This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Syphilis is a bacterial infection that spreads through sexual contact. It can be quiet for years, and it can look like other conditions. It is also one of the most treatable infections a clinician sees. The common questions are what syphilis symptoms look like, how testing works, and whether syphilis is curable. This guide answers those questions with sources and with New York City numbers.

It follows the science-first format of our deep-dive series. Instead of an ingredient, the subject is the organism behind syphilis, the tests that detect it and the medicine a clinician prescribes.

The short answers

Is syphilis curable? Yes. The CDC STI Treatment Guidelines (2021) list penicillin as the preferred treatment, prescribed by a clinician.
What does syphilis look like? It varies by stage. A sore, a rash, or no noticeable signs at all are all possible.
How is it found? Through a blood test, sometimes alongside a swab of a sore. A clinician interprets the results.
Is it common in New York City? The NYC Department of Health and Mental Hygiene (DOHMH) reports thousands of cases each year, which is why routine testing is part of sexual health care here.

What causes syphilis

Syphilis is caused by a bacterium called Treponema pallidum. It is a thin, spiral-shaped organism. Under a microscope it looks like a tiny corkscrew.

The bacterium enters the body through small breaks in the skin or through mucous membranes. These can be in the genital area, the mouth, or the anus. The CDC says syphilis spreads by direct contact with a syphilis sore, and sores can be hidden inside the mouth, vagina, or rectum, where a person may not see them.

The bacterium cannot be cultured in a routine lab the way many other bacteria can. That one fact shapes how syphilis is diagnosed. Clinicians rely mostly on blood tests that look for the body's response to the infection, not on growing the organism.

Syphilis can also pass from a pregnant person to a baby during pregnancy. The CDC calls this congenital syphilis. It is one reason pregnancy screening rules exist, and we cover them below.

The stages of syphilis

The CDC describes syphilis in stages. Not everyone moves through every stage in a neat order. Stages can overlap, and signs can be mild enough to miss. This is what the CDC lists for each one.

Primary syphilis

The first sign is usually a sore called a chancre. It is typically firm, round, and painless. It shows up where the bacterium entered the body. There may be just one, or several.

Because it does not hurt and may be inside the body, many people never notice it. The CDC says the sore heals on its own, usually in three to six weeks, even without treatment. Healing does not mean the infection is gone.

Secondary syphilis

This stage often includes the syphilis rash. The CDC says it can show up as the first sore is healing or several weeks after it has healed.

The rash is often described as rough, reddish-brown or pink spots. It frequently appears on the palms of the hands and the soles of the feet. It can also appear on the chest, back, or elsewhere, and in some people it is faint and easy to overlook. The rash usually does not itch.

Other secondary syphilis symptoms the CDC lists include:

Fever
Swollen lymph glands
Sore throat
Patchy hair loss
Headaches and muscle aches
Tiredness
Weight loss
Moist, wart-like patches in warm areas of the body

These signs can also come with many other conditions. A rash by itself cannot tell anyone whether it is syphilis. Only a clinician and a test can do that.

Latent syphilis

After the secondary stage, signs go away, but the bacterium remains in the body. The CDC calls this the latent stage. A person may have no symptoms at all. The only clue is a positive blood test.

The CDC divides latent syphilis into early latent, meaning infection acquired within the previous year, and late latent or unknown duration. This matters because the type of treatment a clinician chooses depends on it. NYC DOHMH reports early latent syphilis as its own category, which shows how often it is found through testing alone.

Tertiary syphilis

The CDC says that without treatment, a small share of people go on to tertiary syphilis, years or even decades later. It can affect the heart, blood vessels, brain, and other organs. This stage is now uncommon where treatment is available, and it is a strong reason that earlier testing matters.

Neurosyphilis, ocular and otic syphilis

The CDC notes that syphilis can involve the nervous system, the eyes, or the ears at any stage. Possible signs include severe headache, changes in vision, hearing changes or ringing in the ears, and dizziness. Anyone with those signs should contact a clinician promptly and mention any possible syphilis exposure. A clinician may order extra evaluation, such as a closer look at the eyes or ears.

Why the national rise matters

The CDC has reported that syphilis cases in the United States rose over the past decade, including among women and newborns. The CDC's congenital syphilis numbers have drawn particular attention, because every one of those cases is a missed chance to test and treat during pregnancy.

