Syphilis: Symptoms, Stages, and When to Get Checked
✍️ Written by: HOP Medical Centre Health Content Team
📅 Published: August 2026 | 🔄 Last Reviewed: August 2026
Syphilis is unusual among STDs in one specific way: its symptoms don’t just fade. They disappear and reappear across distinct stages, sometimes years apart. This pattern is exactly why an std check up matters more than watching for symptoms. Someone can feel completely fine between stages while the infection keeps progressing underneath.
At HOP Medical Centre, syphilis comes up less often than Chlamydia or Gonorrhoea, but it’s no less serious. Untreated syphilis can eventually affect the heart, brain, and nervous system. This guide walks through each stage, what to watch for, and when testing catches it early.
Why Syphilis Symptoms Come and Go
Syphilis progresses through four stages if left untreated: primary, secondary, latent, and tertiary. Symptoms appear in the primary and secondary stages, then vanish entirely during the latent stage, sometimes for years. Tertiary syphilis can then cause serious organ damage in a minority of untreated cases.
This stop-start pattern makes syphilis easy to dismiss. A sore appears, heals on its own, and the person assumes whatever it was has resolved. It hasn’t. It’s simply moved to the next stage.
The Four Stages of Syphilis
| Stage | Typical Timing | What Happens |
|---|---|---|
| Primary | 2–3 weeks after exposure | A single, usually painless sore (chancre) at the infection site |
| Secondary | Weeks to months after the sore heals | Skin rash, often on palms and soles; can include fever, fatigue |
| Latent | Can last years | No visible symptoms; a test can still detect the infection |
| Tertiary | Years after initial infection, in untreated cases | Potential damage to heart, brain, nerves, and other organs |
The primary sore is often painless. It can also appear somewhere easy to miss, which is one reason it frequently goes unnoticed rather than ignored.
Why Testing Matters More Than Symptom-Watching
Symptoms disappear during the latent stage. Someone can carry syphilis for years without any outward sign, while a blood test can still detect the infection, and it can still progress toward the tertiary stage if left untreated. An std check up that includes syphilis screening is the only way to catch it during this silent window.
- You notice a painless sore in the genital, anal, or oral area
- You develop an unexplained rash, especially on palms or soles
- A partner has tested positive for syphilis
- You’ve had a new sexual partner and haven’t tested recently
- It’s been over a year since your last full screening
How Syphilis Is Diagnosed and Treated
A blood test, typically a Syphilis TP Ab test, diagnoses syphilis. It can detect the infection even during the symptom-free latent stage. In the earlier stages, treatment is straightforward: a course of penicillin, or an alternative antibiotic for those with a penicillin allergy, clears the infection effectively.
Treatment gets more complex the later syphilis is caught. If it has progressed to the tertiary stage, organ damage may already be underway and may not fully reverse. This is the core reason an early std check up matters so much more with syphilis than with infections that stay symptomatic throughout.
Syphilis Testing at HOP Medical Centre
HOP Medical Centre includes syphilis screening (Syphilis TP Ab) in Packages A, B, and F, alongside HIV and Hepatitis B/C testing in Package A, with Herpes added in Package B, and the full comprehensive panel in Package F. These packages use a blood test, with standard turnaround of 2-5 working days. Full pricing and package details are available at (https://hop.sg/stdscreening/).
Frequently Asked Questions About Syphilis
1. Why do syphilis symptoms disappear and come back?
Syphilis progresses through distinct stages. Symptoms appear in the primary and secondary stages, then vanish during the latent stage, even though the infection is still present.
2. Is the primary sore always noticeable?
Not always. It’s often painless and can appear in locations that are easy to overlook, which is why many people don’t realise they’ve been infected.
3. Can syphilis be cured?
Yes, particularly in the earlier stages, with a course of penicillin or an alternative antibiotic. Tertiary-stage damage may not fully reverse.
4. How is syphilis detected during the latent stage, when there are no symptoms?
A blood test detects it, which is why a routine std check up matters even when nothing feels wrong.
5. What packages at HOP Medical Centre test for syphilis?
Packages A, B, and F all include Syphilis TP Ab testing, alongside other blood-based infections.
More Questions About Syphilis Testing
6. How soon after exposure can syphilis be detected?
The primary sore typically appears 2 to 3 weeks after exposure, though blood tests may need additional time to reliably detect antibodies.
7. Is syphilis common in Singapore?
Singapore’s Communicable Diseases Agency (https://www.cda.gov.sg/professionals/diseases/) tracks syphilis as one of the country’s notifiable STIs, alongside chlamydia and gonorrhoea.
8. Can syphilis be passed on during the latent stage?
Transmission risk is generally lower during the latent stage than during primary and secondary stages, but testing is the only way to know your status either way.
9. What happens if syphilis reaches the tertiary stage?
It can cause serious damage to the heart, brain, and nervous system. This is rare in places with accessible testing and treatment, precisely because it’s preventable with earlier detection.
Syphilis’s stop-start symptom pattern makes it one of the easiest STDs to underestimate. An std check up that includes syphilis screening closes that gap, catching the infection during stages that show no outward sign at all. HOP Medical Centre’s Orchard and Tampines clinics offer syphilis testing as part of Packages A, B, and F.