Syphilis vs. Herpes: How to Tell The Difference

Medically reviewed on February 15, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

There are over 35 infectious organisms known to cause sexually transmitted diseases. While many STDs are largely preventable or treatable, they remain a huge burden and a significant health issue in the country. On top of medical costs and complications, many STDs can lead to serious, long-term health issues, including reproductive health problems, increased risk of certain cancers, and fetal and/or perinatal problems [1].

Syphilis and herpes are two of the most common STDs in the United States, but they can be easy to mistake or miss. While a herpes or syphilis test can help you know which STD you might have, it’s important to understand the differences between the two infections. Learn more about syphilis and herpes and how you can tell the difference.

What is Syphilis?

Syphilis is a bacterial infection spread primarily via sexual skin-to-skin contact, though mothers can also pass the infection to a child during birth [2]. It is noted for the appearance of sores, known as chancres, and can be transmitted when skin or mucus membranes make contact with these sores. While early syphilis can be cured, this infection can stay in the body for decades following the initial infection.

So what does syphilis look like? There are four stages to a syphilis infection, often associated with distinct physical signs:

• Primary stage – The first stage of syphilis infection is often characterized by a small, painless sore, known as a chancre, where the infection entered your body.

• Secondary stage – Usually, the secondary stage of syphilis is accompanied by a red or reddish-brown rash, with or without the continued presence of geneital sores. The rash is usually not itchy, but it can be accompanied by the appearance of genital warts and canker sores in the mouth. You may also experience general flu-like symptoms, like fever, sore throat, muscle aches, and swollen lymph nodes. These symptoms can go away after a few weeks, but they can repeatedly come and go for up to two years.

• Latent stage – This stage is marked by the absence of noticeable symptoms. However, this doesn’t mean that the infection has gone away.

• Tertiary stage – Without treatment, the sexually transmitted infection will stay in the system and proceed to the final stage of syphilis. Late stages of syphilis can lead to serious health issues, such as organ damage, heart issues, and damage to the brain and nervous system.

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What is Herpes?

Herpes is an infection caused by two viruses: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2) [3]. The infections are differentiated as follows:

• HSV-1 – This strain of the herpes virus is responsible for oral herpes, such as fever blisters or cold sores in or near the mouth. Often, HSV-1 doesn’t present symptoms and is frequently transmitted via non-sexual contact with the saliva of a person with the herpes simplex virus.

• HSV-2 – Commonly known as genital herpes, you can only contract this strain of the herpes virus by direct contact with the genitals of someone infected.

It is possible to transmit HSV-1, oral herpes, to the genital region via oral sex. It’s also important to know that herpes can spread even in the absence of visible sores. Treatment can help minimize or in some cases prevent herpes outbreaks and can help reduce the risk of passing the virus along to sexual partners.

Herpes is extremely common. Estimates suggest that half of Americans have oral herpes, while roughly 1 out of every 6 Americans has genital herpes. Part of this comes from just how easily the virus spreads. While it is an STD, herpes does not require sex for transmission. Simply contacting an open sore is enough to transmit it from person to person. This becomes even easier given that many people don’t know that they have herpes, as sores can easily be mistaken for other skin conditions.

There is also no cure for herpes, meaning that you can have it for life and not know it. Herpes is thankfully not dangerous or life-threatening to the average, healthy individual, but sores can be uncomfortable and painful.

Syphilis vs. Herpes: Telling Them Apart

Symptoms

Syphilis and herpes can often seem similar to the average person. Both are characterized by skin lesions or sores that can appear on the genitals, rectum, or around the mouth. However, these sores are significantly different in how they look and feel.

Key differences between syphilis and herpes include:

• Incubation period – The incubation period refers to the amount of time it takes for an infection to exhibit symptoms after it enters your body. According to the Centers for Disease Control (CDC), herpes symptoms typically appear within 2–4 days of infection but can take up to 12 days. Syphilis symptoms typically appear 21 days after infection, although it can take as long as three months.

