Syphilis Test

Syphilis is one of many highly contagious sexually transmitted infections, and if you think there's a chance you have it, you need to take a syphilis test. Syphilis can cause devastating health problems if left untreated, including damage to vital organs during the later stages.

Luckily, syphilis infection is easily cured as long as you catch it early. Here, we'll go through what this disease is, as well as which bacteria causes it and how it can be transmitted. Additionally, we'll look at the early symptoms to look out for so you can get tested and treated swiftly and effectively.

But what does a syphilis test involve? Where do you get tested? Testing for syphilis typically begins with a simple blood test, but further screening may be needed.

We've covered this as well, and you can find more information about syphilis tests and the results a bit further down in this article.

Looking after your health, especially sexual, is very important as sexually transmitted infections can cause serious and even life-threatening health issues. If you'd like more information about syphilis and the screening test procedure, be sure to keep reading.

What is Syphilis?

Syphilis is a bacterial infection that's spread through sexual contact, including anal and oral sex. Infected people often don't realise they have syphilis, consequently passing it on to their sexual partners.

According to the Centers for Disease Control and Prevention, syphilis has four stages; primary, secondary, latent, and tertiary. Each stage has different signs and symptoms, so it's important to be aware of each of them.

Syphilis infection is caused by the bacteria known as Treponema pallidum. It's transmitted through direct contact with sores that are caused by the disease on another person.

This typically happens during any sexual activity, but the syphilis bacteria can also enter your body through mucous membranes or if you have any cuts on your skin. The disease can't be transmitted through doorknobs, swimming pools, toilet seats, clothing, or eating utensils.

You have a higher risk of catching syphilis if you:

  • Don't practise safe sex
  • Have more than 1 sexual partner
  • Currently have HIV
  • Are a man who has sexual contact with men

If you're sexually active, there are steps you can take to lower the risks of contracting syphilis infection:

  • Being in a monogamous and long-term relationship with someone who has tested negative for syphilis.
  • Using condoms during sex. Condoms can prevent the disease from being passed on by preventing any contact with a syphilis sore. Be aware, though; these sores can appear in areas that aren't protected by a condom, so the disease can still be passed on.

What are the Symptoms of Syphilis?

Next, let's take a look at the symptoms of each stage of syphilis. There are four stages, and if the disease is left untreated, it will gradually progress through each stage and cause more serious health issues.

Primary Stage

The initial stage of syphilis is called the primary stage, and the main symptom will be a single sore or even multiple sores. The sore will appear at the site where the Treponema Pallidum bacteria entered your body. These sores are typically round, firm, and painless. Because there's usually no pain, the sore can easily be missed.

This symptom tends to appear around 3 weeks after exposure, but it can take 10-90 days. The sore will generally heal after 3-6 weeks, whether you've had treatment or not.

The problem is, even if the sore has gone, without treatment, the disease will still be in your body. You must seek treatment to prevent the disease from progressing into the next stage.

Secondary Stage

If you leave the disease untreated, it can move along to secondary syphilis. Here you may develop lesions on your mucous membranes, skin rashes or both. The lesions appear as sores on your anus, vagina or in your mouth, and this stage typically begins with a skin rash on one or multiple areas.

The rash usually consists of red, rough or brown spots on the soles of your feet or palms. It probably won't be itchy, and it can be very faint, so you may not even notice it.

Additional symptoms may include hair loss, fever, sore throat, swollen lymph glands, and fatigue. These signs will eventually go away whether you get treated or not. But without treatment, the infection will just progress to the next stage.

Latent Stage

The next stage of syphilis is called the latent stage. During this stage, there aren't any visible signs. This can be very dangerous as it lulls you into a false sense of security.

However, the infection is still there, and it's simply lying dormant in your system unless you seek treatment. If you don't get treated, you'll continue to have the disease for years without any symptoms, potentially infecting other people.

Not only that but there's a risk the disease will move to the final stage, which can cause debilitating and potentially fatal health issues.

Tertiary Stage

Tertiary syphilis is the last and most deadly stage. Many people with syphilis don't reach this stage, but if they do, it can cause a lot of damage to major organ systems, including the spinal cord, blood vessels, and heart.

The tertiary stage is extremely serious and can occur anywhere from 10 to 30 years after you first became infected. In tertiary syphilis, the infection causes damage to your vital internal organs and can kill you.

How to Test for Syphilis

Syphilis testing can help identify and diagnose syphilis when the disease is in the early stages, which is when it's easiest to treat. The tests may also be called rapid plasma reagin (RPR), fluorescent treponemal antibody absorption, also known as FTA-ABS, or VDRL - venereal disease research laboratory.

Testing is usually done by collecting bodily fluid, tissue, or blood samples. If the initial screening test shows signs of syphilis, further tests will be performed to confirm a diagnosis.

