Syphilis in Men: Symptoms & Progression

We͏͏ call͏͏ syphilis͏͏ the͏͏ "great͏͏ imitator"͏͏ because͏͏ it͏͏ can͏͏ appear͏͏ as͏͏ though͏͏ a͏͏ person͏͏ has͏͏ almost͏͏ any͏͏ other͏͏ disease.͏͏ This͏͏ STI͏͏ has͏͏ become͏͏ more͏͏ common͏͏ in͏͏ recent͏͏ times,͏͏ particularly͏͏ among͏͏ males.͏͏ Although͏͏ the͏͏ initial͏͏ symptoms͏͏ and͏͏ signs͏͏ of͏͏ this͏͏ STI͏͏ are͏͏ usually͏͏ very͏͏ mild͏͏ and͏͏ at͏͏ times͏͏ not͏͏ even͏͏ noticeable,͏͏ if͏͏ the͏͏ disease͏͏ is͏͏ not͏͏ treated,͏͏ it͏͏ can͏͏ have͏͏ serious͏͏ complications͏͏ that͏͏ include͏͏ the͏͏ failure͏͏ of͏͏ organs͏͏ and͏͏ damage͏͏ to͏͏ the͏͏ nervous͏͏ system.

02 February 2025

8 min read

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The͏͏ CDC͏͏ reports͏͏ that͏͏ syphilis͏͏ diagnoses͏͏ are͏͏ markedly͏͏ on͏͏ the͏͏ rise,͏͏ especially͏͏ among͏͏ males͏͏ who͏͏ have͏͏ intercourse͏͏ with͏͏ men.͏͏ More͏͏ than͏͏ 176,000͏͏ new͏͏ syphilis͏͏ cases͏͏ were͏͏ reported͏͏ in͏͏ the͏͏ US͏͏ during͏͏ 2021,͏͏ up͏͏ 32%͏͏ from͏͏ the͏͏ year͏͏ prior.

Sufficient͏͏ knowledge͏͏ of͏͏ the͏͏ stages͏͏ and͏͏ signs͏͏ of͏͏ syphilis͏͏ is͏͏ crucial͏͏ for͏͏ its͏͏ early͏͏ identification͏͏ and͏͏ intervention.͏͏ This͏͏ article͏͏ will͏͏ outline͏͏ the͏͏ signs͏͏ and͏͏ symptoms͏͏ of͏͏ syphilis͏͏ in͏͏ men,͏͏ the͏͏ stages͏͏ the͏͏ infection͏͏ passes͏͏ through,͏͏ and͏͏ testing͏͏ for͏͏ the͏͏ infection.

Stage͏͏ One:͏͏ The͏͏ First͏͏ Signs

The͏͏ incubation͏͏ period͏͏ of͏͏ most͏͏ syphilis͏͏ infections͏͏ is͏͏ three͏͏ weeks,͏͏ though͏͏ the͏͏ disease͏͏ manifests͏͏ clinically͏͏ from͏͏ ten͏͏ to͏͏ ninety͏͏ days͏͏ following͏͏ exposure.

Symptoms͏͏ of͏͏ Primary͏͏ Syphilis͏͏ in͏͏ Men

A͏͏ painless͏͏ sore:͏͏ You͏͏ can͏͏ have͏͏ such͏͏ a͏͏ sore͏͏ on͏͏ your͏͏ lips,͏͏ mouth,͏͏ scrotum,͏͏ or͏͏ penis.͏͏ It͏͏ is͏͏ round,͏͏ firm,͏͏ and͏͏ does͏͏ not͏͏ itch.
Single͏͏ blister͏͏ or͏͏ multiple͏͏ blisters:͏͏ Though͏͏ it͏͏ is͏͏ possible͏͏ to͏͏ have͏͏ multiple͏͏ chancres,͏͏ a͏͏ single͏͏ sore͏͏ is͏͏ more͏͏ common.
It͏͏ heals͏͏ with͏͏ no͏͏ treatment:͏͏ While͏͏ the͏͏ sore͏͏ may͏͏ heal͏͏ within͏͏ three͏͏ to͏͏ six͏͏ weeks,͏͏ the͏͏ infection͏͏ will͏͏ not͏͏ go͏͏ away͏͏ unless͏͏ you͏͏ get͏͏ antibiotics.

