Syphilis: a silent but dangerous disease
Why syphilis can continue for years without symptoms, what its stages are and when to get tested.
AuthorDr. Sheyla JafarovaDermatovenereologist, aesthetic dermatologist, acne expert
The most frightening thing about syphilis, a sexually transmitted infection, is that it can continue for years without any symptoms. A person feels healthy, but the bacteria stay active in the body and over time can damage the heart, blood vessels and nervous system.
How syphilis develops
- Primary stage: a painless sore with a firm base (chancre) at the site of infection that heals on its own within 3-6 weeks
- Secondary stage: a rash on the body, palms and soles, swollen lymph nodes, hair loss
- Latent stage: no symptoms at all; only a blood test reveals the disease
- Late stage: in some untreated people, damage to the heart and blood vessels, the nervous system and other organs years later
Because the sore is painless and heals by itself, many people are misled. The thought “it went away, so it was nothing” leaves the disease untreated and lets it move into its hidden stage. The nervous system and the eyes, however, can be affected at any stage.
When to get tested
- After unprotected sex
- When a partner has been diagnosed with an infection
- When planning a pregnancy and during pregnancy
- When you have a rash or sore with no obvious cause
Can it be cured?
Yes. Syphilis is treated mainly with penicillin and, if detected in time, can be fully cured. Damage to organs in the late stage, however, may be irreversible. Follow-up tests after treatment are important. Your partner also needs to be examined, otherwise reinfection is possible. Examination and treatment are fully confidential.
No symptoms does not mean no infection.
Scientific references
The information in this article is based on the following peer-reviewed papers and international clinical guidelines.
- Peeling, R. W., Mabey, D., Kamb, M. L., et al. (2017). Syphilis. Nature Reviews Disease Primers, 3, 17073. [PMID: 29022569] | [DOI: 10.1038/nrdp.2017.73]
- Ghanem, K. G., Ram, S., & Rice, P. A. (2020). The Modern Epidemic of Syphilis. The New England Journal of Medicine, 382(9), 845-854. [PMID: 32101666] | [DOI: 10.1056/NEJMra1901593]
- Workowski, K. A., Bachmann, L. H., Chan, P. A., et al. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1-187. [PMID: 34292926] | [DOI: 10.15585/mmwr.rr7004a1]
- US Preventive Services Task Force (2025). Screening for Syphilis Infection During Pregnancy: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA, 333(22), 2006-2012. [PMID: 40358930] | [DOI: 10.1001/jama.2025.5009]
