Table of ContentsView AllTable of ContentsWhat It Looks LikeSimilar RashesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What It Looks Like
Similar Rashes
Diagnosis
Treatment
Signs of the primary stage ofsyphiliscan include small sores, calledchancres, that appear within three weeks of exposure near the site of the exposure. Later, the syphilis rash emerges, in some cases with other symptoms like fatigue, fever, andswollen lymph nodes.
The infection is most often passed via sexual contact but infection can occur during childbirth (congenital) or sometimes breastfeeding.
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Identifying a Syphilis Rash
A syphilis rash doesn’t affect everyone who becomes infected. In fact, many people infected with syphilis are eitherasymptomatic(without symptoms) or they have mild, often unrecognized symptoms.
The secondary stage generally starts four to eight weeks after the primary stage.These are the initial two stages, with latent and late/tertiary phases being the other two. Skin lesions are common with primary, secondary, and tertiary syphilis.
Other skin lesions may accompany the syphilis rash, including:
A syphilis rash usually resolves within two to six weeks. However, in some people, the rash may come and go for up to two years after the initial rash heals.
Other Syphilis SymptomsApart from a faint syphilis rash, other symptoms of secondary syphilis include:FeverFatigueWeaknessMuscle achesSore throatUnintended weight lossHeadachesSwollen lymph nodesEven if the rash is faint, persistent symptoms like these may be a red flag to get tested for syphilis.
Other Syphilis Symptoms
Apart from a faint syphilis rash, other symptoms of secondary syphilis include:FeverFatigueWeaknessMuscle achesSore throatUnintended weight lossHeadachesSwollen lymph nodesEven if the rash is faint, persistent symptoms like these may be a red flag to get tested for syphilis.
Apart from a faint syphilis rash, other symptoms of secondary syphilis include:
Even if the rash is faint, persistent symptoms like these may be a red flag to get tested for syphilis.
Syphilis can mimic many other conditions, which is why some refer to it as the “Great Pretender.” This can make diagnosis challenging. The following are some conditions that syphilis can be confused for:
Secondary syphilis is diagnosed with a blood test. Your healthcare provider may also take a swab of an open sore to look for signs ofTreponema pallidumin the body fluids.
There are also at-home tests that require a few drops of blood on a test card. The card is then mailed to the manufacturer, and the results are delivered via a secure website within three to five days. Though convenient, these tests are less accurate than lab-based tests and prone to user error.
It’s important to note that you do not need to have symptoms to get tested for syphilis. The Centers for Disease Control and Prevention (CDC) recommends syphilis testing for the following at-risk groups:
Syphilis is treated with antibiotics like penicillin shots or infusions. The dosage depends on the current stage of the condition. Early stages of syphilis may only need one shot of penicillin. Late stages require three shots of penicillin with one given each week for three weeks.
Syphilis treatment also includes follow-up blood tests to check if the bacterium is still present. AnnualSTI screeningcan be considered in some people at higher risk.Keep in mind that syphilis that’s successfully treated won’t come back, but you can have a new infection later.
How to Prevent the Spread of Syphilis
Summary
A syphilis rash refers to an outbreak of rash during the secondary stage of infection. Not everyone who gets syphilis will get a syphilis rash but for those who do, the non-itchy rash on the torso, palms, and soles can sometimes be so faint that it is hard to see. You also may experience red or brownish sores that feel rough and scaly, or wart-like growths, mouth sores, patchy hair loss, and small pus-filled pimples.
For this reason, it’s important to recognize the other signs and symptoms of syphilis (including fever, fatigue, and swollen lymph nodes) so that you can seek early diagnosis and treatment. This is especially true if you’ve recently had unprotected sex or other risk factors for infection.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peeling RW, Mabey D, Lamb ML, Chen XS, Radolf JD, Benzaken AS.Syphilis.Nat Rev Dis Primers,2017 Oct 12;3:17073. doi:10.1038/nrdp.2017.73Whiting C, Schwartzman G, Khachemoune A.Syphilis in dermatology: recognition and management.Am J Clin Dermatol.2023;24(2):287–297. doi:10.1007/s40257-022-00755-3Department of Health and Human Services, Office of Women’s Health.Sexually transmitted infections, pregnancy, and breastfeeding.World Health Organization.Syphilis.American Academy of Dermatology Association.Syphilis: signs and symptoms.Lopez P, Kwentoh I, Imbert MV.A peculiar presentation of syphilis as a mysterious rash: a dermatological dilemma.Cureus.2023 Sep;15(9):e45328. doi:10.7759/cureus.45328MedlinePlus.Syphilis.Carnevale C, Richards P, Cohall R.At home testing for sexually transmitted infections during the COVID-19 pandemic.Sex Transm Dis.2021 Jan;48(1):e11–e14. doi:10.1097/OLQ.0000000000001313Centers for Disease Control and Prevention.Sexually transmitted infection treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Academy of Dermatology Association.Syphilis: Diagnosis and treatment.Planned Parenthood.How is syphilis prevented?
