What does a Syphilis sore look like?

A Syphilis sore is known as a chancre (pronounced shang-ker). It’s usually the first sign of Syphilis, and it appears where the bacteria got into your body.

A typical chancre is:

• a single sore, often round
• painless
• firm to the touch
• an open ulcer with a clean base, which may weep clear fluid but not pus

The glands nearby, like those in your groin, may also swell.

Not every sore looks like this, though. A significant minority of people get several sores, or sores that hurt.

A chancre forms where Syphilis got into your body, usually during vaginal, anal or oral sex. It can appear:

• on the penis, including under the foreskin
• on the vulva, in the vagina or on the cervix
• around the anus or inside the bottom
• in the mouth or on the lips
• on the hands, although this is less common

The mouth is the most common place outside the genitals and anus. Sores inside the vagina, bottom or mouth are easy to miss, especially when they don’t hurt.

A chancre usually appears about 3 weeks after infection, but it can take anywhere from 9 to 90 days. It then heals by itself within 3 to 8 weeks, even without treatment.

The sore going away doesn’t mean the infection has gone. Without treatment, Syphilis stays in your body, and you can still pass it on. Read more in “Can you pass on Syphilis without a sore?”

Without treatment, Syphilis moves through stages:

• Second stage: usually around 3 months after infection, you may get a rash on the palms of your hands and soles of your feet that can spread across your body and usually doesn’t itch. Other signs include white patches in your mouth, flu-like symptoms, swollen glands, patchy hair loss and warty growths around the genitals or anus. These clear up by themselves within 3 to 12 weeks.
• Hidden (latent) stage: there are no symptoms, but the infection is still there. About 1 in 4 people who aren’t treated get second stage symptoms again in the first 2 years.
• Late stage: in about a third of people who aren’t treated, Syphilis can damage the heart, brain, nerves, bones and other organs, usually 20 to 40 years after infection. This can be life-threatening.

Syphilis can also affect the eyes and the nervous system at any stage. Read more in “What are the three stages of Syphilis?”

Several things can look like a Syphilis sore:

• Herpes usually starts with tingling, burning or itching, then small blisters that burst to leave red, painful sores. In a first outbreak, sores often appear on both sides.
• An ingrown hair is a raised, itchy bump in an area you shave, and you can sometimes see a hair trapped under the skin. It may fill with pus if it gets infected.
• A Syphilis sore is usually a single, firm, painless ulcer that weeps clear fluid rather than pus.

Looks aren’t reliable, though. Syphilis can cause several tender sores that look like Herpes, and a diagnosis from an examination alone is often wrong. That’s why any sore on the genitals or around the anus should be tested for both Syphilis and Herpes. Read more in “What can be mistaken for Herpes?”

Syphilis is treated with antibiotics. For early Syphilis, UK guidance recommends a single injection of penicillin. If you can’t have penicillin, a 14-day course of doxycycline tablets is one of the alternatives.

After treatment:

• Don’t have sex until 2 weeks after you and your partner have finished treatment.
• You’ll need repeat blood tests over the next year to check the treatment has worked.
• Your recent sexual partners need testing and treatment too. If you’ve had sex with someone who has Syphilis, you may be offered treatment straight away, before your own results, or a repeat test 12 weeks after you last had sex with them.

Some people get a high temperature, headache and aching muscles in the first 24 hours after treatment. Read more in “Can Syphilis be fully cured?”

These steps lower your risk of Syphilis:

• Use a condom for vaginal and anal sex, and a condom or a dam (a thin latex square) for oral sex.
• Remember that condoms only protect the skin they cover, so a sore outside that area can still pass on Syphilis.
• Don’t share sex toys. If you do, wash them and put a new condom on them before anyone else uses them.
• Test regularly if you have new or casual partners. UK advice is for gay and bisexual men with new or casual partners to test every year, or every 3 months if they have sex without condoms.

If you have a sore, a swab from it can show whether it’s Syphilis. A blood test looks for the infection in your body, but it can be negative before the sore appears and for up to 2 weeks after, so a swab is the better test while you have a sore.

Better2Know offers:

• Blemish Screen: tests a swab from a sore, blister or lump for Syphilis, Herpes 1, Herpes 2 and HPV, with results in 5 days. You can book it at one of our clinics or order it as a home test kit.
• Syphilis Swab of Chancre: a swab of a suspected Syphilis sore, tested for the Syphilis bacteria, with results in 5 days, at one of our clinics.
• Syphilis blood test: if you don’t have a sore, or it has healed, this tests your blood from 9 days after sex, with results in 1 day. A Syphilis test in the first 3 months after sex can miss the infection, so you may need a repeat test.

Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Is a Syphilis sore painful?

Usually not, which is why it’s easy to miss. But a significant minority of people have painful sores, and painful sores can also be Herpes, so it’s best to test for both.

Can you have Syphilis without a sore?

Yes. The sore may be hidden inside your bottom, vagina or mouth, or you may not notice it at all. Once it heals, the infection is still there, so a test is the only way to know. Read more in “Can you have Syphilis and not know it?”

How common is Syphilis in the UK?

There were 8,262 diagnoses of infectious Syphilis in England in 2025, 13.5% fewer than in 2024. Most were in gay, bisexual and other men who have sex with men, but diagnoses in women who have sex with men rose by 4.8%.

Can Syphilis affect pregnancy?

Yes. Syphilis can pass to a baby during pregnancy and raises the risk of miscarriage, premature birth and stillbirth. Everyone who is pregnant in the UK is offered a Syphilis blood test, and treating it early lowers the risk to the baby.

A Syphilis sore is usually a single, firm, painless ulcer that heals by itself, which is why it’s so easy to miss. But the infection stays in your body until it’s treated, and it can be cured with antibiotics.

If you’ve noticed a sore on your genitals or around your anus, get it checked. Book a Blemish Screen at a clinic near you or order it as a home test kit. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 21 July 2023 and was last updated on 30 September 2026.

Medical review. This article was medically reviewed by Dr Steve Chapman, Doctor with a wealth of clinical experience in the field of STIs, on 2 October 2025. It is general information and not a substitute for personal medical advice.

Sources

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7. NHS, Ingrown hairs, reviewed 1 September 2026. https://www.nhs.uk/conditions/ingrown-hairs/
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11. NHS, Screening for hepatitis B, HIV and syphilis, reviewed 23 January 2024. https://www.nhs.uk/pregnancy/your-pregnancy-care/screening-for-hepatitis-b-hiv-and-syphilis/