• Sore size, texture, and pain – Although they can appear similar, they differ in size, texture, and pain severity. According to the CDC, herpes sores are small with a diameter of about 1–3 millimeters. They may appear as blisters and can be quite painful. Syphilis sores can be up to three centimeters in size, are painless, and feel hard to the touch.

• Amount of sores – Typically, syphilis will present as a single sore. Herpes, on the other hand, can present as a group of small sores or blisters, according to the CDC.

• Time to heal – Herpes sores typically clear up in a couple of weeks, although they can take as long as one month. Syphilis sores can take longer, up to eight weeks in some cases. After healing, syphilis sores may leave scarring on the skin.

You can also look at other symptoms to tell these two infections apart. Both can potentially cause flu-like symptoms. This occurs with secondary syphilis and with forms of genital herpes caused by HSV-2. However, genital herpes outbreaks can also come with other pain and discomfort around the genitals, including:

• Burning while peeing
• Trouble peeing when sores and swelling block the urethra
• Itching
• General pain and discomfort around the genitals

Syphilis usually does not cause these uncomfortable symptoms in the genitals. On the other hand, secondary syphilis can cause a rash that spreads throughout the entire body, which is not what herpes does.

Complications

It’s also important to understand the potential complications involved. As mentioned, herpes can be deeply uncomfortable and painful with each outbreak, and it can have some serious effects on relationships. However, it is mostly harmless and doesn’t present any real danger to most healthy adults. Symptoms can potentially be more painful and last longer in those with suppressed immunities, like those with HIV or leukemia, and herpes infection can also be potentially dangerous to newborn babies.

Syphilis presents some serious dangers for not only sexual health, but also overall well-being. Left untreated, a syphilis infection can progress to the point where it causes severe damage to the nervous system, bones, joints, blood vessels, and major organs. It can damage the eyes and contribute to vision loss. Serious cases of syphilis can be deadly.

Treatment

Syphilis is easy to treat in its early stages with a round of antibiotics, allowing you to cure the infection completely. Even in its later stages, antibiotics can cure the infection and prevent continued damage to the body (though they can’t reverse or heal existing damage).

Currently, herpes cannot be cured, but medication can reduce the severity and length of outbreaks or even prevent outbreaks from happening at all. This is known as suppressive therapy, and it can be highly effective in even preventing the spread of herpes to your sexual partners [4].

Preventing Syphilis and Herpes

While syphilis and herpes are completely different STIs, they do share one significant thing: they are both easy to miss. Both STDs can present a few noticeable symptoms or symptoms that are easy to mistake for other skin conditions. This is partly why they spread so easily among sexual partners. A good way to prevent the spread of both STDs is to practice safe sex. Use condoms and other protective devices every time you have sex.

Buy At-home STD Testing

Along with safe sex, make sure you get tested for STDs. Testing allows you to catch infections before they become severe and allows for proactive management of personal health. If you don’t have access to a clinic or simply want to take a test in the comfort of your own home, Everlywell offers convenient STD tests: the at-home STD Test – Female and STD Test – Male. These tests offer accurate results for seven common STDs: chlamydia, gonorrhea, hepatitis C, herpes simplex virus type 2 (HSV-2), HIV, syphilis, and trichomoniasis. If your tests come back positive, we can connect you with a healthcare provider to determine the next steps for better health.

Related content

Stages of syphilis

Symptoms of syphilis in women

Signs of syphilis in men

Is monkeypox an STD?

References

1. Sexually transmitted diseases (STDs) – Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.

2. Syphilis – Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.

3. Genital herpes – Symptoms and causes. Mayo Clinic. URL. Accessed February 15, 2022.

4. Herpes – STI Treatment Guidelines. Centers for Disease Control and Prevention. URL. Accessed February 15, 2022.

Herpes, Syphilis or HPV?

You may be suffering from an outbreak of blemishes around the mouth, the genital or anal areas of your body. These can be in the form of sores, ulcers, lesions, warts, blisters or any other breaks in the continuation of skin. Herpes, Syphilis and the Human Papilloma Virus (HPV) are common sexually transmitted infections that trigger these types of symptoms. The only way to know which STI you have contracted is to get tested as soon as possible.

