what to know
Syphilis is surging in the United States.
Here’s what you need to know about it.
Should I test for syphilis?
According to the CDC, if you have had unprotected sex with unfamiliar partners or feel you may be at risk for syphilis, it’s important to test as early as possible—and for certain at-risk populations to test several times per year—to prevent long-term complications to your health.
Syphilis isn’t a disease of the past.
Syphilis rates in the U.S. have reached a level not seen since the 1950s.
Syphilis cases have increased by nearly 80% between 2018 and 2022, according to the CDC. With rapidly rising rates of the disease, sexually active people could be at risk, especially because initial symptoms of syphilis can often be painless or go unnoticed.*
It is important to test yourself regularly.
If you are sexually active, especially with more than one partner, it is important to test yourself regularly. Fortunately, syphilis can be effectively treated and cured with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection has caused.*
You might not think it’s a big deal.
You might not think it’s a big deal, but left untreated, syphilis can cause serious health complications that can even be fatal. While there are effective treatments and cures, it can go unnoticed for years—meaning you could be unknowingly spreading syphilis to sexual partners.*
Stages & Symptoms of syphilis
Syphilis can often go unnoticed for years before symptoms arise.
Throughout each of the four stages of syphilis, different symptoms may arise. The four stages are primary, secondary, latent, and tertiary. The following information from the CDC explains the symptoms of each stage of syphilis.
Primary stage
During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore or sores will appear at the location where syphilis entered your body. These sores usually occur in, on, or around the penis, vagina, anus, rectum, lips, or in the mouth.
Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not even notice it. The sores usually last between three to six weeks and may heal regardless of whether you receive treatment or not. However, even after the sores go away, you must receive treatment to prevent the infection from moving onto the secondary stage.
Secondary stage
During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up while your primary sore is healing or several weeks after the sore has healed.
The rash can be on the palms of your hands and/or the bottoms of your feet and look rough and red or reddish-brown. The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other symptoms at this stage may include:
- Fever
- Swollen lymph glands
- Sore throat
- Patchy hair loss
- Headaches
- Weight loss
- Muscle aches
- Fatigue (feeling very tired)
The symptoms from this stage may also go away regardless of whether you receive treatment or not. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.
Latent stage
The latent stage of syphilis presents no visible signs or symptoms of the disease. Without treatment, syphilis can remain in your body lying dormant for years.
Tertiary stage
Tertiary syphilis is very serious and would occur 10–30 years after your infection began. Most people with untreated syphilis do not develop tertiary syphilis. In tertiary syphilis, the disease damages your internal organs, including the heart and brain, and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.
Neurosyphilis, ocular syphilis, and otosyphilis
Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can occur during any of the stages of syphilis.
Symptoms of neurosyphilis may include:
- Severe headache
- Muscle weakness and/or trouble with muscle movements
- Changes to your mental state (trouble focusing, confusion, personality change)
- Dementia (problems with memory, thinking, and/or decision making)
Symptoms of ocular syphilis may include:
- Eye pain and/or redness
- Changes in your vision or even blindness
Symptoms of otosyphilis may include:
- Hearing loss
- Ringing, buzzing, roaring, or hissing in the ears (tinnitus)
- Dizziness or vertigo (feeling like you or your surroundings are moving or spinning)
Causes of syphilis
You can get syphilis by direct contact with a syphilis sore.
You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex or by kissing someone with a syphilis sore in their mouth. It can also be transmitted from an infected mother to her baby during pregnancy—this is known as congenital syphilis.*
Prevention of syphilis
Practice safe sex today.
Thank yourself tomorrow.
According to the CDC, the only way to completely avoid STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can lower your chances of getting syphilis by:
- Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have syphilis.
- Using condoms the right way every time you have sex.
While condoms prevent the spread of syphilis by preventing contact with a sore, sores can occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.*
I’m pregnant.
If I have syphilis, how can I protect my baby from getting it?
If you are pregnant and have syphilis, you can transmit the infection to your baby. To protect your baby, you should receive syphilis testing at least once during your pregnancy.* The American College of Obstetrics and Gynecology (ACOG) recommends that pregnant women be tested three (3) times during pregnancy: at your first prenatal visit, in the third trimester, and at delivery.**
Consult your doctor or a local clinic to receive treatment right away if you test positive.
*U.S. Centers for Disease Control and Prevention
** The American College of Obstetricians and Gynecologists
Treatment and recovery
Is there a cure for syphilis?
Yes, syphilis is curable with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection has caused.*
What do I do if I test positive for Syphilis?
See your doctor to confirm the result and obtain antibiotic treatment. If you can’t see a doctor, contact your local health department or connect with a telehealth provider for immediate support.
Treatment for syphilis infection is available but requires a consultation with a healthcare provider. Avoid sexual contact with others until after you have consulted with a doctor. You should notify anyone you have had sex with in the last 60 days (2 months) before receiving positive test result or before your symptoms started. If you haven’t had sex in the last 60 days, you should notify your most recent partner.*
Can I get syphilis again after receiving treatment?
According to the CDC, being infected with syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again.
It may not be obvious that a sex partner has syphilis. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis, can be hard to see. You may get syphilis again if your sex partner(s) does not receive testing and treatment.
Testing for syphilis
The CDC recommends the following populations be tested for syphilis.
Women
Asymptomatic women at increased risk for syphilis infection (history of incarceration or transactional sex work, geography, race/ethnicity)
Pregnant women
- All pregnant women at the first prenatal visit.
- Retest at 28 weeks gestation and at delivery if at increased risk due to geography or personal risk (substance use, STIs during pregnancy, multiple partners, a new partner, partner with STIs).
- It is recommended by The American College of Obstetricians and Gynecologists for pregnant women to be tested three (3) times during pregnancy: at your first prenatal visit, in the third trimester, and at delivery.
Men who have sex with women
Asymptomatic adults at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity, and being a male younger than 29 years) for syphilis infection
Men who have sex with men (MSM)
- At least annually for sexually active MSM
- Every 3 to 6 months if at increased risk
- Asymptomatic adults at increased risk for syphilis infection (history of incarceration or transactional sex work, geography, race/ethnicity, and being a male younger than 29 years)
Transgender and gender diverse people
Consider screening at least annually based on reported sexual behaviors and exposure.
Persons with HIV
For sexually active individuals, screen at your first HIV evaluation, and at least annually thereafter. More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology.
Additionally, you should get tested regularly for syphilis
if you are sexually active and
You are taking pre-exposure prophylaxis (PrEP) for HIV prevention, have a partner or partners who have tested positive for syphilis, or have certain risk factors for syphilis—like living in a community with high rates of syphilis.
In-home testing
Should I take an in-home syphilis test?
The First To Know Syphilis Test is for people who think they might have an illness called syphilis because they have symptoms or have been sexually active with someone who has syphilis. Pregnant women should also get checked for syphilis when they visit their doctor.
The First To Know Syphilis Test is sold over-the-counter and provides accurate in-home results, in just 15 minutes.
How It Works
How to test yourself at home for syphilis.
If you test positive for syphilis using the First To Know Syphilis Test, you should see your doctor to confirm the result and obtain antibiotic treatment. If you can’t see a doctor, contact your local health department or connect with a telehealth provider for immediate support.
Treatment for syphilis infection is available but requires a consultation with a healthcare provider. Avoid sexual contact with others until after you have consulted with a doctor. You should notify anyone you have had sex with in the last 60 days (2 months) before receiving a positive test result or before your symptoms started. If you haven’t had sex in the last 60 days, you should notify your most recent partner.