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What Is a Syphilis Sore?

A syphilis sore typically appears as a firm, round bump at the site of the initial syphilis infection. In some cases the sore may be open and wet. Syphilis sores are also called “chancres” and are usually painless. These sores are one of the first signs of infection. You may have one sore or many. Since these bumps don’t usually cause any discomfort, you might not know that you have them.

Where Do Syphilis Sores Appear?

Primary syphilis sores are found at the site where the infection entered your body, usually the genitals, rectum, or mouth. These sores are often confused for pimples or ingrown hairs. The lymph nodes by the groin may become enlarged around the time the sores appear, which can serve as an indicator that you’re dealing with something more than a harmless bump.

If your syphilis is not treated in the initial stage, you may get a skin rash. More small reddish-brown sores will appear as you enter the secondary stage. This rash begins on the trunk of your body and may spread to cover your extremities. The sores associated with a syphilis rash typically appear around the mouth or genitals.

When Do Syphilis Sores Show Up?

Syphilis sores can appear anywhere from three weeks to three months after infection. These sores typically last for three to six weeks. Though the initial syphilis sores will go away, this does not mean that the infection is gone.

If you enter the secondary stage, you may experience a rash and sores that last for two to six weeks. The symptoms associated with the second stage may come and go, laying dormant for up to two years between outbreaks. Regardless, it’s important to treat syphilis as early as possible to stop the disease from progressing.

What Are Other Symptoms of Syphilis?

The initial syphilis sores are the only symptom in the primary stage of the infection. In the secondary stage, you may experience:

  • Fever
  • Sore throat
  • Headaches
  • Hair loss
  • Weight loss
  • Fatigue
  • Muscle aches
  • Swollen lymph nodes

Symptoms of secondary syphilis can come and go. You can infect your partner even when you don’t have active symptoms of the infection.

What Should I Do About a Syphilis Sore?

If you notice a syphilis sore, you should see your local healthcare provider as soon as possible. Your doctor can perform a blood test or test fluid from the sore to determine whether you have syphilis.

Syphilis is easily treatable with antibiotics. However, this medication cannot repair damage that the infection has already done to the body. This is why it’s important to diagnose and treat syphilis as soon as possible.

What Happens If I Don’t Treat Syphilis?

If syphilis is left untreated, it may progress to the latent stage. This means that the infection is dormant, though the bacteria remains in the body. You will not experience any symptoms during this phase of the disease.

Untreated syphilis may also progress to the tertiary stage. Tertiary syphilis can cause damage to your internal organs and may even be fatal. The nervous system, brain, heart, and blood vessels can all be impacted. Tertiary syphilis typically occurs 10 to 30 years after the initial infection. Complications associated with tertiary syphilis include:

  • Stroke
  • Deafness
  • Numbness
  • Changes in personality
  • Inflammation or infection of the membranes around the spinal cord and brain
  • Aneurysm
  • Inflammation of blood vessels

During any stage, syphilis can spread to the nervous system causing neurosyphilis or reach the eye and cause ocular syphilis. Neurosyphilis can cause serious symptoms, including:

  • Paralysis
  • Numbness
  • Dementia
  • Trouble with coordination
  • Severe headaches

Ocular syphilis causes changes in vision and may even result in blindness.

Can I Get Syphilis More Than Once?

Yes, you can get syphilis multiple times. A partner may pass syphilis on even when their symptoms aren’t noticeable. Many syphilis sores go unseen because they can appear under the foreskin of the penis, inside the vagina, or in the rectum. If you’ve been diagnosed with syphilis, it’s best for all of your partners to get tested as well so they can receive proper treatment.

Your doctor will probably test you again for syphilis after your initial treatment to make sure the antibiotics were successful. It’s best to get routine STD screening so you can identify syphilis and other potential problems early.

What Happens if I’m Pregnant With Syphilis?

Your healthcare provider can treat syphilis during pregnancy. It’s best to receive treatment before you have the baby, as infants can become infected during birth. Untreated syphilis in pregnant women can also lead to premature birth, stillbirth, or death of the infant. Infants with syphilis typically have no symptoms, though some develop a rash on the soles of their feet and palms of their hands. Babies with syphilis may suffer from complications later which include:

  • Deafness
  • Saddle nose
  • Teeth deformities

Syphilis Statistics

Syphilis infections are on the rise in the United States. According to the Centers for Disease Control (CDC), there were 30,644 cases of primary and secondary syphilis reported in 2017. This translates to 9.5 cases per 100,000 people. The rate of reported syphilis infections has increased 10.5% since 2016 and 72.7% since 2013.

The most significant increase in syphilis cases occurred in the West. Instances of syphilis per region in the United States in 2017 were:

  • West: 13.2 cases per 100,000 individuals
  • South: 9.7 cases per 100,000 individuals
  • Northeast: 8 cases per 100,000 individuals
  • Midwest: 6.2 cases per 100,000 individuals

Syphilis is most common in men who have sex only with men, accounting for 52 percent of cases. Men who have sex with women account for 15 percent of cases, and men who have sex with men and women account for 6 percent of cases. Another 15 percent of infected men have not provided data on their sex partners. Just 12 percent of those infected with syphilis are women.

Though the complications associated with syphilis are serious, this disease is treatable. Getting regular STD testing that includes testing for syphilis can help protect you from this disease.

Further Reading

Syphilis – CDC Fact Sheet, Centers for Disease Control and Prevention

Sexually Transmitted Disease Surveillance 2017, Centers for Disease Control and Prevention

Management of syphilis during pregnancy, SA Health

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