For a reader, this means three practical things:

Syphilis is not rare, and it is not limited to any one group. It affects people of every gender, orientation, and background.
Because many cases have no noticeable signs, testing is the only way to find them early.
Because it is curable, finding it early gives a clinician the chance to treat it before it causes lasting problems.

The USPSTF recommends syphilis screening for people at increased risk and for all pregnant people. A clinician can help work out whether routine screening makes sense for you. Bring it up at any sexual health visit.

Syphilis in New York City and New York State

These are the most recent figures from the health department and the CDC. They come from different sources and different years, so do not compare the city and state numbers directly.

Measure	Figure	Source
Primary and secondary syphilis, New York City, 2024	17.76 per 100,000 people (1,467 cases)	NYC DOHMH STI Surveillance Annual Report, 2024
Early latent syphilis, New York City, 2024	34.41 per 100,000 people (2,842 cases)	NYC DOHMH STI Surveillance Annual Report, 2024
Congenital syphilis, New York City, 2024	37 cases (43.18 per 100,000 live births)	NYC DOHMH STI Surveillance Annual Report, 2024
Primary and secondary syphilis, New York State, 2023	14.8 per 100,000 people (2,887 cases)	CDC 2023 STI Surveillance State Ranking Tables
Congenital syphilis, New York State, 2023	67 cases (32.2 per 100,000 live births)	CDC 2023 STI Surveillance State Ranking Tables

One more detail from the city report: the 2023 and 2024 city rates were both calculated using 2023 population estimates. That is another reason to read these as snapshots and not as exact trend lines.

These numbers describe a population. They say nothing about any one person. Syphilis testing is a routine, ordinary part of sexual health care in New York City.

How syphilis testing works

The CDC STI Treatment Guidelines (2021) describe two families of blood tests. Most diagnoses use both, because each one answers a different question.

Treponemal tests

These tests look for antibodies made specifically against the syphilis bacterium. Research summarized by the CDC suggests these antibodies usually stay detectable for life, even after successful treatment. So a treponemal test can show that a person has had syphilis at some point. It cannot show by itself whether the infection is recent or old.

Non-treponemal tests

These tests measure a different, less specific response from the body. Results come back as a number, called a titer, such as 1:8 or 1:32. The CDC says the titer can rise with active infection and fall after effective treatment. That makes these tests useful for tracking how the body responds over time.

The CDC also notes that a non-treponemal test can sometimes be positive for reasons other than syphilis. That is why a second, different test is used to confirm.

Which test comes first

Labs follow one of two sequences, both described by the CDC. In the traditional order, a non-treponemal test comes first and a treponemal test confirms. In the reverse order, a treponemal test comes first, and a non-treponemal test follows. Either is accepted. You do not need to choose. A clinician or lab decides.

Swab tests

If there is an open sore, a clinician may take a sample from it for lab testing. This is not available in every setting, so blood work is the usual route.

Timing

The body needs some time to produce the antibodies that tests detect. A test taken very soon after a possible exposure may not show an infection that is actually present. The CDC does not publish a single window period for syphilis that works for everyone, so ask the clinician when a repeat test makes sense after a recent exposure. Do not rely on a single early result alone if you had a recent exposure.

Also remember that a negative result describes the moment of testing. A clinician can tell you how it fits with your own situation.

Is syphilis curable?

Yes. The CDC states that syphilis can be cured with the right antibiotic from a clinician. Penicillin is the preferred drug at every stage. The form and length of treatment depend on the stage, and the clinician decides this. This article does not list doses, because they are individual medical decisions.

Some points from the CDC guidelines are worth knowing:

Treatment stops the infection but may not undo past damage. If syphilis has already affected an organ, treatment halts further harm. Damage that has already occurred may not reverse. This is part of why earlier testing is encouraged.
Penicillin allergy. Penicillin is the safest known treatment in many situations, including pregnancy. A person who reports a penicillin allergy can ask a clinician about allergy evaluation. The CDC says many people who believe they are allergic are not, and a clinician can sort this out. For pregnancy, the CDC says penicillin is the only recommended treatment, so a clinician may arrange allergy evaluation or desensitization.
A temporary reaction. Some people have fever, chills, aches, or headache within the first day after treatment starts. The CDC calls this the Jarisch-Herxheimer reaction. It is typically short-lived. Tell the clinician about any symptoms afterward, and ask what to expect.
Do not self-treat. Leftover or borrowed antibiotics may not cure syphilis and can hide the signs of it. Only a clinician can select the right medicine.
Partners. The CDC advises that recent sexual partners be evaluated and, depending on the situation, treated. The clinic can explain how to reach partners, including anonymous options.

