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About Syphilis and Home Testing

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What is Syphilis?

  • Syphilis is a sexually transmitted infection (STI) caused by bacteria
  • Syphilis can be cured with antibiotics. If it’s not treated and cured early, it can spread through the body and lead to serious health problems
  • Syphilis is usually passed on from sexual contact with someone with syphilis, including direct skin contact with a syphilis ulcer or sore
  • It’s usually passed on through vaginal, oral or anal sex without a condom, but can be passed on from any sexual contact, even without penetration or ejaculation
  • Syphilis can sometimes be passed on from sharing sex toys
  • If you’re pregnant, it’s possible to pass on syphilis to the baby, which can cause very serious health problems
  • Syphilis can easily be detected with a simple blood test

What are the symptoms of syphilis?

Many people with syphilis do not get any noticeable symptoms.

If symptoms do appear, they can often be mistaken for another illness as syphilis can cause just about any symptom in the body.

Syphilis develops in stages. The symptoms of each stage are different.

Primary (first stage) syphilis

Any symptoms usually appear 2 to 3 weeks after contact with syphilis, but it can be earlier or up to 3 months later.

Symptoms may include:

  • A red lump or firm ulcer or sore (called a chancre) appears where syphilis entered the body. This is usually on or around the penis, vagina, anus (bum hole), rectum (inside the bum), or mouth. The ulcer is very infectious. Because the sore is painless, it can easily go unnoticed and be easy to miss, especially if it’s around the anus
  • Swollen glands around the area where syphilis entered the body. These may be noticed as lumps in the groin (at the top of the thigh).

The sore usually heals by itself in around 3 to 8 weeks. But without treatment, the syphilis will spread to other parts of the body.

Secondary (second stage) syphilis

Secondary syphilis can affect almost any part of the body. It happens when syphilis has spread around the body through the bloodstream.

Symptoms typically appear around 3 to 10 weeks after the primary stage (which might have gone unnoticed).

Symptoms may include:

  • A spotty red or reddish-brown rash anywhere on the body. It often involves palms of the hands and soles of the feet. It’s not usually itchy.
  • A flu-like illness, which may include a high temperature, tiredness, sore throat, headaches, muscle aches or swollen glands in the neck, groin or armpits.
  • Lumps, a bit like warts, around the penis, vagina or anus
  • Sores in the mouth, vagina or anus
  • Patchy alopecia (hair loss)
  • Less commonly, some people may get meningitis, hearing loss or eye problems.

Symptoms can easily be mistaken for a different illness, which is one reason it’s important to get tested.

Without treatment, symptoms can last for up to 3 months and may come and go.

Latent syphilis

If syphilis remains untreated, it enters the latent stage. This stage involves no symptoms and can last for many years.

The infection can still be passed on to sexual partners during the first 2 years of the latent stage. It can also be passed on to a baby during pregnancy or birth.

Tertiary (third stage) syphilis

This is the final and most serious stage of syphilis.

It can affect many parts of the body, including the heart and blood vessels, bones, skin, brain and nervous system. This can be life threatening.

Around 1 in 3 people with untreated syphilis develop tertiary syphilis. This is sometimes more than 20 years after first getting syphilis.

How to test for syphilis in London

There are a few different types of syphilis test.

A blood test is the most common way of detecting syphilis. It can take up to 3 months after acquiring syphilis before a blood test comes back positive. if you have a blood test less than 3 months after your last sexual contact, and the test is negative for syphilis, it’s advisable to re-test at a later date.

At a clinic

SHL recommends that anyone with new ulcers or sores gets checked for syphilis at a sexual health clinic. This is because the clinic may do a swab test (in addition to a blood test). A swab test can sometimes identify syphilis before a blood test result is back and/or before the blood test is able to detect syphilis. There are two types of swab test:

  • A highly sensitive swab (PCR) taken from the sores. This is sent to a laboratory. Results are back in a few days
  • A less sensitive swab taken from ulcers or sores, which is examined under the clinic microscope (dark ground microscopy). This gives an immediate result, and if syphilis is confirmed this way you can start treatment the same day

Self-sampling with SHL

SHL can provide a free syphilis blood test. You collect the sample yourself and send it to our lab for testing.

At SHL, we provide a range of syphilis blood tests, depending on if you’ve had syphilis before. Once an individual has had syphilis infection, their syphilis screening test will always remain positive and so a different syphilis blood test (RPR) is needed. The RPR test can show if you’ve got syphilis again or if your previous infection was not effectively treated. At SHL we ask on your kit order form if you have a history of syphilis so that we can adapt our testing process to make sure you get the right type of test.

