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Signs and symptoms

  • "The great imitator". You may not notice symptoms or may mistake symptoms for something else.
  • A sore (chancre) on the genitals, mouth or rectum usually appears1- 3 weeks after exposure, and can last up to 3 months.
  • A skin rash, often on the trunk, palms and soles, but not always, commonly starts 5 - 12 weeks after infection.
  • Swollen lymph nodes
  • Heaped up wart like lesion in gluteal folds, perineum or perianal
  • Neurosyphilis, which can occur at any stage of the disease:
    • Ringing in the ears or hearing loss
    • Vision changes, including vision loss
    • Other neurologic signs/symptoms


  • Oral, anal or vaginal sex
  • Infected mother to baby during birth


  • Use condoms/barriers consistently and correctly during oral, anal or vaginal sex
  • Maintain a mutually monogamous relationship with a partner who has been tested for syphilis and is not infected
  • Get tested regularly and treated for STDs
  • Get an infected partner treated
  • Do not have sex with a partner who has syphilis until they complete treatment


  • See a health care provider for exam and tests to figure out the best treatment
  • Treatment includes medicines prescribed by a health care provider and depends on the stage of infection
  • Neurosyphilis may require more intensive therapy
  • Get a follow-up exam to make sure the treatment has worked

If not treated

  • Can increase risk for getting HIV
  • Damage major organs including the brain, heart and liver
  • Damage blood vessels, bones, eyes and joints
  • Paralysis, blindness, dementia or death
  • Neurosyphilis:
    • Blindness - hearing loss - other irreversible condition
  • During pregnancy:
    • Premature delivery, birth defects including deafness & blindness - if left untreated, can lead to miscarriage or death in the newborn

If you have syphilis

  • Refrain from sex (oral, anal or vaginal sex) if there are symptoms
  • Seek medical care, including STD tests
  • Get tested for HIV
  • Do not have sex until you have completed treatment
  • Take all medicines prescribed, even if your symptoms are gone
  • Re-test in 1, 3, 6, 9 and 12 months
  • Make sure sex partners get treated
  • Get yearly STD screens if sexually active


For patients:

For King County health care providers: