Can You Pass Syphilis Without a Sore?

Picture this scenario: You were having a good time at a party and had sex with a new partner. They said they hadn’t done a rapid STD test recently, but they “seemed clean,” so you didn’t mind. A few weeks later, you notice strange blisters showing up around your genitals. Now you’re wondering, “Can you pass syphilis without a sore?”

Unfortunately, the answer is yes. It is possible for someone to spread syphilis to you without any sores if they’re in the early stage of the disease before symptoms appear.

Syphilis was once on the decline, but in recent years, it’s had a strong resurgence. The World Health Organization (WHO) estimates that more than seven million people aged 15 to 49 contracted the disease in 2020 alone. That sounds scary, but if you stay informed, you have a better chance of protecting yourself. Let’s go over syphilis symptoms, transmission, and treatment so you know how to protect yourself from this STD — and what to do if you have sex with a partner who has it.

The Impact of Syphilis on the Body

Syphilis is an infection caused by the bacteria Treponema pallidum. If you have syphilis, the first symptom you’ll notice is a small sore (chancre) on your genitals, mouth, or anus.

Because this sore is tiny and painless, many people don’t notice it, and you can have syphilis without a breakout. Quite a few people who have syphilis aren’t even aware they’ve contracted the disease. This makes it very easy to spread syphilis from one person to another.

Syphilis cases are steadily on the rise in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 176,000 people contracted syphilis in 2021. This is far higher than the prior year’s number of only 133,954 cases.

Syphilis is curable with a shot of penicillin if you’re able to catch it on a 10-panel STD test quickly enough. Without treatment, the sore will disappear, but that doesn’t mean you’re in the clear.

Syphilis can lay dormant for years without you knowing it. During this time, it could damage your organs, heart, and brain. Eventually, it can become life-threatening.

Syphilis can also affect your eyes, which is called ocular syphilis. It can cause floating spots in your vision, redness, eye pain, blurriness, sensitivity to light, and eventually, blindness.

It may surprise you to know that syphilis can even affect your ears, which is called otosyphilis. If you develop this condition, you might have trouble balancing, vertigo, dizziness, and a ringing or buzzing sound in your ears (tinnitus).

The Impact Advanced Syphilis Can Have on the Brain

It’s also important to know how syphilis and the spinal cord interact. When left untreated, the bacteria can infiltrate the spinal cord and surrounding nerves. This can lead to the development of a condition called tabes dorsalis.

Tabes dorsalis causes the gradual breakdown of the nerve fibers that carry information to the brain. It’s more common in men than women, and symptoms can include:

• Weakness
• Unsteady gait
• Poor reflexes
• Deafness
• Loss of coordination
• Vision problems
• Personality changes
• Dementia

If syphilis reaches the brain or spinal cord, it can cause a condition called neurosyphilis. A few types of neurosyphilis include:

• General paresis: This condition can develop about 30 years after contracting syphilis. It can cause mood disturbances and personality changes.
• Meningeal syphilis: This condition can develop within the first few weeks to the first several years after getting syphilis. It can cause nausea, vomiting, headache, and stiffness in the neck. It can cause deafness and blindness as well.
• Meningovascular syphilis: This condition causes the same symptoms as the meningeal variety, but it can also cause strokes.

All About Syphilis Transmission

Syphilis goes through three stages, and it’s important to recognize each one so you know whether you need to get same-day STD testing. The sooner you notice symptoms and seek diagnosis and treatment, the better your outcome will be.

Syphilis spreads through contact with sores or bodily fluids from an infected person. It can also pass from moms to their babies during birth.

Some of the ways you can catch syphilis include:

• Having sex with no condom
• Oral contact with the anus
• Allowing genitals to come into contact with an infected person’s genitals, which means you can catch it even without penetration
• Sharing sex toys that you haven’t washed or covered with a condom before use

The first stage of syphilis is called primary syphilis. It begins about 10 days to three months after infection. During this stage, a small, painless sore can appear on your genitals, anus, mouth, lips, or tongue. Usually, you’ll only see a single sore, but some people develop more.

The sore typically disappears after two to six weeks, which can cause some people to believe they’re better. Unfortunately, this is not the case, and you do not always have a sore with syphilis.

Several weeks after the sore vanishes, you’ll develop secondary syphilis. You might start to feel like you’re coming down with the cold or flu. You could have a fever, fatigue, and swelling of the lymph nodes in your neck, groin, or armpits.

You may also develop a non-itchy rash. It can appear anywhere on your body, but you’ll usually see it on the palms of your hands.

Other less common symptoms you might have include joint pain, patchy hair loss, and weight loss.

Regardless of your symptoms, they can either disappear within a couple of weeks or come and go for the next few months.

After this, the infection becomes latent. This is incredibly dangerous for both the infected person and their partners. During the first year of this stage, it’s possible to transmit syphilis to others even without symptoms. So if you’re wondering “Can you pass syphilis without a sore?” the answer is yes.

After the first year of latent syphilis, you’re asymptomatic. However, the bacteria continue to do silent damage in your body, sometimes for decades.

Eventually, the infection progresses to tertiary syphilis. About one in three people who don’t receive treatment for syphilis will develop serious symptoms in this stage. These symptoms can include:

• Blindness and deafness
• Paralysis
• Skin rashes
• Numbness
• Dementia
• Stroke
• Loss of coordination
• Heart disease

At this stage, syphilis has become dangerous enough to cause death.

Your doctor can diagnose syphilis with a basic blood test. If you have sores, your doctor may also want to take a fluid sample from them.

Anyone can get syphilis, although some people are at a higher risk than others. You have a higher risk of catching syphilis if:

• You’re non-monogamous (you have sex with multiple people)
• You don’t use a condom when having genital, oral, or anal sex
• You’re a man who has sex with men
• You use illicit drugs
• You’ve had syphilis before
• You have HIV
• You live in an area with a high prevalence of syphilis cases
• You are homeless 

Treatment for Syphilis

If you have early-stage syphilis, your doctor will treat it with a single injection of long-lasting penicillin. If you have late-stage latent syphilis or aren’t sure how long you’ve been infected, you’ll receive three doses of penicillin at weekly intervals. 

It’s important to be honest with your doctor and give them as much detail as possible so they can choose the best treatment for you. If your doctor gives you the wrong type of penicillin, it won’t get rid of syphilis, which means the bacteria will continue to grow.

Some people may develop a fever, headache, and muscle aches shortly after treatment. This is called the Jarisch-Herxheimer reaction. It most commonly happens in people with early-stage syphilis when viral loads are at their highest. You can use aspirin, acetaminophen, and other NSAIDs to manage the symptoms.

If some of your hair has fallen out, you may wonder, “Will my hair grow back after syphilis treatment?” After your body has eliminated the syphilis bacteria, your hair should start to grow back within three months. If it doesn’t, your doctor might prescribe you an antibiotic called doxycycline.

What if your hair never grows back? Unfortunately, people who have had syphilis usually aren’t good candidates for a hair transplant. Syphilis can cause hair to fall out on the back and sides of your head, which are the two areas providers tend to take donor hair from.

Leaving Syphilis Untreated

Treatment may not be the most pleasant, but what can happen if you leave syphilis untreated? The sore that shows up when you’re first infected will eventually go away, but don’t be fooled. The infection is still inside your body, even if you don’t have any other symptoms.

A few weeks later, you might feel run-down and tired. You might try chugging coffee or napping, but the fatigue just won’t seem to go away. You might also have sore, swollen lymph nodes, and your hair could start falling out in patches.

You may lose weight, too. At first, this can seem great if you’ve been wanting to shed a few pounds, but then you realize you’ve been dropping weight no matter how much you eat. If you’re losing weight without changing your eating habits, it’s a sign of progressing syphilis.

Eventually, the infection will go dormant, possibly for a very long time. It may not rear its head again for years, maybe even decades. If you have syphilis but your partner doesn’t, your partner may have entered the dormant stage. It’s important to schedule an STD test to be sure of your diagnosis. 

By the time syphilis goes dormant, it may have damaged your ears, eyes, heart, spine, and brain. Your doctors may try to mitigate the damage, but there’s only so much they can do.

Living With Syphilis

If you suspect that you have syphilis, the most important thing you can do is get yourself tested and see a doctor for treatment if you test positive. You do not have to live with syphilis for the rest of your life. A single shot of penicillin (or three shots if you’re in the latent stage) is all it takes to clear the infection up.

While taking penicillin, avoid certain foods and drinks such as:

• Alcohol, which can decrease the effectiveness of antibiotics
• Dairy products, which contain calcium that can block antibiotic absorption
• Foods high in fiber, acid, or sugar

You should also avoid staying in direct sunlight for too long. Antibiotics can increase light sensitivity, making it easier for you to develop a sunburn. If you must go outdoors, wear sunscreen or long-sleeved clothes.

While receiving treatment for syphilis, avoid sexual contact with anyone until your doctor gives the okay. You could still be infectious for a little while after treatment, which means you can spread the infection in that time. The chances of getting syphilis from one encounter with an infected partner could be as high as 64%.

Once your doctor says it’s safe to resume sex, tread carefully. Unlike some other STDs, it’s possible to catch syphilis again after you’ve already been treated for it. To avoid dealing with another infection:

• Encourage your partners to get tested for STDs regularly and ask to see the results. This can be embarrassing, but your health is worth any temporary discomfort.
• Schedule STD testing once per year, or more often if you have sex with multiple partners.
• Request an STD test if you’re pregnant. Syphilis and other STDs can spread from mothers to their babies during childbirth. Some STDs can also pass through breast milk.
• Use condoms with all partners if you don’t know their STD status. If a partner tries to push you into having sex without a condom, do not agree. They may have an STD regardless of how “clean” they say they are.
• Use a dental dam when engaging in oral sex.

Order a Rapid STD Test and Know Your STD Status

Now that you know the answer to “Can you pass syphilis without a sore?” are you concerned that you may have syphilis? If so, it’s critical that you get tested right away so your doctor can treat you. Remember, the faster you seek treatment, the sooner you’ll feel better. If you delay, that gives the infection the chance to grow and damage your body.

Rapid STD Testing offers confidential syphilis testing that you can order from home. Order your test and head to a nearby lab, and you’ll get your results in only one to three days.