Herpes Simplex Virus I & II

The Herpes virus comes in two forms: Herpes Simplex Virus I (HSV 1) and Herpes Simplex Virus II (HSV 2). HSV 1 is commonly associated with causing sores or blisters around the mouth, often known as cold sores. HSV 2 is often linked with genital sores or blisters. Despite this, the two strains are not limited to these areas. It is possible to contract HSV 2 around the mouth and HSV 1 around the genital area.

Herpes I could have been contracted in childhood from kisses off a relative, remaining dormant until triggered by illness, stress or a weakened immune system.

Herpes I & II can be transmitted through unprotected sexual contact, including oral, anal or vaginal intercourse. There is a high chance of Herpes transmission if you or your partner engage in unprotected sexual activities whilst experiencing a Herpes outbreak. This is because direct skin-to-skin contact with an active blister or sore will pass on the virus.

Other symptoms of a Herpes infection include:

• Pain when urinating
• Unusual discharge in women
• Tingling or pain around the site of infection
• Flu-like symptoms (fever, tiredness, swollen glands and muscle aches).

Once you have acquired Herpes, the virus remains in your system for life. You can still engage in sexual activities, and protection should always be used. If you are experiencing an outbreak, you are advised to abstain from sexual contact to prevent transmission to your partner. There are creams available to help with Herpes outbreaks; medications may be prescribed by a doctor if your outbreaks are particularly severe and frequent.

Syphilis

Syphilis is a bacterial infection that is transmitted sexually. Unprotected oral, anal or vaginal intercourse is the most common way to transmit a Syphilis infection. Direct contact with a Syphilis chancre, sore or lesion is highly likely to result in Syphilis transmission.

There are three phases to a Syphilis infection, with symptoms varying depending on the stage (primary, secondary, latent or tertiary).

• First stage: A Syphilis chancre has manifested.
• Second stage: Fever, swollen glands, rashes, headaches, muscle aches, sore throat and hair loss.
• Latent stage: Signs of infection clear but the infection is still in your system and you can still transmit Syphilis to your sexual partners.
• Third stage: If Syphilis remains untreated, damage to your internal organs, brains, nerves and eyes may occur.

Syphilis can cause pregnancy and delivery complications for women if it is left untreated. Though Syphilis is still curable at the third stage of infection, the damage to your system can be irreversible.

Syphilis can be cured with a course of antibiotic treatment – your Syphilis treatment will depend on how long you have been infected:

• For Syphilis infections of less than two years: one injection of penicillin into your buttocks or a 10-14-day course of antibiotics if you are allergic to penicillin is the most likely course of treatment.
• For Syphilis infections of over two years: three penicillin injections at weekly intervals or a 4-week course of antibiotics if you cannot have penicillin will generally be required to cure your infection.

Human Papillomavirus (HPV)

The Human Papillomavirus affects both men and women. There are over 100 different strains of HPV, with around 30 types affecting the genital area. Most strains of HPV show few or no symptoms in an infected individual. However, when symptoms are present they can manifest in the form of Genital Warts. Some HPV types are linked to causing Cervical Cancer, as well as cancers of the throat, oesophagus and other parts of the body.

You can choose to be vaccinated against various strains of HPV, including some types of HPV that cause Genital Warts.

HPV affects the moist membranes lining your body and your skin, including in areas such as your anus, cervix, penis, throat and mouth. The viral infection is transmitted sexually, with unprotected oral, anal or vaginal sex increasing the chances of HPV transmission. For HPV, penetrative sex is not required for the virus to infect you or your sexual partner. Skin-to-skin contact is enough to result in the transmission of HPV.

There is no cure for HPV but there is treatment available for the symptoms of HPV: Genital Warts. There is a wide range of treatments for Genital Warts. Better2Know offers cryotherapy which involves freezing warts off.

Better2Know’s Blemish Screen in the Middle East

Better2Know’s Blemish Screen is available at various private sexual health clinics in the Middle East. The Blemish Screen provides confidential, accurate results for Herpes I/II, HPV and Syphilis.