Screening Tests

The screening tests typically used include:

  • Venereal disease research laboratory: This test checks the spinal fluid or blood for antibodies that are produced in syphilis sufferers. These aren't produced as a result of the disease specifically, so the test results may be abnormal for other reasons.
  • Rapid plasma reagin: This test also checks for syphilis antibodies.
  • Rapid immunochromatographic test: This test identifies antibodies that are produced in response to the disease specifically. Unlike the other tests, the tissue or blood sample isn't sent to a laboratory; rather, your doctor or health care provider will give you the results.

If your screening test is positive, you'll be sent for more syphilis tests to either confirm or rule out a diagnosis. Most follow up tests also check for syphilis antibodies, and sometimes your health care provider or doctor will perform tests for syphilis bacteria instead of antibodies.

Syphilis Test for Men

Syphilis tests are the same for males and females and typically start with screening to find signs of infection.

There is a link between syphilis and HIV, and in the US, roughly 50% of men that have sex with men who tested positive for the disease also had HIV. Additionally, men who have sex with men who are HIV negative but positive for syphilis have a higher risk of contracting HIV later on.

The reason for this link between the two diseases is that the syphilis sores make it much easier to pass on and catch the HIV infection during sexual activity.

Initial syphilis tests usually involve a blood sample being taken from a vein in one of your arms. The health care worker will insert a needle and draw a small amount of blood into a vial. You may feel a scratch as the needle goes in, but it should be a painless procedure.

Syphilis Test for Women

Just like for men, a blood test will be performed to check for any signs of syphilis. There is a danger that the infection can be passed onto an unborn baby during pregnancy; this is known as congenital syphilis. Every pregnant woman should have a syphilis blood test at the initial prenatal appointment.

Some will also need to be tested again in the third trimester and around the time of delivery. This especially includes women who:

  • Were untested previously
  • Live in locations of high morbidity from syphilis
  • Have a higher risk of catching the infection, i.e. from having multiple sexual partners, drug use, or no prenatal care.

The NHS recommend that a discussion about the treatment of sexual partners and continual risk behaviour should be had. This is to try to prevent the chance of reinfection.

According to the Centers for Disease Control and Prevention, many untreated syphilis cases can result in the death of the baby, specifically up to 40% of cases.

Pregnant women may have a much higher risk of giving birth to infants who die after delivery, or stillbirths depending on how long they have been infected.

If an infected baby is born alive, there may not be any immediate signs or symptoms. But if it's left untreated, the infant may start suffering from serious problems after just a few weeks.

Untreated infants may suffer from developmental delays, seizures, or death. All babies born to mothers with the disease should be screened and checked thoroughly for signs of congenital syphilis.

How long does a syphilis test take?

This depends on which syphilis tests you have and the methods used. Usually, blood or tissue samples are sent to a laboratory, and the results can take 3-5 days to come back.

The best place to go for syphilis tests is a sexual health clinic. These clinics can also be called genitourinary medicine clinics (GUM). They're run by healthcare professionals who have specific expertise in sexually transmitted diseases.

They also have better access to the tests and medication needed to treat infections than local GP surgeries.

Will a syphilis test always be positive?

Sometimes, people may not have antibodies even if they've been infected with the disease. This means that some tests can be inaccurate.

The antibodies produced in response to the disease can also remain in peoples' systems even after they've been treated. This means the test results may always be positive.


What tests are used to diagnose syphilis?

The syphilis tests used to confirm a diagnosis include:

  • Enzyme immunoassay: This test involves a blood sample being taken to identify syphilis antibodies.
  • Fluorescent treponemal antibody absorption: This also tests for antibodies, and it can be done by taking a blood or spinal fluid sample.
  • TPPA test: This is another antibody test, and it's used once another method has tested positive.
  • Darkfield microscopy: This test involves a specialised microscope to identify the germ in a fluid sample. This is usually done to confirm the infection in its early stages.
  • MHA-TP test: This test is done to confirm the infection once another test comes back positive.

How long does a syphilis blood test take?

Blood tests are a very quick and painless way of testing for sexually transmitted diseases. It should only take a few days for you to get the results back, so you can get the proper treatment quickly.

Tests involving blood samples can detect the disease as early as 2 weeks after infection, with the highest level of accuracy being within the first three months.

When should I test for syphilis?

You should go for tests as soon as you notice symptoms. If you've had unprotected sex with new or multiple sexual partners, you should go for tests, even if you don't have symptoms. This is because sores caused by the infection can appear in places that aren't visible.

The sooner you get a confirmed diagnosis, the easier it is to treat. But remember, having the disease once won't protect you from catching it a second time. You can still get re-infected even after successful treatment.

The only way to lower the risk of being infected again is to use condoms during sexual activity and go for syphilis tests.


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