An͏͏ Actual͏͏ World͏͏ Example:͏͏ Ignoring͏͏ the͏͏ Initial͏͏ Indications

A͏͏ 34-year-old͏͏ man͏͏ named͏͏ James͏͏ from͏͏ New͏͏ York͏͏ thought͏͏ he͏͏ had͏͏ an͏͏ ingrown͏͏ hair͏͏ when͏͏ he͏͏ noticed͏͏ a͏͏ small,͏͏ painless͏͏ lesion͏͏ on͏͏ his͏͏ genital.͏͏ He͏͏ did͏͏ not͏͏ seek͏͏ medical͏͏ care͏͏ because͏͏ he͏͏ thought͏͏ it͏͏ would͏͏ heal͏͏ by͏͏ itself.͏͏ Several͏͏ weeks͏͏ later,͏͏ he͏͏ developed͏͏ a͏͏ systemic͏͏ rash͏͏ that͏͏ showed͏͏ he͏͏ had͏͏ entered͏͏ the͏͏ secondary͏͏ stage͏͏ of͏͏ syphilis.͏͏ James͏͏ could͏͏ have͏͏ avoided͏͏ further͏͏ complications͏͏ if͏͏ he͏͏ had͏͏ been͏͏ tested͏͏ earlier.

Stage͏͏ Two:͏͏ The͏͏ Generalized͏͏ Rash͏͏ and͏͏ Flu-Like͏͏ Symptoms

A͏͏ secondary͏͏ stage͏͏ of͏͏ syphilis͏͏ will͏͏ develop͏͏ a͏͏ few͏͏ weeks͏͏ to͏͏ months͏͏ after͏͏ the͏͏ initial͏͏ sore͏͏ has͏͏ disappeared,͏͏ if͏͏ the͏͏ disease͏͏ has͏͏ not͏͏ been͏͏ treated.

Symptoms͏͏ of͏͏ Secondary͏͏ Syphilis͏͏ in͏͏ Men

Skin͏͏ itch:͏͏ Most͏͏ of͏͏ the͏͏ time,͏͏ skin͏͏ surfaces͏͏ of͏͏ feet͏͏ and͏͏ hands͏͏ show͏͏ symptoms.͏͏ There͏͏ is͏͏ an͏͏ outbreak͏͏ of͏͏ rough,͏͏ red,͏͏ or͏͏ brown͏͏ spots͏͏ on͏͏ the͏͏ skin͏͏ but͏͏ not͏͏ itchy.
Flue Symptoms: Classic͏͏ symptoms͏͏ of͏͏ flu͏͏ such͏͏ as͏͏ fever,͏͏ swollen͏͏ lymph͏͏ nodes,͏͏ sore͏͏ throat,͏͏ muscle͏͏ and͏͏ joint͏͏ pains͏͏ and͏͏ fatigue.
Hair Loss: Partial͏͏ hair͏͏ loss͏͏ is͏͏ experienced͏͏ by͏͏ certain͏͏ males͏͏ due͏͏ to͏͏ no͏͏ seeming͏͏ causes.
Skin Lesions: The͏͏ skin͏͏ lesions͏͏ occurring͏͏ to͏͏ the͏͏ mucous͏͏ membranes͏͏ are͏͏ seen͏͏ as͏͏ ulcers͏͏ in͏͏ the͏͏ mouth͏͏ and͏͏ vagina The͏͏ most͏͏ prevalent͏͏ area͏͏ of͏͏ growth͏͏ of͏͏ condyloma͏͏ latas,͏͏ a͏͏ huge͏͏ wart-like͏͏ blister͏͏ is͏͏ in͏͏ the͏͏ groin͏͏ area.

According͏͏ to͏͏ WHO,͏͏ rashes͏͏ of͏͏ the͏͏ palms͏͏ and͏͏ soles͏͏ occur͏͏ in͏͏ 40-50%͏͏ of͏͏ males͏͏ suffering͏͏ from͏͏ secondary͏͏ syphilis.͏͏ Many͏͏ patients͏͏ delay͏͏ seeking͏͏ needed͏͏ treatment͏͏ due͏͏ to͏͏ a͏͏ mistaken͏͏ belief͏͏ that͏͏ these͏͏ symptoms͏͏ result͏͏ from͏͏ an͏͏ easily͏͏ treatable͏͏ skin͏͏ irritation.