No incubation period is required for this confidential screening option. This is the time between potential exposure to infection and your STI test. If you are experiencing any sores, ulcers, warts or blisters, then this is the STI screen for you and you can get tested at your earliest convenience. Your experienced sexual health advisor will arrange your private appointment for a time and date that suits your busy schedule.

Your Better2Know doctor can answer any additional questions you may have before taking your swab sample.

Once you have arrived at Better2Know’s private STI clinic, you will be seen by a qualified doctor who will explain the sampling process before taking a swab of the affected area. Your sample will then be sent to Better2Know’s fully certified, central laboratory for fast, accurate testing. Your results will be available within five working days after your sample has arrived at the laboratory.

Better2Know’s dedicated Patient Services team will contact you once all your results are ready to report unless you request otherwise. You can also view your results online as soon as they are available using Better2Know’s secure patient area. Simply log in through our website with the details your Better2Know advisor will provide upon confirming your confidential booking.

If you test positive, Better2Know can help you get the treatment you need. Your advisor will arrange a private doctor’s consultation for you to discuss your diagnosis and receive advice on treatment moving forward.

Booking Your STI Test in the Middle East

Better2Know is the Middle East’s leading private provider of STI testing services. Our private sexual health clinics are conveniently situated throughout the region, with same or next-day appointments available at many locations.

We provide a wide range of STI tests and screens designed to target your specific sexual health concerns, giving you the clarity and control you deserve over your STI status.

Arrange your confidential appointment in the Middle East by getting in touch with Better2Know’s friendly sexual health advisors. Phone them now on the number listed at the top of the page; lines are open 24/7 for your convenience. Alternatively, you can book online whenever it is convenient for you by selecting the orange button above.

Fee for frivolity

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The goddess of love Venus – it is with her name that venereal diseases are associated, although they have the most remote relation to love. Sexually transmitted diseases are often the result of promiscuous behavior and a careless attitude towards one’s health, the victims of which are innocent loved ones of the patient. Syphilis, gonorrhea, chlamydia, trichomoniasis, ureaplasmosis, genital herpes – this is a far from complete list of sexually transmitted diseases. If these diseases are not treated, the consequences can be very sad.

Especially dangerous and insidious is syphilis, which has the ability to especially disguise itself as other diseases. This is told by the chief dermatovenereologist of the city, deputy chief physician of the Regional Dermatovenerologic Dispensary No. 3 Marina Yuryevna VASYLKOVA .

The World Health Organization (WHO) defines venereal diseases as four diseases, two of which are found on our territory – syphilis and gonorrhea. Other diseases – chlamydia, ureaplasmosis, trichomanias, etc., currently there are more than 20 of them, are called sexually transmitted infections. They also include HIV infection. Every year, new sexually transmitted infections are discovered, i.e. their number will grow.

Syphilis is a marker of well-being or, conversely, trouble in the region in terms of sexually transmitted infections. According to the results of the last 2 years, the incidence of syphilis in Chelyabinsk slightly exceeds the incidence rate in the region. Most often, syphilis affects people of sexually active age – from 20 to 40 years. This is the fertile age when a woman is ready to have a baby. In the city of Chelyabinsk, every fifth woman with syphilis was pregnant at the time the disease was detected. Another alarming fact is the high incidence of syphilis among children and adolescents who became infected mainly through sexual contact. Syphilis has been and remains a serious disease that affects all organs and systems of the human body. Today, this disease is registered among quite prosperous, and not only asocial, segments of the population.

Unfortunately, if syphilis is not treated in time, intrauterine infection of the fetus and the birth of a sick child is possible. The reason for the development of congenital syphilis is ignoring the requirements of doctors by pregnant women who are irresponsible about their health. Many of them, even knowing about their pregnancy, are in no hurry to register with the antenatal clinic and undergo the necessary examination. With the timely registration of a pregnant woman, if syphilis is detected, there will be enough time to cure both the woman herself and prevent intrauterine infection of the fetus.

