Syphilis testing: quick facts and what to expect

Syphilis can show no symptoms for years yet still cause serious problems. Testing is quick, affordable, and the only way to know for sure if you have it. You don’t need to feel embarrassed—clinics see this often and the tests are routine.

Most doctors start with a nontreponemal test like RPR or VDRL. These look for antibodies your body makes when infected. They’re cheap and useful for screening and for tracking treatment because results give a titer number that falls with successful therapy.

Treponemal tests (FTA‑ABS, TPPA, or modern EIAs) detect proteins specific to the syphilis bug. They stay positive for life in many people, so doctors rely on both test types together: nontreponemal for current activity, treponemal to confirm exposure.

Timing matters. It can take several weeks after exposure for antibodies to show up. If you test too early, a repeat test at 3 months gives a clearer answer. If there’s a recent high-risk exposure, some clinics offer earlier repeat testing or direct treatment advice right away.

Positive results need context. A reactive screening test usually leads to a confirmatory treponemal test or a reflex algorithm that the lab follows. False positives happen with other illnesses or pregnancy, and rare “prozone” effects can hide a true positive unless the lab dilutes the sample. Ask your provider to explain titers and what changes mean for your care.

Get tested if you have a new painless sore, unexplained rashes, swollen glands, or any sexual partner who tested positive. Pregnant people should test early and again later in pregnancy—untreated syphilis can harm the baby. Routine testing is also wise if you have multiple partners or inconsistent condom use.

Free or low-cost testing is available at local health departments, Planned Parenthood, and sexual health clinics. Many primary care offices offer testing too. If you prefer privacy, home test kits that collect finger-prick blood are an option—but pick a lab-backed kit and be ready to follow up with a clinic for positives.

If a test is positive, treatment with penicillin is the standard and usually cures the infection. You’ll need follow-up blood tests to show the titer is falling. Don’t have sex until your doctor says it’s safe, and tell recent partners so they can get tested and treated too. If you’re allergic to penicillin, ask about alternatives or allergy testing.

Quick FAQ

Cost varies: many clinics test free, while private labs may charge. Insurance often covers testing; ask before. Results timing ranges from a few days to a week for lab tests, faster for rapid tests. If you travel or plan pregnancy, get tested as a precaution. Keep copies of results for medical records and future care. Ask questions if you’re worried.