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Experts͏͏ in͏͏ Secondary͏͏ Syphilis:͏͏ A͏͏ Quote͏͏ from͏͏ the͏͏ CDC

"Because͏͏ the͏͏ symptoms͏͏ of͏͏ secondary͏͏ syphilis͏͏ are͏͏ mild͏͏ and͏͏ disappear͏͏ on͏͏ their͏͏ own,͏͏ many͏͏ cases͏͏ of͏͏ the͏͏ disease͏͏ go͏͏ undiagnosed. If͏͏ the͏͏ infection͏͏ is͏͏ left͏͏ untreated,͏͏ however,͏͏ the͏͏ disease͏͏ will͏͏ progress͏͏ further͏͏ and͏͏ become͏͏ more͏͏ serious.͏͏"

This͏͏ is͏͏ the͏͏ CDC's͏͏ fact͏͏ sheet͏͏ on͏͏ syphilis.

Latent Stage:͏͏ The͏͏ Infection͏͏ That͏͏ Is͏͏ Not͏͏ Visible

Syphilis͏͏ becomes͏͏ latent͏͏ after͏͏ the͏͏ secondary͏͏ symptoms͏͏ have͏͏ cleared͏͏ up.͏͏ During͏͏ this͏͏ stage͏͏ of͏͏ the͏͏ disease,͏͏ there͏͏ are͏͏ no͏͏ signs͏͏ and͏͏ symptoms͏͏ of͏͏ the͏͏ infection.͏͏ This͏͏ stage͏͏ can͏͏ last͏͏ for͏͏ years,͏͏ possibly͏͏ even͏͏ decades.

Understanding͏͏ Latent͏͏ Syphilis

Early͏͏ latent͏͏ syphilis͏͏ is͏͏ highly͏͏ contagious͏͏ during͏͏ the͏͏ first͏͏ year.

Key͏͏ Facts͏͏ About͏͏ Latent͏͏ Syphilis

Early͏͏ latent͏͏ syphilis͏͏ (first͏͏ year):͏͏ Still͏͏ highly͏͏ contagious.
Late͏͏ latent͏͏ syphilis͏͏ (after͏͏ a͏͏ year):͏͏ Non-contagious͏͏ but͏͏ still͏͏ active.
May͏͏ never͏͏ progress͏͏ to͏͏ tertiary͏͏ stage,͏͏ but͏͏ without͏͏ treatment,͏͏ there’s͏͏ always͏͏ a͏͏ risk.

The͏͏ call͏͏ for͏͏ testing͏͏ is͏͏ then͏͏ reiterated͏͏ when͏͏ men͏͏ reach͏͏ this͏͏ point͏͏ because͏͏ without͏͏ the͏͏ symptoms,͏͏ they͏͏ may͏͏ be͏͏ tricked͏͏ into͏͏ thinking͏͏ that͏͏ they͏͏ are͏͏ cured.

Tertiary͏͏ Stage:͏͏ Potentially͏͏ Deadly͏͏ Complications

If͏͏ syphilis͏͏ is͏͏ not͏͏ treated,͏͏ then͏͏ it͏͏ can͏͏ progress͏͏ into͏͏ tertiary͏͏ syphilis;͏͏ 30͏͏ percent͏͏ of͏͏ cases͏͏ do͏͏ develop͏͏ the͏͏ long-term͏͏ damage.͏͏ This͏͏ could͏͏ be͏͏ many͏͏ years,͏͏ sometimes͏͏ decades͏͏ since͏͏ one͏͏ got͏͏ infected.