Syphilis is different from HIV, herpes, and HPV, which are treatable or manageable but not curable. For syphilis, the goal of treatment is cure.

A note on doxycycline after sex

In 2024 the CDC issued guidance on doxycycline taken after sex (doxy-PEP). It may be considered for some people, specifically gay, bisexual, and other men who have sex with men, and transgender women, who have had a bacterial STI in the past year. A clinician prescribes it and explains how it works. It does not replace regular testing. Research suggests it lowers the chance of syphilis, chlamydia, and gonorrhea, but it does not eliminate it. Doxy-PEP is offered at the NYC Sexual Health Clinics and at Callen-Lorde.

Follow-up blood tests after treatment

Treatment is not the last step. The CDC recommends follow-up blood tests so a clinician can confirm that the infection is responding.

Here is what that generally means:

A clinician repeats the non-treponemal test at set intervals after treatment. The schedule depends on the stage, and the clinician sets it.
The CDC says that after effective treatment, the titer is expected to fall over time. The clinician compares your new number with the earlier one.
If the number does not fall as expected, or it rises, the clinician decides what to do next. Options include re-checking for a new exposure, further evaluation, or more treatment.
The treponemal test often stays positive for life. This is normal and does not mean treatment failed.
Some people keep a low, stable non-treponemal titer after treatment. The CDC calls this serofast. A clinician can explain what it means for you.

It helps to keep a record of your test dates and results. If you move between clinics, bring the record so the new clinician can compare the numbers.

People with HIV may be followed on a different schedule. The CDC guidelines include specific advice for them.

Safety profile and who needs extra care

Syphilis testing itself is a standard blood draw. The side effects are those of any needle stick, such as brief soreness or a small bruise.

For treatment, the CDC guidelines point to a few groups where the clinician takes extra care:

Pregnant people. Penicillin is the recommended treatment. Syphilis in pregnancy needs prompt treatment and follow-up because of the risk to the baby.
People with HIV. Syphilis can be treated as in others, and the clinician may monitor more closely.
People with a documented penicillin allergy. A clinician will discuss allergy evaluation or options.
Anyone with signs involving the brain, eyes, or ears. These can need a different treatment plan.

If you take other medicines or have medical conditions, tell the clinician at the visit.

Quality indicators: what good testing and care look like

Instead of sourcing a product, the useful question here is how to recognize good care. These are reasonable signs:

The clinic explains which tests it is running, and why. For syphilis, that is typically a blood test.
Results come with a clear explanation, and a plan for follow-up testing if syphilis is found.
Treatment comes from a licensed clinician, and the clinician explains the next steps.
The clinic offers confidential care and does not make assumptions about your gender, orientation, or relationships.
Other tests are offered in the same visit, such as HIV, chlamydia, and gonorrhea. The CDC encourages people to consider syphilis testing together with HIV testing.

Where to get tested in New York City

The NYC Department of Health and Mental Hygiene runs Sexual Health Clinics that offer STI testing, HIV testing, treatment, PrEP, PEP, and doxy-PEP. The health department says care is low to no cost. Adults 19 and older are asked for insurance or a sliding-scale fee, no proof of income is required, no payment is collected at the clinic, and no one is turned away for inability to pay. Most services are walk-in only, and clinics may close early once they reach capacity. Because of that, going earlier in the day may help.