Free Syphilis and STI Testing Kit

Test for syphilis and common STIs. Get your free NHS-funded STI test kit delivered to your door in London.

Take a self-sample at home and return it for free. Get your results online within a week.

Access SHL free services now

What is the treatment for syphilis?

If you test positive for syphilis for the first time through SHL, we may ask you to go to a local sexual health clinic for further syphilis testing and/or treatment.

You’ll be given one or more injections of penicillin or a course of antibiotic tablets. The length of treatment depends on the stage of the syphilis.

Syphilis can be cured at any stage. But if it has caused any damage to your body, treatment cannot always reverse this. This is one reason that early testing and treatment is so important.

After completing treatment, you may be advised to test for syphilis again after 3, 6 and 12 months. This is to check the treatment has worked and that you have not got syphilis again.

People who have had syphilis before

You can get syphilis more than once. Previous successful syphilis treatment doesn't make you immune to acquiring syphilis again.

At SHL, we provide a range of syphilis blood tests, depending on if you’ve had syphilis before. Once an individual has had syphilis infection, their syphilis screening test will always remain positive and so a different syphilis blood test (RPR) is needed. The RPR test can show if you’ve got syphilis again or if your previous infection was not effectively treated. At SHL we ask on your kit order form if you have a history of syphilis so that we can adapt our testing process to make sure you get the right type of test.

If your SHL screening syphilis test is reactive (positive), one of our SHL team may call you to discuss this. It’s very helpful if you can tell us about any positive syphilis tests and treatment you’ve had, when this was, and what your last RPR (Rapid Plasma Reagin) blood test result was. Depending on your answers, you may be referred to a clinic for further tests and may need treatment as well. Otherwise, we may reassure you that no further action is needed.

It’s always helpful for you to keep any treatment information about syphilis for future reference. This includes the date and name/type of treatment received and your last RPR readings. This can help you avoid any unnecessary tests or treatment.

Do I need to tell my sexual partners?

If you have syphilis, you’ll need to tell current and recent sexual partners so they can get tested.

Depending on the stage of syphilis and whether you’ve had a negative syphilis test result before, you may also be advised to tell partners from quite a while ago.  The SHL team or a healthcare professional at your sexual health clinic can discuss which partners need to be tested.

Informing, testing and treating partners is really important because it lowers the chances of:

  • You getting syphilis again
  •  Syphilis being passed on to a partner’s sexual partner(s)

If you feel unable to tell sexual partners, one of the SHL team can tell them without mentioning your name.

Partners can order a syphilis test by post from SHL or from their local sexual health service if they don’t live in an area covered by SHL. If they need treatment, they’ll need to get this from a clinic.

If partners choose to get tested in clinic, they may be offered syphilis treatment straight away before their test results are known. This is called epidemiological treatment.

Taking care of your sexual health

If you have syphilis, you may also have another STI. It’s advisable to have a full sexual health screen, including tests for chlamydia, gonorrhoea , HIV, hepatitis B and hepatitis C.

You can get syphilis more than once. To avoid getting it again, do not have oral, anal or vaginal sex until:

  • at least 2 weeks after finishing all treatment and
  • your current sexual partner(s) complete treatment and
  • you and your partner’s symptoms have gone

As well as having follow-up syphilis tests after 3, 6 and 12 months, it’s advised to do another full sexual health screen after 3 months as you have a higher chance of getting an STI in the next year.

Using condoms is one of the best ways to help protect your sexual health in future. But be aware that syphilis may sometimes affect areas that are not covered by a condom and so transmission can still take place.

If you’re sexually active, consider testing for STIs at least once a year and after a change in partner, especially if you have sex without a condom. Encourage your sexual partners to test for STIs too.

You don’t usually need to get tested if:

  • you have just one long-term partner and
  • you only have sex with each other and
  • you’ve both tested for STIs since you’ve been together.

Anyone who lives in an area covered by SHL can have up to 4 free STI testing kits a year.

If you’re HIV negative, you may benefit from an HIV prevention medicine called PrEP.

People at higher risk of syphilis and chlamydia may also be offered doxyPEP. This is an antibiotic you take soon after sex to lower your chance of getting chlamydia or syphilis. Ask your local clinic if doxyPEP is suitable for you.

Related Pages:

More information about syphilis and STI testing

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FAQs about free NHS syphilis tests in London

Get answers to some common questions.

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Why should I take a free syphilis self-sampling test?

Syphilis rates in London are increasing and many people with syphilis will not have any symptoms, so you could have it without knowing.

If syphilis is not treated and cured, it can lead to unpleasant symptoms and health problems. In some people the health problems can eventually be so serious that they’re life-threatening.

