Most cases present symptoms in 2-4 weeks after exposure. The main symptom is chancre, which is a painless sore on genital area. The sore may be obvious in men, but remain inconspicuous in women if it is situated deep inside the vagina. Even if it is left untreated, the painless sore will heal by itself giving a false impression of cure.
After the appearance of chancre for 6-8 weeks, infected patients will have wide-spread and symmetrical skin rashes. Palms and soles are commonly involved. Infected patients may have malaise, fever, enlarged lymph nodes, alopecia, mucous membrane lesions or appearance of warty growth change. These symptoms will subside gradually.
Patients are asymptomatic in latent stage syphilis. The disease can only be diagnosed by blood test.
Late syphilis may occur a few years to decades after the initial infection. Heart, eyes and central nervous system will be affected resulting in blindness, cardiovascular diseases, neurological and mental illness, physical disability and even death.