolds
  • Fever
  • Loss of appetite
  • Muscle and joint pain
  • Swollen lymph nodes
  • Changing vision
  • Hair loss

How Long Does Syphilis Rash Last?

A syphilis rash can last for about two to six weeks. Syphilis rashes can reappear after being dormant for up to two years.

Even if a syphilis rash has cleared on its own, you can still pass it on to others, and the bacteria remain active in the body.

The tertiary phase of syphilis can manifest as tumors, heart disease, brain disorders, vision loss, and joint deterioration.

Other Rashes That Look Like Syphilis

There are other conditions and rashes that could be confused with syphilis. These include:

  • Genital or oral herpes: A viral STI that can create sores
  • Viral rash: A rash caused by a viral infection
  • Medication allergy: A rash that is a side effect of or result of an allergy to a medication
  • Psoriasis: An autoimmune disorder in which the body overproduces skin cells
  • Sarcoidosis: A rare disorder of swollen tissue, often around the lymph nodes
  • Thrush: A yeast infection that can affect the genitals and other areas

Complications and Risk Factors Associated With a Syphilis Rash

Even though primary syphilis bumps can disappear on their own, the bacteria remain in the body, and a person can infect others while putting themselves at risk for complications of a tertiary phase (the third phase of syphilis) 10 to 30 years later. Possible complications include:

  • Heart, brain, and blood vessel damage (cardiovascular syphilis)
  • Nerve, spinal cord, and brain damage (neurosyphilis)
  • Bone and joint damage
  • Skin, bone, and liver tumors called gummas

When to See a Healthcare Provider

See your healthcare provider if you experience any of the following scenarios:

  • Syphilis symptoms or having a partner with syphilis symptoms
  • A sexual partner who has been diagnosed with syphilis or another STI
  • Having had sex with a new partner without a condom
  • Being pregnant or wanting to become pregnant and having syphilis symptoms
  • Using a drug needle that is shared with a person with syphilis symptoms

Are There Tests to Diagnose Syphilis?

Syphilis is usually diagnosed with a blood test. At times, a spinal fluid test is conducted. There might be a second test to confirm the bacterium is that of syphilis if the blood test is positive.

There are also at-home syphilis tests in which you typically take a blood sample from a finger prick and mail it to a lab.

How to Treat Syphilis

Syphilis is treated with antibiotics like penicillin. Syphilis treatment also includes:

  • Blood tests at three, six, 12, and 24 months after treatment to check if the bacteria is still present
  • Avoiding sexual contact and/or using condoms until the infection has been successfully treated
  • Treatment for any sexual partners of a person who has syphilis

Summary

Syphilis is an STI caused by the bacterium Treponema pallidum. There are four stages of syphilis symptoms: primary, secondary, latent, and tertiary.

The primary stage of syphilis includes a sore on the genitals, mouth, skin, or rectum and swelling of the lymph nodes. The secondary stage is when most syphilis symptoms appear. These include rash, warts, swelling of the lymph nodes, fever, body pain, hair loss, and vision problems.

It's advised to get tested for syphilis at the first sign of syphilis or if a sexual partner has symptoms of syphilis. If left untreated, syphilis can attack all of the body's organs, joints, and bones. Syphilis is usually diagnosed with a blood test and treated with antibiotics.

A Word From Verywell

Noticing syphilis symptoms may cause apprehension, but the infection is usually easily diagnosed and treated.

If you have a sore that could be an STI, it's important to get tested as soon as possible. Syphilis, which remains active in the body with or without symptoms, could eventually damage the body's organs and bones.

As many as 1 in 5 people in the United States have an STI. Remembering how common these infections are can help you to avoid shame about getting diagnosed and allow you to get the help you need.

Frequently Asked Questions

  • A syphilis rash is usually found on the palms or soles of the feet. Sometimes the rash, which usually consists of rough red and brown spots, can appear in other areas of the body and be very faint. A syphilis rash that is not on the palms or feet could be mistaken for other conditions like an allergic reaction, skin conditions like psoriasis, or other sexually transmitted infections.

  • A syphilis body rash usually occurs during the secondary stage, or about four to eight weeks after the first stage (or six to 11 weeks after infection). While it takes time for a rash to appear, it's advised to get tested and treated for syphilis as soon as the first stage, when a painless wart can appear around the mouth, genitals, rectum, or skin. Syphilis can remain in the body and be contagious to others, even without symptoms. It's also advised to get tested and treated if a sexual partner is diagnosed with syphilis.

  • Yes, syphilis is more contagious when a rash is present. The condition can be passed through skin-to-skin contact. However, even when a syphilis rash or sore is not present because a person has received treatment, it's important to use protection during sex for about two years after treatment. It's advised to avoid sexual contact when a sore is present.

  • Syphilis rashes are usually not itchy. The rashes usually appear as rough brown or red spots at the sole of the feet or in the palms. Sometimes syphilis rash can appear in other places, or it can be difficult to notice because it is faint.

13 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Neha Kashyap
Neha is a New York-based health journalist who has written for WebMD, ADDitude, HuffPost Life, and dailyRx News. Neha enjoys writing about mental health, elder care, innovative health care technologies, paying for health care, and simple measures that we all can take to work toward better health.

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