Syphilis Testing & Treatment

Primary

A single, firm, painless sore (chancre) at the site of infection, appearing 2–12 weeks after exposure. It's easy to miss precisely because it doesn't hurt.

Secondary

A rash — notably including the palms and soles — often with fever and swollen glands.

Latent

No symptoms at all, sometimes for years. The infection is still present and, in early latent stage, can still be transmitted. See our latent syphilis guide for more.

Tertiary

Rare today because most people get treated first, but if it's reached, it can cause serious damage to the heart, brain, nerves, and other organs.

Direct contact with a syphilis sore during vaginal, anal, or oral sex. A pregnant person can also pass it to their baby, which is why prenatal screening is standard and important.

A blood test is the standard way to diagnose syphilis, including during the symptom-free latent stage.

Penicillin (specifically benzathine penicillin G) is the standard treatment and the only option confirmed safe and effective during pregnancy. Dosing and duration depend on the stage. Treatment cures the infection but can't reverse damage already done, which is why earlier treatment matters so much.

Beyond tertiary-stage organ damage, untreated syphilis can affect the eyes (ocular syphilis) and ears (otosyphilis), and — as covered in our syphilis and mental health guide — can eventually cause genuine cognitive and psychiatric symptoms.

Can you get syphilis again after treatment?

Yes — treatment clears the current infection but doesn't provide immunity against future exposure.

How long after exposure should I test?

Around three weeks is typical for a reliable blood test result.