Tertiary͏͏ Syphilis͏͏ Symptoms͏͏ in͏͏ Men

Neurosyphilis͏͏: Neurosyphilis͏͏ can͏͏ cause͏͏ such͏͏ symptoms͏͏ as͏͏ amnesia,͏͏ abnormal͏͏ behavior,͏͏ loss͏͏ of͏͏ vision,͏͏ and͏͏ inability͏͏ to͏͏ coordinate͏͏ muscular͏͏ movements.
Cardiovascular͏͏ Syphilis͏͏: Cardiovascular͏͏ syphilis͏͏ results͏͏ in͏͏ aneurysms͏͏ because͏͏ the͏͏ disease͏͏ causes͏͏ damage͏͏ to͏͏ the͏͏ heart͏͏ and͏͏ blood͏͏ vessels.
Gummas: Gummas͏͏ are͏͏ noncancerous͏͏ growths͏͏ that͏͏ can͏͏ cause͏͏ damage͏͏ to͏͏ tissues.͏͏ Skin,͏͏ liver,͏͏ and͏͏ bones͏͏ are͏͏ common͏͏ places͏͏ for͏͏ them͏͏ to͏͏ appear.

Late-Stage͏͏ Complications:͏͏ A͏͏ Case͏͏ Study

In͏͏ 2018,͏͏ a͏͏ 49-year-old͏͏ man͏͏ from͏͏ the͏͏ UK͏͏ was͏͏ diagnosed͏͏ with͏͏ neurosyphilis͏͏ following͏͏ a͏͏ period͏͏ of͏͏ confusion͏͏ and͏͏ behavioral͏͏ abnormalities.͏͏ His͏͏ neurological͏͏ system͏͏ was͏͏ permanently͏͏ damaged͏͏ due͏͏ to͏͏ the͏͏ syphilis͏͏ he͏͏ suffered͏͏ from,͏͏ which͏͏ was͏͏ left͏͏ untreated͏͏ for͏͏ almost͏͏ fifteen͏͏ years.

The͏͏ Mayo͏͏ Clinic͏͏ on͏͏ Advanced͏͏ Syphilis:͏͏ An͏͏ Expert͏͏ Opinion

"Tertiary͏͏ syphilis͏͏ can͏͏ affect͏͏ multiple͏͏ organ͏͏ systems,͏͏ often͏͏ causing͏͏ irreversible͏͏ damage.͏͏ The͏͏ only͏͏ way͏͏ to͏͏ prevent͏͏ serious͏͏ complications͏͏ is͏͏ to͏͏ get͏͏ treatment͏͏ as͏͏ early͏͏ as͏͏ possible.͏͏" -͏͏ Dr.͏͏ Robert͏͏ Friedman͏͏ of͏͏ Mayo͏͏ Clinic

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Reasons͏͏ for͏͏ Syphilis͏͏ Testing

Due͏͏ to͏͏ the͏͏ mildness͏͏ or͏͏ misinterpretation͏͏ of͏͏ syphilis͏͏ symptoms,͏͏ testing͏͏ remains͏͏ the͏͏ only͏͏ sure͏͏ way͏͏ of͏͏ confirming͏͏ an͏͏ infection.

You͏͏ Should͏͏ Get͏͏ Tested͏͏ If

You͏͏ notice͏͏ any͏͏ sores,͏͏ rashes,͏͏ or͏͏ unexplained͏͏ symptoms.
You’ve͏͏ had͏͏ unprotected͏͏ sex͏͏ with͏͏ a͏͏ new͏͏ or͏͏ multiple͏͏ partners.
You’re͏͏ a͏͏ man͏͏ who͏͏ has͏͏ sex͏͏ with͏͏ men͏͏ (MSM)͏͏ –͏͏ a͏͏ high-risk͏͏ group͏͏ for͏͏ syphilis.
You’re͏͏ pregnant͏͏ –͏͏ syphilis͏͏ can͏͏ be͏͏ transmitted͏͏ to͏͏ an͏͏ unborn͏͏ baby.

Types͏͏ of͏͏ Syphilis͏͏ Tests

Blood͏͏ tests:͏͏ Detect͏͏ antibodies͏͏ for͏͏ syphilis.
Dark-field͏͏ microscopy:͏͏ Identifies͏͏ the͏͏ syphilis͏͏ bacteria͏͏ in͏͏ sores.
Lumbar͏͏ puncture:͏͏ Used͏͏ for͏͏ suspected͏͏ neurosyphilis.

