Syphilis is one of the oldest STIs we know — and one of the simplest to cure. A single dose of long-acting penicillin clears early-stage syphilis completely. Late-stage syphilis takes three doses but is also fully curable.
The problem is access and awareness. US cases have doubled since 2018, and congenital syphilis (mother-to-baby) is at a 30-year high. Free at-home test kits, public-health clinics, and primary-care testing make syphilis screening accessible to almost anyone — testing is the way out.
Below: the four stages, transmission, neurosyphilis, treatment, and one personal story.
What syphilis is and how it spreads
Syphilis is a bacterial STI caused by Treponema pallidum. Curable with penicillin at any stage — but if left untreated, it progresses through four stages with potentially life-altering consequences.
Neurosyphilis and late-stage complications
Untreated syphilis can invade the nervous system — sometimes years after the original infection. Neurosyphilis is preventable but serious when it occurs.
Living with a syphilis diagnosis
A syphilis diagnosis can feel terrifying. It is also one of the most treatable STIs. Real stories from people who walked through it.
In-depth Syphilis guides
All guides →Syphilis symptoms by stage
The four stages, neurosyphilis, congenital risks.
How syphilis testing actually works
Two-step blood tests, RPR/VDRL vs TPPA, how to read titer results.
Syphilis epidemic 2026 — why cases are rising
US cases up 7x since 2010. Congenital syphilis quintupled. What drives it.
Syphilis test types compared — RPR, VDRL, TPPA
Non-treponemal vs treponemal tests, the two-step algorithm, reading titers.
Syphilis in pregnancy & congenital syphilis prevention
Universal screening, penicillin treatment, why timing matters for fetal outcomes.
Frequently asked questions
Is syphilis curable?+
Yes. Syphilis is curable at any stage with penicillin. Primary, secondary, and early latent syphilis are treated with a single intramuscular dose of benzathine penicillin G. Late latent and tertiary syphilis require three weekly doses. Penicillin-allergic patients have alternative regimens.
What are the stages of syphilis?+
Syphilis has four stages: (1) primary — a painless sore (chancre) at the site of infection; (2) secondary — rash, mucous patches, flu-like symptoms; (3) latent — no symptoms, but the bacterium is still present; (4) tertiary — gummas, cardiovascular damage, neurosyphilis, sometimes decades later.
How is syphilis transmitted?+
Syphilis spreads through direct contact with a syphilis sore (chancre) during vaginal, anal, or oral sex. It can also pass from mother to baby during pregnancy (congenital syphilis). It does not spread through toilet seats, shared utensils, or casual contact.
What is neurosyphilis?+
Neurosyphilis is what happens when untreated syphilis invades the brain or spinal cord — can occur at any stage, sometimes 10-30 years after the original infection. Symptoms include vision changes, hearing loss, confusion, paralysis, and dementia-like presentations. Treatable but easier to prevent with early syphilis treatment.
How is syphilis tested?+
Two tests are run together: a non-treponemal test (RPR or VDRL) screens broadly; a treponemal test (FTA-ABS or TP-PA) confirms. Both are blood tests. CDC recommends screening for everyone with risk factors, all pregnant women, and anyone with a new sex partner since their last screen.
Why are syphilis cases rising in 2025-2026?+
US syphilis cases have more than doubled since 2018, driven by gaps in public health funding, reduced STI screening during COVID, and dating-app-era partner change. Congenital syphilis (mother-to-baby) is at a 30-year high. Free clinics and at-home testing kits are widely available — testing is the way out.
Can I have sex again after syphilis treatment?+
Wait at least 7-14 days after completing penicillin treatment, and only after any sores have fully healed. All sex partners from the past 90 days (or longer depending on stage) should be tested and treated. Follow-up blood testing at 6 and 12 months confirms cure.
Walking through a syphilis diagnosis?
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