Manifestations of syphilis are primarily characterized by rashes on the skin and mucous membranes. And only a specialist dermatovenereologist with the help of laboratory tests can correctly diagnose. Therefore, I would like to warn those who like to be treated on the advice of friends or those who draw medical knowledge from the Internet. In this case, self-medication is unacceptable, since syphilis can simulate any skin disease. The patient can be treated for years to no avail, not realizing the true cause of the disease.

The incubation (latent) period for syphilis lasts an average of 3 to 4 weeks. If during this period a person who had contact with a patient with syphilis is given preventive treatment, he will not get sick.

The insidiousness of syphilis is that it is characterized by an undulating course without pain manifestations. The first sign of syphilis (chancre) most often appears on the genitals if there was sexual contact with a sick person. In women, only a gynecologist can sometimes detect a chancre. That is why it is so important that every woman undergoes a preventive examination twice a year. You can get infected with a completely innocent kiss, if the partner had syphilitic rashes in the mouth. Therefore, the rash on the lips (red border), the patient, as a rule, does not associate with syphilis.

Hard chancre – occurs at the site of the introduction of the pathogen. This is a regular erosion or ulcer that does not bleed, does not itch, does not hurt. When taking a scraping, a huge amount of the causative agent of syphilis, pale treponema, is found in it. 7 – 10 days after the appearance of the chancre, nearby lymph nodes increase, usually inguinal (bubo), if the ulcer is located on the genitals. “The bubo follows the chancre like a thread follows a needle,” the French say. This is the primary period of syphilis.

Approximately 2 months after infection, the generalization of the process begins, when the causative agent of syphilis actively multiplies and spreads throughout the body, all groups of lymph nodes increase. There are symptoms resembling a flu-like condition, when the temperature rises, pain in the bones, body aches bother. This is the prodromal period, followed by the so-called secondary period of syphilis. If left untreated, the secondary period can last from 2 to 5 years. It is characterized by a variety of clinical manifestations that patients take for a cold, an allergic disease, etc. and under any pretext postpones a visit to the doctor, self-medicating.

Hoarseness of voice, rash on the body, nodules on the skin of the palms and soles, warty growths on the genitals, loss of hair on the eyebrows and head (moth-eaten appearance of fur or uniform hair thinning), white spots on the skin of the neck, which already speaks of damage to the nervous system – this is an incomplete list of clinical manifestations of the secondary period of syphilis. This period is the most contagious, and at this time you can get infected from the patient through the household. Currently, syphilis is treated successfully. And the earlier the dermatovenereologist made a diagnosis, the more favorable the prognosis. The disease is treated both on an outpatient basis and in a hospital. Children and adolescents, as well as pregnant women, are hospitalized without fail. For those wishing to be treated anonymously, an anonymous office operates in our dispensary.

It’s time for holidays and vacations. It is in the summer when a person allows himself to “relax”, he can lose control of his behavior, and we are seeing the rise of sexually transmitted diseases. In recent years, mixed infections have often occurred, when one person can immediately become infected with several STIs: at the same time syphilis, gonorrhea, trichomonas or chlamydial infection, in a word, “how lucky”.

A frivolous attitude to one’s health, self-treatment primarily affects reproductive health. AT 9Sexually transmitted diseases are the cause of infertile marriages in 2-98% of cases. Chlamydial infection is dangerous, which leads to impaired fertility in women (inability to become pregnant or bear a child, etc. ), in men – to inflammatory processes, incl. prostatitis, the consequence of which can also be infertility and impotence.

The person himself decides what choice to make. Losing health is easy, but getting it back is very difficult. And in order not to regret later, you need to deal with and protect your health. Given the high incidence of STIs among adolescents, a teenage office for the prevention and treatment of sexually transmitted infections has been opened in the dispensary. It operates on a budgetary basis and accepts children and teenagers from all over the city. The office is located in the branch of polyclinic No. 2 at the address: Komsomolsky Prospekt, 66A.

