Syphilis and lip sores or changes

The first sore may be firm, round, and painless, and it can heal without treatment. Later infection can cause pale patches in the mouth, a sore throat, swollen glands, or a rash elsewhere, but not everyone notices these changes. Cold sores, mouth ulcers, irritation, trauma, and other infections can also affect the lip. The look of a lesion cannot identify its cause, and absence of pain does not make syphilis more or less certain.

Arrange a clinical assessment for a new lip or mouth sore that follows sexual contact, lasts longer than expected, keeps returning, or occurs with a rash or swollen glands. Tell the clinician about oral sex, possible exposure, previous syphilis, and any treatment. Testing may include blood testing and, if suitable, assessment of the lesion. Avoid kissing or sexual contact involving the mouth until advised, and do not share prescribed antibiotics.

Seek prompt care for a painless lip or mouth sore after possible exposure, or for a rash involving the palms or soles. Get urgent help if mouth swelling affects breathing or swallowing, or if you develop eye symptoms, hearing changes, severe headache, confusion, weakness, or balance problems. Pregnancy with possible exposure needs prompt medical advice.

Ask whether the lesion needs a swab or other examination, which blood tests are appropriate, and whether testing should be repeated. Discuss partner assessment, the antibiotic plan if syphilis is confirmed, and when mouth contact is safe again.