Syphilis: What You Need to Know Now

Syphilis is a bacterial STD that can look mild at first but cause serious problems if left alone. A painless sore, a rash that shows up on your palms or soles, or flu-like symptoms after sex could all be signs. The tricky part: symptoms can come and go, so many people miss it until later stages. Quick testing and treatment stop most harm.

How testing works and when to get checked

Testing usually uses two kinds of blood tests: a non-treponemal test (RPR or VDRL) that gauges active infection and a treponemal test that confirms exposure. Early infection can sometimes give a negative result, so if you’ve had recent exposure or have sore(s), tell the clinic and consider repeat testing in 2–4 weeks. Pregnant people should get tested early in pregnancy and again in the third trimester if risk is ongoing.

If you find a painless ulcer, go in right away. Swabs from sores can also detect the bacteria, which helps start treatment faster and protects partners.

Treatment made simple

The gold standard is an injection of benzathine penicillin G. For early syphilis this is usually a single shot. If the infection is older (late latent), treatment often means three weekly injections. If you’re allergic to penicillin, non-pregnant people may get doxycycline pills, but pregnant people who are allergic need penicillin after a desensitization procedure—this is crucial to protect the baby.

After treatment, follow-up blood tests at 6 and 12 months make sure your levels fall as expected. Avoid sex until your doctor says it’s safe—usually at least 7 days after treatment and only after sores fully heal. Tell recent sexual partners so they can get tested and treated if needed.

Antibiotic resistance hasn’t replaced penicillin for syphilis, but some other drugs like azithromycin aren’t reliable anymore in many places. That’s why clinics stick with penicillin or recommended oral alternatives when appropriate.

Prevention is mostly about safer sex and regular testing. Condoms lower the risk but don’t eliminate it when sores are outside the covered area. If you have multiple partners, get tested regularly—every 3 months is common for higher-risk people. Pregnant people should be screened early and again later if risk continues.

If you’re worried you were exposed, don’t wait for symptoms. Call a sexual health clinic or your doctor, get tested, and ask about treatment options. Early action protects your health and stops spread to others, including newborns who can face severe outcomes without treatment.

Need local testing or treatment options? Check with community clinics, sexual health centers, or your primary care provider. If you want, we can point you to resources that help find testing near you.