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peeling RW, Mabey D, Lamb ML, Chen XS, Radolf JD, Benzaken AS.Syphilis.Nat Rev Dis Primers,2017 Oct 12;3:17073. doi:10.1038/nrdp.2017.73Whiting C, Schwartzman G, Khachemoune A.Syphilis in dermatology: recognition and management.Am J Clin Dermatol.2023;24(2):287–297. doi:10.1007/s40257-022-00755-3Department of Health and Human Services, Office of Women’s Health.Sexually transmitted infections, pregnancy, and breastfeeding.World Health Organization.Syphilis.American Academy of Dermatology Association.Syphilis: signs and symptoms.Lopez P, Kwentoh I, Imbert MV.A peculiar presentation of syphilis as a mysterious rash: a dermatological dilemma.Cureus.2023 Sep;15(9):e45328. doi:10.7759/cureus.45328MedlinePlus.Syphilis.Carnevale C, Richards P, Cohall R.At home testing for sexually transmitted infections during the COVID-19 pandemic.Sex Transm Dis.2021 Jan;48(1):e11–e14. doi:10.1097/OLQ.0000000000001313Centers for Disease Control and Prevention.Sexually transmitted infection treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Academy of Dermatology Association.Syphilis: Diagnosis and treatment.Planned Parenthood.How is syphilis prevented?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Peeling RW, Mabey D, Lamb ML, Chen XS, Radolf JD, Benzaken AS.Syphilis.Nat Rev Dis Primers,2017 Oct 12;3:17073. doi:10.1038/nrdp.2017.73Whiting C, Schwartzman G, Khachemoune A.Syphilis in dermatology: recognition and management.Am J Clin Dermatol.2023;24(2):287–297. doi:10.1007/s40257-022-00755-3Department of Health and Human Services, Office of Women’s Health.Sexually transmitted infections, pregnancy, and breastfeeding.World Health Organization.Syphilis.American Academy of Dermatology Association.Syphilis: signs and symptoms.Lopez P, Kwentoh I, Imbert MV.A peculiar presentation of syphilis as a mysterious rash: a dermatological dilemma.Cureus.2023 Sep;15(9):e45328. doi:10.7759/cureus.45328MedlinePlus.Syphilis.Carnevale C, Richards P, Cohall R.At home testing for sexually transmitted infections during the COVID-19 pandemic.Sex Transm Dis.2021 Jan;48(1):e11–e14. doi:10.1097/OLQ.0000000000001313Centers for Disease Control and Prevention.Sexually transmitted infection treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Academy of Dermatology Association.Syphilis: Diagnosis and treatment.Planned Parenthood.How is syphilis prevented?
Peeling RW, Mabey D, Lamb ML, Chen XS, Radolf JD, Benzaken AS.Syphilis.Nat Rev Dis Primers,2017 Oct 12;3:17073. doi:10.1038/nrdp.2017.73
Whiting C, Schwartzman G, Khachemoune A.Syphilis in dermatology: recognition and management.Am J Clin Dermatol.2023;24(2):287–297. doi:10.1007/s40257-022-00755-3
Department of Health and Human Services, Office of Women’s Health.Sexually transmitted infections, pregnancy, and breastfeeding.
World Health Organization.Syphilis.
American Academy of Dermatology Association.Syphilis: signs and symptoms.
Lopez P, Kwentoh I, Imbert MV.A peculiar presentation of syphilis as a mysterious rash: a dermatological dilemma.Cureus.2023 Sep;15(9):e45328. doi:10.7759/cureus.45328
MedlinePlus.Syphilis.
Carnevale C, Richards P, Cohall R.At home testing for sexually transmitted infections during the COVID-19 pandemic.Sex Transm Dis.2021 Jan;48(1):e11–e14. doi:10.1097/OLQ.0000000000001313
Centers for Disease Control and Prevention.Sexually transmitted infection treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.
American Academy of Dermatology Association.Syphilis: Diagnosis and treatment.
Planned Parenthood.How is syphilis prevented?
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