There are four stages of syphilis, and the disease and the symptoms change with each stage. In chronological order, the stages of syphilis are primary syphilis, secondary syphilis, latent syphilis, and tertiary syphilis. Not everyone who contracts syphilis will go through all four stages, and for some people, it may never advance past the primary stage. In general, the disease becomes more dangerous and potentially damaging as it progresses through the stages. In the final tertiary stage, syphilis can potentially be fatal.
Primary syphilis is the first and least dangerous of the stages of syphilis. A small sore will generally appear in the area of the body where the disease was contracted, which is usually in the genital or mouth area. This sore is called a chancre, and it isn’t associated with any pain. For most patients, there will only be one sore, but some may have a group of sores—the chancre will generally linger for 20 to 40 days, and then it will go away. For some people, syphilis ends right here, but for others, it advances.
It sometimes takes months after the end of primary syphilis for secondary syphilis to appear. In this stage, patients suffer a much more diverse set of symptoms, including rashes on their skin, loss of weight, pain in the joints, and fever. The rash during this stage may not show up anywhere near the area where the chancre was, partly because this stage is when the syphilis infects the entire body. Special sores that resemble warts tend to form during this stage, usually near the anus, mouth and vaginal entrance, and they help pass the disease on to other people.
Without treatment during the secondary stage, a person will almost always progress to the latent stage. Among the stages of syphilis, this is the most deceptive, because the disease seems to disappear. There are no symptoms or any other signs that the individual is infected. Sometimes the disease actually does go away, but sometimes it doesn’t. The latent stage can go on for years before advancing.
For about 25% of patients, the latent stage will eventually progress to the potentially deadly tertiary stage. This is when syphilis can begin to do serious damage to a person’s body. People can suffer nerve damage that makes it hard for them to move or think clearly. They may begin to go blind, and they may become paralyzed. Some people eventually develop problems with their heart, liver and other organs. Even at this stage, the disease can be cured with treatment, but any damage done to the body during this stage is often permanent.