How to know if you have syphilis or herpes?

March 15, 2024
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Sexually transmitted infections (STIs) result from exposure to a virus, fungus, bacteria, or parasite that is passed from one individual to another during sexual contact. Two of the most common types of STIs are syphilis and genital herpes.

The bacterium Treponema pallidum causes syphilis. This STI is transmitted when an individual has a wound or mucus membrane that comes into direct contact with a chancre (aka syphilitic sore) during oral, vaginal, or anal sex. In addition, a mother who has syphilis can pass it on to her unborn baby. For this reason, pregnant women are tested for this STI.

There are two types of herpes simplex virus (HSV): HSV-1 and HSV-2. HSV-1 typically develops around the mouth, and this sore is referred to as a cold sore or fever blister. HSV-2 is usually the virus responsible for genital herpes. Nonetheless, according to the CDC, HSV-1 can cause genital herpes. This happens when there is contact between the mouth of someone with HSV-1 and the genital area. HSV-1 and HSV-2 can be transmitted through body fluids even when there are no visible signs of the virus.


Syphilis vs. Herpes

Syphilitic sores are typically round, firm, and painless. HSV-2 lesions have a red base with clusters of blisters on top of them. The size and shape of the blisters and bases vary.

Syphilis and HSV-2 cannot be spread through casual contact with:

  • Doorknobs
  • Toilet seats/Bidets
  • Bathtubs
  • Hot tubs
  • Swimming pools
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What Are the Symptoms of Syphilis?

Syphilis has four stages: primary, secondary, latent, and tertiary. The signs and symptoms of each stage vary.


Primary Stage

The first sign of syphilis is the development of one or more chancres. The sore(s) develops at the location where the bacteria that causes syphilis enters the body during sexual contact. Therefore, chancres usually develop on or around the vagina, penis, rectum, anus, and lips, or inside the mouth. Unlike the sores with herpes, chancres are typically painless. The chancres are present anywhere from three to six weeks, and they heal without treatment. However, even once the chancre heals, treatment is essential. Otherwise, the infection moves into the secondary stage.


Secondary Stage of Syphilis

This stage typically begins with sores and/or a skin rash developing on one or more parts of the body. The areas of the body susceptible to these symptoms include the mouth, anus, and vagina. This rash and/or new sores can develop while the primary stage sore(s) are still present or several weeks after they have healed.

The rash can also develop in the palms of the hands and/or on the bottoms of the feet. The rash on the hands and feet typically doesn’t itch and can be faint, which is why some people don’t notice it. The rash can be red or reddish brown and look rough.

Other symptoms that may be present include:

  • Swollen lymph glands
  • A fever
  • Patchy hair loss
  • A sore throat
  • Weight loss
  • Headaches
  • Fatigue
  • Muscle aches

Again, the signs and symptoms of the secondary stage will diminish without treatment. However, if treatment is not sought, the infection progresses to the latent stage of syphilis.


Latent Stage of Syphilis

There are no visible signs or symptoms during this third stage of syphilis. Without treatment, this STI can remain in the body.


Tertiary Stage of Syphilis

The majority of people who have syphilis and do not seek treatment will not develop the fourth stage of syphilis. However, if someone does develop the tertiary stage of syphilis, many different body systems can be negatively affected, including the brain, nervous system, heart, and blood vessels. The tertiary stage of syphilis presents itself 10 to 30 years after infection. The damage this disease causes can lead to death.

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The Typical Pattern for an Outbreak of HSV-2

Following exposure, symptoms become evident within two weeks. The initial herpes outbreak is usually the most severe. The lymph nodes in the groin may be tender and swollen. Flu-like symptoms may also be present (e.g., fever, headache, and joint pain). Women may experience pain in the legs, buttocks, or vagina, as well as difficulty urinating or painful urination. They may have a feeling of pressure beneath their stomach. There may also be changes in their vaginal discharge, as well as a burning sensation, itching, or tingling in the anal area or vagina.

Herpes lesions start as a red base, then clusters of blisters develop on top of them. The size and shape of the blisters and bases vary. The blisters are filled with a fluid that is clear or has a yellowish tint. Once the top of the blisters comes off, they may start to leak a clear or yellowish fluid. After breaking open, these blisters become ulcers. The blisters and sores that develop with herpes are usually painful. As time passes, these open sores crust over, healing on their own.

Before a flare-up, there may be a variety of genital herpes symptoms, including:

  • Nausea
  • Fever
  • Chills
  • Fatigue
  • A tingling or prickly feeling in the areas where lesions will develop
  • Muscle aches
  • Nerve pain
  • Joint pain


Where Do Herpes Lesions Develop?

Lesion location depends on the individual’s gender. Women typically develop lesions inside the vagina, as well as on the vulva, anus, buttocks, and thighs. Men usually develop lesions on the scrotum and penis. Although less common, men may also develop lesions on the anus, buttocks, and thighs.


How Long Do Herpes Lesions Last?

Once lesions develop, they can last anywhere from seven to 10 days. New lesions can develop up to seven days after the initial group appears.


Diagnosing HSV-2 and Syphilis

Healthcare providers will use a blood test or fluid from a sore to diagnose these STIs.


Treating Syphilis and Herpes

Since syphilis is a type of bacterial infection, it is curable. The CDC recommends that patients who are in the primary, secondary, and early latent stages receive a single dose of long-acting Benzathine penicillin G. Patients who are in the late latent stage of syphilis, or latent syphilis of an unknown duration, should receive a dose of long-acting Benzathine penicillin G once a week for three weeks in a row.

Antivirals can help control the course of HSV-2. Unfortunately, there are no medications available to cure herpes.

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The Importance of Seeking Treatment for STIs

Although, with the right antibiotic, syphilis is curable, reinfection is possible following treatment. And any damage resulting from the infection may be permanent. Interrupting transmission of syphilis and preventing reinfection by ensuring sexual partners also receive treatment is an important component of managing this STI.

HSV-2 is a lifelong virus, and with treatment, people can manage the virus. In addition, to help prevent the spread of infection, people should wear condoms while participating in sexual activity.

If you are experiencing any symptoms of syphilis or herpes or have concerns about potential exposure to a sexually transmitted infection, contact a healthcare professional for testing right away. After receiving an STI diagnosis, seeking treatment right away can reduce the likelihood of permanent health conditions and damage to your reproductive system resulting from the disease.

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