Does Syphilis Rash Itch? - Verywell Health

Syphilis is a sexually transmitted infection (STI) that can cause a variety of symptoms across the four stages of the infection.

In secondary syphilis, a rash may appear.

Learn more about syphilis rash, what it looks like, if it hurts, how long it lasts, when to see a healthcare provider, and the treatment options available.

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What Does a Syphilis Rash Look Like?

In secondary stage syphilis, a rash may appear on one or more areas of the body.

The rash may develop on the palms of the hands or the soles of the feet and look:

• Rough
• Reddish brown
• Red

Sometimes, rashes can appear elsewhere on the body and look different from the rash on the palms or soles of the feet. In some cases, rashes may be faint and not noticeable, or they may resemble rashes caused by other illnesses.

The rash may appear as syphilis sores are healing or several weeks after syphilis sores have healed.

Does a Syphilis Rash Itch?

A syphilis rash that occurs in secondary syphilis does not typically cause itching. In some cases, the rash will be completely unnoticeable.

Does a Syphilis Rash Hurt?

In most cases, a rash from syphilis won't hurt. It may not even be noticeable.

But a rash can also be accompanied by other symptoms that may cause discomfort.

These symptoms include:

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

How Long Does a Syphilis Rash Last?

Symptoms of secondary syphilis—including a syphilis rash—will often develop a few weeks after the symptoms of primary syphilis have cleared up.

Once symptoms like a rash are present, they usually take a few weeks to go away.

In some cases, symptoms like a rash may return and go away again over a period of several months before completely disappearing.

Even if a rash and other symptoms have vanished, it is still possible to be infected with syphilis, so being treated is important.

Without treatment, the infection can last for years and even decades and lead to serious complications.

It is also possible to pass the infection to others during this time, but typically this only occurs within two years of the initial infection with syphilis.

When to See a Healthcare Provider

If you notice sores, a rash, or any other symptoms that may be indicative of syphilis or any other STI, it is a good idea to make an appointment with a healthcare provider.

Anyone with a sexual partner who has tested positive for syphilis should see a healthcare provider for testing. This includes all kinds of sex like:

• Vaginal sex
• Oral sex
• Anal sex

Other people who should see a healthcare provider for testing include:

• People who have had unprotected sex
• People who have had sexually transmitted infections previously
• Men who have sex with men
• People with many sexual partners

Some people should see their healthcare provider regularly for a routine screening test for syphilis. This includes people who are:

• Pregnant
• Living with human immunodeficiency virus (HIV) and are also sexually active
• Men who are sexually active and have sex with men
• Taking PrEP (pre-exposure prohylaxis) for the prevention of HIV
  

Diagnosis

Reaching a diagnosis of syphilis may require a number of approaches.

A healthcare provider will typically begin by asking you questions about your health and sexual history. They may also utilize a number of tests.

These may include:

• A blood test: This can help detect if syphilis is present or if an infection was previously present. In some cases, if the test is negative, a repeat test may be required a few weeks later. This ensures an accurate result.
• A physical exam: During this test a healthcare provider will examine the genital area and other parts of the body—including inside the vagina—to look for any sores, growths, or rashes that may indicate syphilis.

A healthcare provider may also recommend getting tested for other STIs like gonorrhea or chlamydia.

While waiting for test results, you should avoid having sex or sexual contact with other people.

Testing for syphilis is not always a standard part of a regular checkup with a primary care physician or gynecologist. For this reason, it is important to be honest and upfront in requesting a test.

You can see a healthcare provider and request testing at a number of places, including:

• A healthcare provider's office
• Planned Parenthood
• A community health clinic
• A health department

If your test results for syphilis are negative, it likely means you don't have syphilis. However, it can sometimes take a couple of weeks after being infected for the antibodies that are detected in these tests to develop.

For this reason, you may be advised to have a second test later if you feel you have been exposed to syphilis.

If your test results come back positive, it means antibodies from syphilis are present. A healthcare provider may request another test to confirm the diagnosis.

Conditions That May Be Mistaken for Syphilis

The sores from syphilis may be mistaken for pimples, ingrown hairs, or even just harmless bumps.

The rash due to syphilis may also be mistaken for rashes from a different condition, like psoriasis or a rash due to a virus.

Syphilis sores may also be mistaken for genital herpes.

Treatment

A course of antibiotics is the typical treatment required for syphilis. The duration of treatment will depend on how long a syphilis infection has been present.

A serious case of syphilis in the later stages of the infection may require daily injections.

Summary

Syphilis is a sexually transmitted infection. It can cause a variety of symptoms, including a rash in the second stage of the infection.

The rash is not typically itchy or painful and may go unnoticed. It may take a few weeks to go away, but it is still important to receive treatment. Syphilis can be treated successfully with antibiotics.

A Word From Verywell

Dealing with an unusual rash can be distressing. If you have any symptoms that may be indicative of syphilis or another STI, don't hesitate to contact your healthcare provider for help.

Frequently Asked Questions

• Not everyone with syphilis will develop a rash. Those who do develop a rash may not notice it as it can be so faint. Other people will notice red or reddish-brown blotches.

  This may be on the palms or soles of the feet.

• A rash from syphilis can be mistaken for a number of other conditions. These include:

  • An acute HIV infection
  • Psoriasis
  • Pityriasis rosea (a rash caused by a virus)
  • Inflammatory skin conditions
  • Widespread viral skin rashes
  • Sarcoidosis
    

• Not everyone with syphilis will get a rash. A rash typically occurs as part of secondary-stage syphilis.

  If syphilis is treated in the primary stage, this may prevent the infection from progressing.