Centers͏͏ for͏͏ Disease͏͏ Control͏͏ and͏͏ Prevention͏͏ recommend͏͏ that͏͏ all͏͏ sexually͏͏ active͏͏ men,͏͏ especially͏͏ those͏͏ who͏͏ engage͏͏ in͏͏ sexual͏͏ activities͏͏ with͏͏ men,͏͏ or͏͏ have͏͏ multiple͏͏ sex͏͏ partners͏͏ should͏͏ undergo͏͏ syphilis͏͏ testing͏͏ during͏͏ their͏͏ routine͏͏ STI͏͏ check-ups.

FAQs

1.͏͏ How͏͏ long͏͏ after͏͏ a͏͏ man͏͏ has͏͏ contracted͏͏ syphilis͏͏ will͏͏ he͏͏ start͏͏ developing͏͏ symptoms?

Symptoms͏͏ of͏͏ primary͏͏ syphilis͏͏ typically͏͏ appear͏͏ three͏͏ weeks͏͏ after͏͏ exposure,͏͏ but͏͏ they͏͏ can͏͏ appear͏͏ anywhere͏͏ from͏͏ ten͏͏ to͏͏ ninety͏͏ days͏͏ after͏͏ exposure.

2. Does͏͏ syphilis͏͏ ever͏͏ go͏͏ away͏͏ by͏͏ itself?͏͏

If͏͏ left͏͏ untreated,͏͏ syphilis͏͏ won't͏͏ go͏͏ away.͏͏ It͏͏ will͏͏ linger͏͏ and͏͏ then͏͏ spread.͏͏ The͏͏ early͏͏ symptoms͏͏ may͏͏ disappear,͏͏ but͏͏ the͏͏ disease͏͏ progresses͏͏ to͏͏ more͏͏ serious͏͏ stages.

3.- Sores͏͏ from͏͏ syphilis͏͏ look͏͏ like͏͏ what?

Round,͏͏ firm,͏͏ and͏͏ painless,͏͏ chancres͏͏ are͏͏ sores͏͏ that͏͏ start͏͏ to͏͏ develop͏͏ when͏͏ one͏͏ has͏͏ syphilis.͏͏ They͏͏ can͏͏ occur͏͏ on͏͏ the͏͏ infected͏͏ penis,͏͏ anus,͏͏ lips,͏͏ or͏͏ mouth.

4.͏͏ Can͏͏ syphilis͏͏ be͏͏ transmitted͏͏ in͏͏ other͏͏ ways͏͏ than͏͏ sexual?

Yes,͏͏ one͏͏ can͏͏ get͏͏ syphilis͏͏ by͏͏ contacting͏͏ an͏͏ infected͏͏ syphilis͏͏ sore͏͏ by͏͏ mere͏͏ touching.͏͏ Sharing͏͏ needles,͏͏ oral͏͏ intercourse,͏͏ or͏͏ kissing͏͏ can͏͏ also͏͏ be͏͏ examples͏͏ of͏͏ this.

5.͏͏ How͏͏ is͏͏ syphilis͏͏ diagnosed?

Neurosyphilis͏͏ can͏͏ only͏͏ be͏͏ diagnosed͏͏ from͏͏ a͏͏ lumbar͏͏ puncture͏͏ whereas͏͏ the͏͏ diagnosis͏͏ is͏͏ made͏͏ by͏͏ means͏͏ of͏͏ blood͏͏ testing,͏͏ dark-field͏͏ microscopy͏͏ to͏͏ visualize͏͏ sores͏͏ for͏͏ bacteria,͏͏ as͏͏ well͏͏ as͏͏ suspected͏͏ neurosyphilis.

6. Can͏͏ syphilis͏͏ be͏͏ cured?͏͏

Definitely͏͏ yes,͏͏ syphilis͏͏ can͏͏ be͏͏ cured͏͏ with͏͏ just͏͏ one͏͏ dose͏͏ of͏͏ penicillin.͏͏ On͏͏ the͏͏ other͏͏ hand,͏͏ it͏͏ is͏͏ unclear͏͏ whether͏͏ or͏͏ not͏͏ late-stage͏͏ can͏͏ be͏͏ treated͏͏ for͏͏ syphilis.

