Secondary Syphilis: Symptoms, Diagnosis & Treatment

Syphilis is a serious and highly contagious sexually transmitted disease caused by the treponema pallidum bacteria, which is a spirochete, or spiral-shaped, bacteria that can live anywhere in your body and quickly spread. There are four stages of syphilis including primary, secondary, latent and tertiary. Each of these stages can last for years before progressing to the next stage. Latent syphilis may not be treatable and tertiary syphilis can cause life-threatening complications, so it is important to be treated during the primary or secondary syphilis stages.

What Are the Symptoms of Secondary Syphilis?

Syphilis is usually first noticed as just a single sore at the primary stage. It normally shows about 3 weeks after becoming infected, but can appear anytime from 10-90 days after the initial infection. This small, round sore is referred to as a chancre. It is firm and does not cause pain. Its location depends on where on the body the infected started, usually the genitals, anus or mouth. Sometimes the sore is not even noticed and then heals on its own in about a month.

If the sore is not noticed or treated, the syphilis bacteria will begin travelling through your bloodstream, leading to secondary syphilis. This occurs anywhere between 2 and 8 weeks after the primary syphilis infection.

The main symptom of secondary syphilis is a rash that is not itchy. It may cover many parts of your body or just one area. The rash may be scaly or smooth, or very faint and hardly noticeable. It sometimes appears on the palms of your hands and soles of your feet as brownish-red spots that are rough to the touch. Since other diseases can also cause rashes, secondary syphilis rash can sometimes be difficult to diagnose.

In addition to the rash, other symptoms of secondary syphilis include:

  • Fever
  • Sore throat
  • Headache
  • Swollen lymph glands and nodes
  • Fatigue
  • Muscle aches and joint pain
  • Weight loss and loss of appetite
  • Hair loss
  • Patches near genitals or skin folds that resemble warts
  • Vision changes

How Is Secondary Syphilis Diagnosed?

Your doctor may examine a sample taken from any sores that you have, and place them under a microscope to see if syphilis bacteria are present. You may also have blood taken and tested for syphilis antibodies. Antibodies are made by the body in order to combat an infection it has come into contact with in order to fight it off. Syphilis can also be detected by taking and testing a sample of your spinal fluid.

It is especially important for pregnant women who may have syphilis to be tested and treated for the infection, because syphilis can be passed along to the baby, which can be fatal.

If you are diagnosed with syphilis, be sure to inform any sexual partners you have had so that they can find out if they have been infected and receive treatment as soon as possible. Both primary and secondary syphilis are very contagious.

How Is Secondary Syphilis Treated?

If you are diagnosed with syphilis during its early stages, it is easy to be treated and cured of the infection. Penicillin is the antibiotic that is normally prescribed and is effective in getting rid of the syphilis bacteria. If you happen to be allergic to this medication, other alternate antibiotics can be prescribed.

If you have had syphilis for less than a year, it can be stopped from spreading with a single shot of penicillin. If you have been infected for a longer period of time, several doses may be required.

If you are pregnant, penicillin is the only antibiotic that is recommended for the treatment of syphilis. If you are pregnant but allergic to penicillin, the doctor can arrange for you to have a desensitization process so that you can still be treated with this drug. After you have given birth, your baby should also be treated with penicillin.

After you have received the treatment, you may suffer from a reaction known as Garish-Herxheimer, during which you may have nausea, aches and pains, headache, fever and chills. Usually, these symptoms only last one day.

It is also important that you receive follow-up care if you have been diagnosed with and received treatment for syphilis. Follow-up care and advice will likely include the following.

  • You should have blood tests and other exams by your doctor to ensure that the penicillin treatment is working.
  • You must avoid having sex until your treatment is completed and you have been told that you are free of the infection.
  • You should make your intimate partners aware of your infection so that they may seek medical care.
  • You need to be tested for HIV.

How to Prevent Developing Secondary Syphilis

Secondary syphilis can be prevented by being tested and cured of the disease while it is still at the primary stage. It can also be prevented by using a condom, or by avoiding sex altogether.

It is important to be checked for sexually transmitted infections regularly if you have multiple partners or do not practice safe sex.

Be sure to stop having sex and see your doctor right away if you notice any rash or sores near your anus, genitals, or mouth. 

The earlier you receive treatment for syphilis, the better. Be sure to inform your partners if you are diagnosed with this very contagious infection.