Testing for Syphilis

Getting tested for syphilis involves either a blood test that looks for antibodies or a swab test that will determine the presence of the bacteria that causes syphilis. Since you can have syphilis and not have symptoms, testing plays an important role in getting timely treatment.

What's measured by a syphilis test?

The syphilis test looks for a specific bacteria called treponema pallidum. This bacteria spreads through sexual contact and can cause sores on the infected areas, or no symptoms at all.

When should I get a syphilis test?

Syphilis doesn't always cause symptoms. Even when it does, signs can be so mild that many people don't realize they have the infection, says the CDC.

If you believe you may have had sexual contact with an infected person, you should get a syphilis test even if you don't notice any signs.

The CDC recommends undergoing syphilis testing if you're pregnant at your first prenatal appointment. You may need to retest at 28 weeks gestation and again at delivery if you're at high risk of contracting the infection.

If you have multiple sexual partners, have a partner with an STD, have HIV, or live in a community where syphilis is prevalent, the CDC recommends that you get tested regularly.

If you have an increased risk of contracting the infection, you may need to undergo testing every three to six months.

Because syphilis symptoms can mimic several other diseases, it's often called "The Great Pretender" and can only be diagnosed via lab testing.

Syphilis infections typically progress in stages, which can last for weeks or even years, depending on the person.

If you have any small, often painless sores around your genitals, rectum or mouth---even if you think they may be due to another condition---you should get tested just to be safe.

Types of syphilis tests

The two ways to test for syphilis are a blood test or a swab test.

Each one is quick and can be done with minimal discomfort. For either test, the blood sample or swab is sent to a lab for testing. The results can take hours to days depending on your location and the type of test.

A blood test is the most common test for syphilis, and can yield accurate results even if you have no symptoms.

Syphilis can also be tested for at home, though these tests may have a larger margin of error.

If your initial test shows that you are positive for syphilis, you may need to undergo a second phase of testing to confirm the diagnosis.

What to expect with a syphilis test

A blood sample is typically used to test for syphilis. Fluid swabbed from a syphilis sore can also be used for testing. These tests are generally performed by a healthcare provider in a lab, clinic or hospital setting.

Before the test

In most cases, patients do not need to prepare for syphilis testing. You should tell your doctor about any prescription or over-the-counter drugs you are taking, just like you would for any other blood test, but it is unusual to have to change prescriptions before undergoing a syphilis test.

During the test

To do the blood draw for the syphilis test, they'll insert a thin needle into the vein, collect a small amount of your blood in a vial or test tube, and then remove the needle.

You may feel a minor sting during the needle insertion or removal, but any discomfort should dissipate quickly. The entire process usually takes less than five minutes.

Home tests may use a finger prick as a way to collect a blood sample.

After the test

Following a syphilis test, it is recommended by the CDC to abstain from further sexual activity until after the test results are received.

If your test results indicate an active syphilis infection, you should consult your healthcare provider regarding next steps and ensure you avoid spreading the infection to others.

Risks of getting a syphilis test

While there are no common risks of getting a syphilis test, if your symptoms indicate that you may have a syphilis infection of the brain or nervous system, your healthcare provider may order cerebral spinal fluid (CSF) testing.

This type of test requires a lumbar puncture (spinal tap) to collect fluid from your spinal canal.

During this simple outpatient procedure, your healthcare provider will have you sit on an exam table or lie on your side.

You'll be given an anesthetic that numbs the area, so you don't feel pain during the spinal tap. Once you're numb, your provider will insert a hollow, thin needle into the lower portion of your spinal canal to withdraw a sample of CSF.

Syphilis test results

If you test positive for syphilis, your provider may want a second test to confirm the diagnosis. This is because there are some factors that may cause a false-positive result.

According to the CDC, some of these factors include:

• age
• pregnancy
• autoimmune conditions
• other medication conditions
• recent vaccination
• drug or medication use
• other infections

If you test negative for syphilis, then your provider may want to reorder the test if you are experiencing symptoms or you have been exposed. A false-negative is rare, but can happen if tested too early.

Finding a syphilis test

Testing for syphilis is a fairly simple process.

If you have a primary care provider, the test would be most commonly ordered by them. The test could be conducted at a medical laborator, hospital, doctor's office, or community health clinic.

If you are not under the care of a physician, a syphilis test can be ordered for yourself through an online provider like Solv.

Once you've ordered the test online, you will be sent to a Clinical Laboratory Improvement Amendments (CLIA)-approved lab for your test with a physician consultation made available to you following a positive test result.

Can I get a syphilis test at home?

Yes, syphilis is one of the STD tests that you are able to screen for through an at-home testing kit, which usually involves a finger prick style blood draw.

However, the CDC does not recommend home tests for anyone who has active symptoms or who has had sexual contact with someone who has tested positive for syphilis. This is because home tests will need to be sent to a laboratory, and results can take several days.

If you are at high risk for syphilis, the CDC recommends that you be tested by a doctor near you so that you can begin treatment as soon as possible.

Cost of an syphilis test

On average, syphilis testing ranges from $10 to $200 depending on location and insurance coverage. Syphilis testing can be done by itself or combined with other STI testing.

Because the symptoms of syphilis are similar to other STIs, you may want to consider expanded STI testing.

More information about syphilis

What is Syphilis?

Syphilis is an infection spread through sexual contact caused by the bacterium treponema pallidum.

Some people may never develop syphilis symptoms, making it exceedingly easy to transfer from person to person.

When symptoms do develop, syphilis can cause small sores called chancres in your genitals, throat, and rectum. Advanced stages of syphilis can cause ulcers, rashes, and lesions throughout your body, reports the CDC.

Syphilis is curable, yet seldom goes away on its own.

If your test results are positive, the CDC recommends that you should begin treatment right away and be checked often. If syphilis is not treated, it can cause harm to the brain, eyes, heart, nerves, bones, joints, and liver.

Syphilis symptoms to watch for

Syphilis initially presents as a small, painless sore on the genitals, anus, or mouth. After these sores heal, the CDC says that the infection can persist for weeks, months, or even years progressing through four stages if left untreated:

Primary syphilis

Chancres are little, painless sores that form roughly 3 weeks after being exposed to the treponema pallidum bacteria responsible for syphilis. This is most commonly seen near the genitals, anus, or mouth.

Secondary syphilis

A few weeks after the chancres heal, the CDC says you may see a crimson or reddish-brown rash on your body, which frequently extends to your palms and soles. Additional signs and symptoms may include:

• fever
• sore throat
• swollen lymph nodes
• headaches
• oral and anal sores
• muscle aches
• patchy hair loss
• weight loss

Latent syphilis

There are generally no active symptoms in the latent stage of syphilis. The virus can lay dormant in the body for years before causing tertiary syphilis.

Tertiary syphilis

The advanced stage of syphilis, or tertiary syphilis, might appear several years after the initial infection. If untreated, the CDC reports that it can have a wide range of effects on the body's systems, including:

• brain and nervous system
• eyes
• heart
• blood vessels
• bones and joints