You should remember a few simple rules for the prevention of STIs:

1. Use individual prophylaxis.

2. Timely completion of preventive examinations.
3. Regular visits to a gynecologist and early registration for pregnancy – for women.
4. If rashes appear on the skin or mucous membranes, consult a specialist.
5. Never self-medicate!
6. If casual sexual contacts have taken place, it is recommended to undergo an examination.
7. If young people want to start a family, it is also recommended to be tested to rule out STIs.
8. If STIs are detected, be sure to tell your partner or pass information about your partner to your doctor.
9. Couples should be treated at the same time and preferably in the same facility.
10. Strictly follow the doctor’s recommendations.

Syphilis treatment, symptoms, tests | Clinic “Good Health”

Syphilis is one of the most serious, dangerous venereal diseases, which has a long, undulating course and has an unpleasant feature of affecting all organs and systems of the body. Therefore, according to the classification of the disease, it belongs to the systemic, and according to the method of infection – venereal.

The causative agent of the disease is a bacterium called pallidum spirochete (treponema). The main route of infection is sexual (up to 98% of cases), as well as syphilis is transmitted by exchanging secrets (by kissing, by breastfeeding, through the blood of drug addicts or in the hospital. The household route of infection or the transmission of the pathogen from a sick mother to a child is much less common. During sexual contact, infection is more likely than more pathogenic bacteria in the secretory fluids of a sick person, as well as if the partner has open injuries on the skin and mucous membranes (wounds, abrasions, scratches). blood vessels in all human systems.Already at this time, the patient, although he still does not suspect infection, is contagious.The intake of certain drugs can lengthen the incubation period up to several months.After this period, the first symptoms of the disease appear.

Symptoms of syphilis

The first sign of infection – at the site of penetration of the pathogen occurs primary syphiloma – hard chancre. It is a hard, non-tender, ulcerative lesion. Along with it, an increase in regional lymph nodes is observed. This is primary syphilis.

Secondary syphilis has the longest duration, it can be from 2 to 5 years. Significant disturbances occur in the structure of internal organs, outwardly this is manifested by generalized rashes of purulent ulcers on the skin, and baldness. The course of the disease can take place in waves, periods of relapse alternate with periods of calm, when the symptoms disappear.

Tertiary syphilis is the last, irreversible stage of the disease. It has gross violations of the functions of internal organs, especially the central nervous system, the human body is covered with ulcers, which, when opened, disfigure a person.

Treatment of syphilis should begin immediately at the first sign of primary syphilis. Hard chancres that form during this period on the mucous membranes of the genital organs, near the anus, in the oral cavity, on shirts, on the arms, mammary glands, on the abdomen and in the groin. In men, most often a hard chancre is localized on the glans penis, on the foreskin and frenulum. In women – on the large and small labia, in the vagina, on the cervix, inside the urethra.

Due to the fact that syphilis affects all body systems, it is dangerous for its complications. With tertiary syphilis, irreversible changes in internal organs occur, which can lead to disability and even death.

The main method for diagnosing syphilis is microscopic examination of the serous contents of ulcers. In the absence of pronounced lesions on the skin, as well as with “dry” rashes, a serological analysis of blood components (plasma, cerebrospinal fluid, serum) is performed. They also carry out reactions of fast plasma reagins and the Wasserman reaction, which determine the presence of antibodies to the pathogen in the blood.

Treatment of syphilis

Once the diagnosis of syphilis has been confirmed by laboratory testing, treatment begins. It is necessarily produced individually and occurs in a complex. The prognosis for treatment in modern conditions of the development of venereology and subject to the timely start of treatment is favorable.

In any case, only a qualified venereologist should treat syphilis and select an adequate treatment regimen. It is unacceptable to engage in self-medication, besides, at home you will not be able to be sure of recovery, since the cure is confirmed only clinically, it is necessary to be tested for syphilis. Untreated syphilis becomes chronic, the patient remains contagious and will pose a danger to others.

The mainstay of treatment for syphilis is the use of penicillin antibiotics. If the patient has an individual intolerance to penicillin, then it is replaced by tetracycline, erythromycin, cephalosporin. With late treatment and secondary syphilis, in addition to the main treatment, iodine and bismuth preparations are prescribed, immunomodulatory therapy, and physical therapy are carried out. Treatment of primary syphilis lasts 2-3 months or more, depending on the stage and complexity of the disease.