7.͏͏ Can͏͏ syphilis͏͏ cause͏͏ men͏͏ to͏͏ become͏͏ sterile?

While͏͏ syphilis͏͏ on͏͏ its͏͏ own͏͏ cannot͏͏ lead͏͏ to͏͏ infertility,͏͏ it͏͏ can͏͏ predispose͏͏ one͏͏ to͏͏ other͏͏ illnesses͏͏ leading͏͏ to͏͏ infertility,͏͏ which͏͏ cannot͏͏ be͏͏ treated.͏͏

8.͏͏ Can͏͏ a͏͏ person͏͏ get͏͏ syphilis͏͏ more͏͏ than͏͏ once?

A͏͏ previous͏͏ case͏͏ of͏͏ syphilis͏͏ does͏͏ not͏͏ exclude͏͏ a͏͏ subsequent͏͏ illness.͏͏ There͏͏ is͏͏ the͏͏ possibility͏͏ of͏͏ reinfection͏͏ following͏͏ subsequent͏͏ exposure.

9.͏͏ What͏͏ will͏͏ happen͏͏ if͏͏ syphilis͏͏ is͏͏ not͏͏ treated?

Worst-in͏͏ tertiary͏͏ syphilis͏͏ can͏͏ result͏͏ in͏͏ blindness,͏͏ paralysis,͏͏ heart͏͏ disease,͏͏ neurosyphilis,͏͏ which͏͏ is͏͏ damage͏͏ to͏͏ your͏͏ brain,͏͏ and͏͏ even͏͏ death͏͏ if͏͏ not͏͏ treated.

10.͏͏ How͏͏ can͏͏ I͏͏ avoid͏͏ getting͏͏ syphilis?

You͏͏ can͏͏ help͏͏ prevent͏͏ syphilis͏͏ by:

Always͏͏ using͏͏ a͏͏ condom͏͏ and͏͏ a͏͏ dental͏͏ dam͏͏ when͏͏ having͏͏ sex.
Getting͏͏ tested͏͏ for͏͏ STDs͏͏ regularly.͏͏ Anyone͏͏ who's͏͏ sexually͏͏ active͏͏ should͏͏ be͏͏ tested͏͏ periodically.
Avoiding͏͏ direct͏͏ contact͏͏ with͏͏ syphilis͏͏ sores.
Tell͏͏ your͏͏ partners͏͏ to͏͏ get͏͏ tested͏͏ and͏͏ treated.

Watch͏͏ out͏͏ for͏͏ the͏͏ Signs͏͏ and͏͏ Symptoms

If͏͏ syphilis͏͏ is͏͏ caught͏͏ in͏͏ its͏͏ early͏͏ stages,͏͏ it͏͏ is͏͏ easily͏͏ treatable͏͏ with͏͏ antibiotics.͏͏ If͏͏ left͏͏ ignored,͏͏ shocking͏͏ health͏͏ complications͏͏ may͏͏ arise͏͏ that͏͏ can͏͏ also͏͏ be͏͏ irreversible.

Don't͏͏ wait-seek͏͏ testing͏͏ today͏͏ if͏͏ you͏͏ have͏͏ any͏͏ of͏͏ these͏͏ symptoms. The͏͏ secret͏͏ to͏͏ avoiding͏͏ complications͏͏ is͏͏ early͏͏ detection.͏͏ You͏͏ can͏͏ detect͏͏ syphilis͏͏ in͏͏ the͏͏ comfort͏͏ of͏͏ your͏͏ own͏͏ home͏͏ using͏͏ trusted͏͏ at-home͏͏ test͏͏ kits.͏͏ Effective,͏͏ private,͏͏ and͏͏ accurate͏͏ results.

Take͏͏ responsibility͏͏ for͏͏ your͏͏ health;͏͏ know͏͏ the͏͏ signs,͏͏ symptoms,͏͏ and͏͏ risk͏͏ factors͏͏ that͏͏ come͏͏ with͏͏ syphilis͏͏ to͏͏ avoid͏͏ long-term͏͏ damage͏͏ later͏͏ on.