03, Oct, 2025

What Are the Symptoms of Early vs. Late Syphilis?

Syphilis is a sexually transmitted infection (STI) that has been around for centuries, yet it remains an important health concern in the UK today. While it’s entirely treatable with antibiotics if caught early, untreated syphilis can lead to serious complications, including damage to the heart, brain, and other organs. Recognising the symptoms at different stages - early versus late - is crucial not only to protect your own health but also to prevent spreading the infection to others. In London, where STIs are on the rise, understanding how syphilis progresses could save you from long-term consequences.

What Is Syphilis, and How Does It Progress?

At its core, syphilis is caused by a spiral-shaped bacterium called Treponema pallidum. It spreads through direct contact with a syphilitic sore during unprotected sexual activity or even through kissing if there’s an open sore in the mouth. The infection unfolds in four distinct stages: primary, secondary, latent, and tertiary. Each stage comes with its own set of symptoms, making it vital to understand what to look out for.

Why does distinguishing between early and late syphilis matter? Early detection allows for effective treatment before the bacteria wreak havoc on your body. Once syphilis enters the late stage, irreversible damage may occur despite successful eradication of the bacteria. For those living in the UK, resources like NHS guidelines provide excellent support when navigating this condition.

Early Symptoms of Syphilis (Primary & Secondary Stages)

Primary Syphilis – First Signs After Infection

The journey begins shortly after exposure, typically within 10 days to three months. During this phase, known as primary syphilis, most people develop a single sore called a chancre at the site of infection. This sore is usually painless, which is why many people might overlook it. Common sites include the genitals, anus, rectum, or inside the mouth.

Accompanying the chancre, nearby lymph nodes may swell slightly. Since the sore heals on its own without treatment, some individuals mistakenly assume they’re fine. However, ignoring it means the infection moves into the next stage. If you notice such sores, especially after unprotected sex, don’t brush them off - they could be more than just a random bump.

Secondary Syphilis – Rash and Flu-Like Symptoms

A few weeks to months later, secondary syphilis kicks in. This stage is harder to miss because it often presents with a characteristic rash. Unlike typical rashes, this one tends to appear on the palms of the hands and soles of the feet - and it doesn’t itch. Other signs include mucous patches in the mouth, wart-like growths around the genital area, and patchy hair loss.

To make matters worse, flu-like symptoms often accompany these skin changes. You might experience fever, fatigue, headaches, swollen lymph nodes, and unexpected weight loss. These symptoms can mimic other illnesses, leading some people to dismiss them as a common cold or stress-related issues. But remember, if you’ve had unprotected sex recently, these could be red flags pointing to syphilis.

Latent Syphilis – Hidden but Dangerous

After the drama of the first two stages fades, syphilis enters a sneaky phase called latent syphilis. Here, the infection goes undercover; there are no visible symptoms, but the bacteria remain active in your system. Latent syphilis itself splits into two categories: early latent (lasting less than two years) and late latent (lasting more than two years).

During this time, the absence of symptoms doesn’t mean you’re safe. Without treatment, the infection can silently progress to the final and most destructive stage: tertiary syphilis. Regular testing is key here, particularly if you’ve engaged in high-risk behaviours or haven’t been screened recently.

Late / Tertiary Syphilis Symptoms

If syphilis remains untreated, it reaches its most severe form: tertiary syphilis. By this point, the infection has likely persisted for years - even decades. Unfortunately, the damage inflicted during this stage can be permanent and life-threatening. Let’s break down the major complications associated with late-stage syphilis:

Neurological Complications (Neurosyphilis)

When syphilis affects the nervous system, it leads to neurosyphilis. Symptoms vary widely but often include memory problems resembling dementia, difficulty coordinating movements, numbness, vision disturbances, and even stroke-like episodes. Hearing loss is another potential consequence. Imagine struggling to recall simple tasks or experiencing unexplained dizziness - these could all stem from untreated syphilis affecting your brain.

Cardiovascular Complications

Another alarming aspect of late syphilis is its impact on the cardiovascular system. Aortitis, inflammation of the aorta, weakens the walls of this major blood vessel, potentially causing aneurysms. Chest pain, shortness of breath, and irregular heartbeat are warning signs that shouldn’t be ignored. Left unchecked, these issues can escalate into heart failure or sudden death.

Gummas and Other Organ Damage

Tertiary syphilis can also cause gummas - soft, tumour-like lesions that destroy tissue in various parts of the body, including the skin, bones, liver, and other organs. These lesions are not cancerous but can still impair function and quality of life. Picture dealing with chronic ulcers or debilitating joint pain - all stemming from an infection that could have been treated years ago.

When Should You Seek Medical Advice in the UK?

Knowing when to seek medical help is critical. If you’ve had unprotected sex, especially with a new partner, or if you notice any unusual symptoms like sores, rashes, or flu-like feelings, it’s time to get tested. In London, you have several options:NHS sexual health clinics offer free and confidential services, while private STD clinics provide quicker appointments if needed.

Testing is straightforward - a simple blood test can confirm whether you have syphilis. And here’s the good news: penicillin, the standard treatment, works effectively at every stage of the infection. While it won’t undo damage already done in the late stages, it will stop the bacteria from causing further harm. Don’t delay - acting fast makes all the difference.

Know the Signs, Take Action

If you notice unusual symptoms, act fast. Schedule a private consultation now to detect and treat syphilis early.

Final Thoughts

From the initial painless sore of primary syphilis to the devastating effects of tertiary syphilis, the progression of this STI highlights why vigilance is so important. Early recognition and treatment can prevent a host of complications, ensuring your health stays intact. Whether you live in bustling central London or quieter suburbs, routine STI checks should be part of your healthcare routine.

Remember, knowledge is power. Armed with information about the stages and symptoms of syphilis, you’re better equipped to protect yourself and others. So, if you notice anything unusual - whether it’s a strange sore, a persistent rash, or lingering fatigue - don’t hesitate. Book an appointment with a sexual health clinic in London or your local NHS service today. Your future self will thank you.