Rising sharply in the UK, and its early signs are painless and easily missed. A single sore that heals on its own is the classic presentation, which is why so many cases are only found on a blood test. The window is around 12 weeks.
Syphilis diagnoses in the UK are at their highest level since the 1940s. It is worth taking seriously, and it is entirely curable when found.
What makes syphilis different from most STIs is how it behaves over time. The first sign is often a single painless sore that heals on its own within a few weeks, which is exactly why it gets missed. Weeks or months later a rash can appear, often on the palms and soles, and that settles too. The infection then goes quiet for years while remaining present and, untreated, can eventually damage the heart, brain and nervous system. Because the early stages disappear by themselves, feeling better is not evidence of getting better.
The test is a blood sample with next-day results. If it is positive, treatment cures the infection. What matters is that a doctor interprets the result properly, because a positive syphilis antibody test can reflect a past treated infection rather than a current one, and telling those apart requires more than a yes or no.
Syphilis antibodies are detectable in most people from around six weeks after exposure, and UK guidance regards twelve weeks as the point at which a negative result reliably excludes infection. If it has been less than that we will tell you, and may recommend testing now and repeating.
Book an appointment rather than waiting for a window to pass. A visible sore can be assessed and, where appropriate, swabbed directly, which can confirm the diagnosis earlier than a blood test would.
Same-day slots are usually available across all ten clinics, Monday to Friday, 8 am to 7 pm and Saturday mornings.
Step 1
Six weeks for most people, twelve weeks for a definitive negative. If you have a sore or rash now, book regardless.
Step 2
Same day slots available. Nothing is shared outside the clinic without your consent.
Step 3
A quick blood sample. If you have a visible sore, it may also be swabbed.
Step 4
Next-day results, with a doctor explaining what they mean, treatment arranged, and HIV testing offered alongside.
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Confidential syphilis testing is available at ten CQC registered clinics across the UK. Choose your nearest.
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STI Early Detection
Less than 10 days£295
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STI Complete
After 10 days£495
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HIV Only Test
After 28 days£195
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Syphilis is an infection caused by the bacterium Treponema pallidum, passed on through unprotected vaginal, anal or oral sex, through close skin contact with an infectious sore, and from a pregnant woman to her baby.
It progresses in stages, and understanding them explains why it is so often missed:
Primary: Around two to three weeks after exposure, a single sore, called a chancre, appears where the bacteria entered. It is typically firm, round and painless, which is why people ignore it. It heals by itself within three to six weeks whether or not you are treated.
Secondary: Weeks to months later, a rash often appears, characteristically on the palms and soles, alongside flu like symptoms, swollen glands, patchy hair loss or mouth ulcers. This also resolves on its own.
Latent: The infection then persists with no symptoms at all, sometimes for decades.
Tertiary: In a proportion of untreated cases, years later, syphilis causes serious damage to the heart, blood vessels, brain and nerves. This stage is largely preventable, and preventing it is the entire argument for testing.
On testing and results: The blood test looks for antibodies to the bacterium. These usually stay positive for life, even after cure, so a reactive result alone does not tell you whether infection is active. A quantitative test (RPR or VDRL) measures how active the infection is, and together with your history it tells a clinician whether this needs treating now, was treated before, or needs specialist staging. This is the reason a syphilis result should be explained by a doctor rather than read off a report.
Treatment cures it: Injectable penicillin clears the infection at any stage, though damage already done at the tertiary stage cannot be reversed. Follow-up blood tests confirm the treatment h
| Private Syphilis Test | NHS GP | |
|---|---|---|
| Cost | From £195 | Free at point of use |
| Typical Wait | Book directly, same day usually | Days to weeks |
| Results | Next day | Typically several days to two weeks |
| Result interpretation | Doctor consultation | Clinic consultation, with staging expertise |
| Quantitative titre | Ask at your appointment | Standard practice |
| Staging and complex cases | Referral to specialist services | Managed in house |
Said plainly, as with gonorrhoea: specialist NHS sexual health clinics are a strong option for syphilis. They are free, they treat with the correct agent, and they have the expertise to stage an infection and manage follow up serology, which is genuinely specialist work. Private testing is worth paying for when you want a next day result or a chosen appointment time. If you test positive, getting correct treatment and proper follow up matters more than where you got tested.
Most people from around six weeks. Twelve weeks is the point at which a negative result reliably excludes infection.
The next day.
Yes. Healing is what the primary stage does, and it does not mean the infection has gone.
Not necessarily. Antibodies persist for life after infection, including after cure, so a reactive result needs interpreting alongside a quantitative titre and your history. That is why a doctor explains it.
Yes, it is recommended alongside a syphilis diagnosis, and the two are often acquired together.
Yes, and possibly partners from further back than you would expect, given how long syphilis can be present without symptoms. We will help you work out the period that matters.
A blood sample. If you have a visible sore it may also be swabbed.
Classically a single painless sore two to three weeks after exposure, then weeks or months later a rash often on the palms and soles. Both resolve on their own while the infection continues.
With injectable penicillin, which cures the infection.
Yes. Follow up serology confirms that treatment has worked, and it is an important part of care rather than an optional extra.
Yes, untreated syphilis can pass to a baby with serious consequences, and treatment prevents it. Screening is part of routine NHS antenatal care, and if you are pregnant and test positive here you need urgent specialist and maternity input.
Only if you ask us to.
Book a confidential syphilis test at your nearest clinic. Next day results, with a doctor to explain exactly what they mean.
