Syphilis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Syphilis?
A primary care doctor or a doctor at a sexual health clinic can test for and treat syphilis. An infectious disease specialist, a doctor who treats infections, may help with harder cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is syphilis?
Syphilis is a sexually transmitted infection, or STI. That means it is an infection that spreads through sex. It is caused by bacteria, which are tiny germs, named Treponema pallidum.
Without treatment, syphilis can cause serious and even life-threatening problems. In the early stages, it is easy to treat with medicine.
Symptoms
Syphilis happens in four stages, and each stage has different symptoms. The symptoms are often mild and hard to notice. They may also come and go.
- Primary stage: a small, painless sore called a chancre. It can show up on the genitals, mouth, skin, or rectum. It heals by itself in 3 to 6 weeks. Lymph nodes (small glands) near the sore may swell.
- Secondary stage: a skin rash, usually on the palms of the hands and the soles of the feet. It is not usually itchy. Fever, swollen glands, and patchy hair loss can also happen.
- Latent stage: the infection stays in the body, but there are no signs or symptoms. This stage can last for many years.
- Late (tertiary) stage: the infection can hurt organs such as the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.
Sores and rashes can fade even without treatment. The infection is still in the body, though. Without treatment, it can cause heart problems and brain problems, such as memory problems and dementia.
Causes and who gets it
Syphilis is caused by a bacterium named Treponema pallidum. It is most often spread through sexual contact. It spreads through direct contact with a syphilis sore or rash during vaginal, oral, or anal sex.
A mother can also pass syphilis to her baby during pregnancy. This is called congenital syphilis, which means the baby is born with the infection. Syphilis can also spread by sharing needles used to inject drugs.
Young adults ages 20 to 35 have the highest risk. People who have HIV, or who have sex with multiple or unknown partners, are also at higher risk.
How doctors diagnose it
A doctor does a physical exam and asks about your symptoms. Blood tests are used to screen for syphilis. If a blood test is positive, more tests are done to confirm the diagnosis.
If you have a sore, the doctor may look at fluid from the sore under a special microscope.
Treatment
Syphilis is treated with antibiotics, which are medicines that kill bacteria. Penicillin is the best medicine for syphilis at all stages.
If you are allergic to penicillin, other medicines might work in the early stages. These other medicines cannot be used during pregnancy.
Finish all of your medicine, even if the symptoms go away. You will go back several times in the first 12 months to be retested.
Your current and recent sexual partners also need to be tested and treated. Do not have sex until 2 weeks after you and your partner have finished treatment. Penicillin treats syphilis, but it cannot fix permanent damage already done to the organs.
When to see a doctor
See a doctor or go to a sexual health clinic if you have symptoms of syphilis. Go too if a partner has syphilis or another STI, or if you are pregnant and think you might have syphilis.
Call 911 or go to the emergency room if you have chest pain, trouble breathing, fainting, sudden weakness, trouble speaking, or confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can evaluate you, help with follow-up after treatment, and refer you to a sexual health clinic or an infectious disease specialist when needed.
Common questions
Can syphilis be cured?
Yes, syphilis can be cured if it is found and treated early. However, treatment cannot fix permanent damage already done to the heart or brain.
How do you get syphilis?
You most often get syphilis through sexual contact with someone who has it. A mother can also pass it to her baby during pregnancy.
Can syphilis go away on its own?
No, the infection does not go away on its own. The sores and rash may improve or disappear, but without treatment the infection is still in the body.
Is syphilis dangerous during pregnancy?
Yes, syphilis can be dangerous during pregnancy. It can cause miscarriage, stillbirth, or the baby's death soon after birth. All pregnant women should be screened for syphilis, and treatment with penicillin prevents passing it to the baby.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
