Early and Late Syphilis Explained: Key Signs You Shouldn’t Miss

Sexually transmitted infections (STIs) are more common than you might think, and syphilis is one of them. This bacterial infection, which has been around for centuries, can quietly wreak havoc on your health if left untreated. In recent years, the UK has seen a worrying rise in syphilis cases, with NHS data showing an increase of over 20% in some areas. The good news? Early detection and treatment can stop it in its tracks. Whether you’re a Londoner navigating the dating scene or someone simply looking out for their sexual health, understanding the signs of early and late syphilis could save you from serious complications. Let’s dive into what you need to know.

What is Syphilis?

Syphilis is caused by the bacterium Treponema pallidum and is primarily spread through unprotected sexual contact, including vaginal, anal, and oral sex. It can also be passed from mother to child during pregnancy, a condition known as congenital syphilis. What makes syphilis tricky is that it progresses in stages—primary, secondary, latent, and tertiary—each with its own set of symptoms. Early stages often go unnoticed because the symptoms can be mild or mistaken for other conditions. However, untreated syphilis can lead to severe health issues down the line, making awareness and timely action critical.

Early Syphilis: Signs and Symptoms

3.1 Primary Stage

The first sign of syphilis is usually a painless sore, called a chancre, that appears at the site of infection—often on the genitals, anus, or mouth. These sores are sneaky; they don’t hurt, and they might be hidden in areas you can’t easily see. They typically show up about 3 weeks after exposure but can take anywhere from 10 to 90 days. Because they’re painless, many people dismiss them or mistake them for something less serious. But here’s the kicker: this stage is highly contagious. If you spot any unusual sores, don’t ignore them—get checked immediately.

3.2 Secondary Stage

If syphilis isn’t treated during the primary stage, it moves into the secondary stage, usually within a few weeks to months. This phase is harder to miss because the symptoms are more noticeable. Think rashes (often on the palms of your hands or soles of your feet), flu-like symptoms such as fever and fatigue, and mucous membrane lesions (sores in your mouth or genital area). Unlike other STIs, these symptoms can come and go, which might make you think you’re recovering when, in fact, the infection is still there. This stage lasts a few weeks but can recur if untreated.

Late Syphilis: Signs and Risks

4.1 Latent Stage

After the secondary stage, syphilis enters the latent stage, where it becomes a silent intruder. During this period, which can last for years, there are no visible symptoms, but the bacteria are still present in your body. This is where regular STI screening becomes crucial. Without testing, you might not realise you have syphilis until it progresses to the most dangerous stage.

4.2 Tertiary Stage

If left untreated, syphilis can progress to the tertiary stage, which affects about 15-30% of people with the infection. At this point, the bacteria can damage vital organs like the heart, brain, and nervous system. Conditions like neurosyphilis (affecting the brain and spinal cord) and cardiovascular syphilis (damaging the heart and blood vessels) can develop, leading to life-altering complications. Imagine struggling with memory loss, paralysis, or even blindness—all because an infection wasn’t caught early. Scary, right? That’s why understanding the progression of syphilis is so important.

How Syphilis is Diagnosed in the UK

In the UK, diagnosing syphilis is straightforward and confidential. You can visit an NHS sexual health clinic or opt for private testing. A healthcare professional will likely take a blood sample to check for antibodies to the syphilis bacteria. If you have visible sores, they may also take a swab from the affected area. The results are usually available within a few days, and your privacy is guaranteed. Many clinics even offer walk-in appointments, making it easier than ever to get tested.

Treatment Options

The good news is that syphilis is treatable, especially when caught early. The standard treatment is a course of antibiotics, typically penicillin. For early-stage syphilis, a single injection is often enough to clear the infection. Late-stage syphilis might require multiple doses over a longer period. After treatment, follow-up tests are essential to confirm the infection has been fully eradicated. Remember, completing the full course of treatment is non-negotiable—even if you start feeling better.

Prevention and Safe Practices

Preventing syphilis starts with safe sex practices. Using condoms consistently and correctly reduces your risk significantly. Regular STI screenings are also key, especially if you’re sexually active with multiple partners. If you test positive, notifying your sexual partners is crucial so they can get tested and treated too. Open communication about sexual health might feel awkward, but it’s a vital step in breaking the cycle of transmission.

When to Seek Medical Help

Certain red flags should prompt immediate medical attention. These include persistent sores, unexplained rashes, or neurological symptoms like headaches, vision changes, or muscle weakness. Booking an appointment is easy in the UK—you can visit an NHS sexual health clinic or choose a private provider. Don’t wait for symptoms to worsen; early treatment can prevent long-term damage.

Conclusion

Syphilis might seem like an old-fashioned disease, but it’s very much alive and kicking in modern times. Recognising the differences between early and late syphilis is crucial for protecting your health. Early symptoms like painless sores and rashes are manageable with prompt treatment, while late-stage complications can be devastating. Regular sexual health check-ups aren’t just a precaution—they’re a necessity. By staying informed and proactive, you can take control of your sexual health and reduce the stigma surrounding STIs.

Don’t let fear or uncertainty stand in the way of your health. Book an appointment at a confidential STI clinic in the UK today. For more information, visit NHS Sexual Health Services or check out resources from trusted local clinics. Your health is worth it!