Open NYC Health clinics listed by the department include:

Chelsea Sexual Health Clinic: 303 9th Avenue, First Floor, Manhattan, NY 10001. Monday to Friday, 8:30 a.m. to 3:30 p.m.
Central Harlem Sexual Health Clinic: 2238 Fifth Avenue, First Floor, Manhattan, NY 10037. Monday to Friday, 8:30 a.m. to 3:30 p.m.
Fort Greene Sexual Health Clinic: 295 Flatbush Avenue Extension, Brooklyn, NY 11201. Monday to Friday, 8:30 a.m. to 3:30 p.m.
Morrisania Sexual Health Clinic: 1309 Fulton Avenue, Second Floor, Bronx, NY 10456. Monday to Friday, 8:30 a.m. to 3:30 p.m.
Jamaica Sexual Health Clinic: 90-37 Parsons Boulevard, First Floor, Queens, NY 11432. Monday to Friday, 8:30 a.m. to 3:30 p.m.
Corona Sexual Health Clinic: 34-33 Junction Boulevard, First Floor, Queens, NY 11372. Monday to Wednesday and Friday, 8:30 a.m. to 3:30 p.m.; Thursday, 8:30 a.m. to 7:15 p.m.

The health department lists one phone line for the clinics, the Sexual Health Clinic Hotline at 347-396-7959, Monday to Friday, 9 a.m. to 3:30 p.m. For urgent exposure questions, the health department also lists a 24/7 PEP Hotline at 844-373-7692. The health department says the Crown Heights and Riverside clinics are closed until further notice, and its open list has no clinic on Staten Island. Check the NYC Health sexual health clinics page before you go, since hours can change.

Other options include:

Callen-Lorde Chelsea: 356 W 18th St, New York, NY 10011, 212-271-7200. Callen-Lorde is an LGBTQ+ community health center. It says services are provided regardless of ability to pay, with a sliding fee for people who are uninsured or underinsured. Its site lists sexual health visits by appointment on weekdays with limited walk-in, and Saturday walk-in from 9 a.m. to 3 p.m., first come, first served. It also has sites in the Bronx and Brooklyn. Check with the center for details.
Mount Sinai Adolescent Health Center: 312-320 East 94th Street, New York, NY 10128, 212-423-3000. It serves young people ages 10 to 26 and says its services are completely free, with walk-in hours Monday to Saturday, 8:30 a.m. to 4 p.m.

For a fuller comparison by borough, see our guide to where to get tested for STIs in New York City. You can also use the CDC's locator at gettested.cdc.gov.

The clinic pages we reviewed do not list a syphilis-specific price or turnaround time. Ask the clinic about both when you call or arrive. One note on speed: the health department says the main Chelsea clinic does not offer rapid results and that results usually take about seven days. Its rapid "Quickie Lab" is for chlamydia and gonorrhea, not syphilis.

Rules that apply in New York

Teens and young adults

New York Public Health Law section 2305 lets a licensed physician diagnose and treat a person under 21 for a sexually transmitted infection, or exposure to one, without parental consent or knowledge. NYC Health says its Sexual Health Clinics serve anyone 12 or older without parental consent, regardless of immigration status.

Pregnancy

The NYS Department of Health requires at least three syphilis tests during pregnancy: at the first prenatal exam, in the third trimester (at 28 weeks, and no later than 32 weeks), and at delivery. The NYC Health Code separately requires physicians to draw blood for syphilis testing at 28 weeks, or as soon as reasonably possible and no later than 32 weeks. If you are pregnant, you can ask your prenatal provider whether each of those tests has been done.

Reporting

The NYC Health Code requires syphilis, at all stages including congenital, to be reported to the health department within 24 hours, along with chlamydia and gonorrhea. Reports go to the health department, which uses them to track cases and to help connect people with care and partner services.

What research suggests, and what to do next

Research summarized by the CDC suggests that syphilis does best when it is found early. Penicillin has been the standard treatment for decades, and the bacterium has not developed resistance to it. Blood tests are widely available and routine. Follow-up testing makes it possible to track the response.

If you are wondering about syphilis symptoms, a rash you cannot explain, a recent exposure, or a partner's diagnosis, a clinician can help. Here is a simple way to start:

Pick a free or low-cost option from the list above, or use gettested.cdc.gov.
Ask for syphilis testing along with HIV and other STI tests, if they fit your situation.
If a recent exposure is the reason, ask the clinician when a repeat test makes sense.
If treatment is prescribed, follow the clinician's plan and keep your follow-up blood test appointments.
Ask how to notify recent partners, including anonymous options.

Getting tested is a routine act of health care. It does not reflect on anyone's character, and no one at these clinics will judge you for it.

Syphilis in New York City: Symptoms, Testing and Treatment