Difference Between Syphilis and Herpes

Syphilis and Herpes are two sexually transmitted diseases (STD). They both are highly dangerous and cause widespread damage to the body. While both may present similarly, there are many fundamental differences between the two and that will be discussed here in detail.


Syphilis is a serious sexually transmitted disease with such drastic effects. All undiagnosed genital ulcers are considered to be syphilis till proven otherwise. Syphilis is caused by Treponema pallidum. Treponema enters the body through abrasion during sex. It causes obliteration of small arteries, which is the foundation for all its symptoms. It is common among homosexuals. Syphilis is on the rise in developed countries as well as in developing countries.

Syphilis progresses in four stages. The Treponema incubates for 9 to 90 days after entering the body. During primary syphilis, small macule forms at the site of infection. It then transforms itself to a small hard ulcer known as the primary chancre. Secondary stage starts 4 to 8 weeks after the onset of the chancre. Fever, malaise, lymph node enlargement, rash, hair loss, multiple warts, snail tract ulcers in mouth, liver, and meningeal inflammation, kidney failure, and painful red eye are known clinical features of the secondary stage. Tertiary syphilis follows after a 2 to 20 years latency period. Gummas in skin, lungs, eyes, joints, and bones are the cardinal feature of tertiary syphilis. Quaternary syphilis includes cardiovascular, meningovascular, general paresis of insane and tabes dorsalis varieties. 

Cardiolipin antibodies and Treponema specific antibodies in serum are the investigations of choice for definitive diagnosis. Other investigations are required to assess systemic function. Procaine penicillin is the drug of choice.


Herpes simplex virus 1 and 2 are responsible for a wide spectrum of disorders. Herpes falls into two main categories according to the site of infection: oro-facial herpes and genital herpes. HSV 1 affects mouth, face, eyes, throat and brain. HSV 2 causes ano-genital herpes. After the virus enters the body, it goes into the nerve cell bodies and remains dormant in ganglions. Antibodies formed against the virus after the first infection, prevent a second infection by the same type. Anyway the immune system is unable to remove the virus from the body completely.

Herpes gingivostomatitis affects the gums and mouth. This is the first presentation in most of the cases. It causes gum bleeding, sensitive teeth, and pain in gums. Blisters appear in groups, in the mouth. This comes on more severely than herpes labialis. Herpes labialis presents as groups of characteristic blisters on the lips.

Genital herpes features clusters of papules and vesicle surrounded by inflamed skin on the outer surface of penis or labia. Herpetic whitlow is a very painful infection on the finger or toe nail cuticles. Herpetic whitlow is transmitted by contact. Fever, headache, swollen lymph node accompany herpetic whitlow. 

Herpes meningitis and encephalitis are thought to be due to retrograde migration of virus along nerves to the brain. It affects the temporal lobe mainly. Herpes is the commonest cause of viral meningitis. Herpes esophagitis occurs in immune deficient individuals and feature painful difficult swallowing. Bell’s palsy and Alzheimer disease are known association of herpes.

Analgesics and antivirals are the main treatment methods. Barrier methods can prevent herpes. There is a high risk of transmission to the baby if the mother gets infected during the last days of pregnancy. Acyclovir can be given after 36 weeks. Caesarian section is recommended to minimize contact during delivery.

What is the difference between Syphilis and Herpes?

• Syphilis is a bacterial infection while herpes is a viral infection. (Read the Difference Between Viral and Bacterial Infection

• Herpes can be caused by two viruses while syphilis is due to Treponema only.

• Syphilis progresses in three stages while herpes does not have such a natural history.

• Syphilis causes a hard primary chancre while herpes causes small clustered pustules.

• Secondary syphilis causes generalized features like fever, malaise, and lymph node enlargement while herpetic whitlow too causes such symptoms.

• Herpes causes viral meningitis while quaternary syphilis may affect meninges.

• Syphilis responds to penicillin while herpes responds to acyclovir.


Read more:

1. Difference Between Genital Warts and Herpes

2. Difference Between Acne and Herpes

3. Difference Between Herpes and Ingrown Hair

4. Difference Between HPV and Herpes

5. Difference Between Pimple and Herpes