Untreated syphilis can also be passed on to sexual partners.

Who should get a free syphilis home self-sampling test?

Anyone sexually active can get syphilis. You’re more likely to have it if you’ve had sex without a condom. In London, syphilis is most commonly found in gay, bisexual and other men who have sex with men, and trans people. But syphilis rates are also increasing in heterosexual people.

If you’re sexually active, it’s a good idea to test for syphilis and other STIs once a year or when you have a new partner, especially if you have sex without a condom. Some people may be advised to test more often.

If you’re sexually active, it can be a good idea to test for syphilis and other STIs at least once a year or after a change in partner, especially if you have sex without a condom. Some people may be advised to test more often.

You don’t usually need to get tested if:

  • you have just one long-term partner and
  • you only have sex with each other and
  • you’ve both tested for STIs since you’ve been together.

If you’re planning to get pregnant, consider doing a syphilis test. Untreated syphilis can cause serious problems with a pregnancy and be passed on to the baby causing them very serious health problems.

If you’re pregnant, you’ll be offered a syphilis test as part of your early pregnancy care (usually at around 12 to 14 weeks). If you think you may have been exposed to syphilis in the 3 months before taking the test or at any time after taking the test, it’s important to test again.

When should I take a syphilis home self-sampling test?

Test for syphilis now if:

  • you have any symptoms of syphilis or
  • a sexual partner has syphilis or another STI

Order a syphilis test kit now.

Depending on your symptoms, we may suggest you get tested at a sexual health clinic instead of using a home self-sampling kit.

If you go to a clinic, they may do a blood test to check for syphilis. They may also swab any ulcers or sores you have to check if they are caused by syphilis.


Consider waiting until 3 months after your last sexual contact if:

  • you have no symptoms
  • you just want a sexual health check-up

This helps your test be as accurate as possible. Syphilis may not show up on a test straight away. Testing too early may mean you test negative even if you do have early syphilis. More about when to take a test.

How do I order a free syphilis test kit?

Londoners can order a free syphilis and STI testing kit online. Your kit should arrive by post in the next few days.

  • Answer some online questions – your answers are confidential
  • We work out which tests are best for you
  • Your free STI test kit arrives by post in the next few days – in a discreet plain package

If you want to get tested at a sexual health clinic instead, search for your nearest London sexual health clinic.

How do I use my syphilis self-sampling test kit?

Your free testing kit comes with all you need to take your own sample. This is called self-sampling.

A self-sampled syphilis test is done with a simple finger-prick blood test. You need a very small amount of blood – less than 1 millilitre.

Pack your samples into the freepost box and send them back to our lab for testing. Post them in any Royal Mail postbox.

What if I’ve had syphilis before?

You can get syphilis more than once.

When you order your syphilis test kit, we ask if you’ve had syphilis before. It’s helpful for us to know this because, even if the syphilis was cured, a standard syphilis blood test usually remains positive. This means you may need additional blood tests to check whether you have a new syphilis infection. We can adapt our testing process to make sure you receive the right type of test.

If your SHL syphilis test is reactive (positive), one of our SHL team may call you to discuss this.

It’s very helpful if you can tell us about any positive syphilis tests and treatment you’ve had, when this was, and what your last RPR (Rapid Plasma Reagin) blood test result was. If you share this information with us, it can help us know whether you may need any further tests or treatment.

When will I get my syphilis test results?

You’ll usually get your results 2 or 3 days after your self-sample arrives at our lab.

You’ll be able to view the results online. They’re completely secure and private.

Order your syphilis testing kit now to get your results as soon as possible.

What do my syphilis test results mean?

A negative result means syphilis antibodies were not detected in your blood.

  • If it’s been 3 months or more since you had sexual contact that could have exposed you to syphilis, this means you did not have syphilis at the time of the test.
  • If it’s been less than 3 months, it’s advisable to test again after 3 months to make sure you still get a negative result.

A positive or reactive result means syphilis antibodies were detected in your blood.

  • If this is the first time you’ve had syphilis, or if we don’t know whether you’ve had syphilis before, we’ll usually advise you to go to a sexual health clinic. They can do another blood test to confirm the result and give you treatment to cure the syphilis.
  • If you told us you’ve had syphilis before, one of our SHL team may call you to discuss your result. We’ll ask you if/when you last had syphilis. It’s helpful if you have details of any previous tests and treatment and your last RPR (Rapid Plasma Reagin) blood test result. Depending on your answers, you may need to go to a clinic for further tests or treatment. Otherwise, we’ll reassure you that no further action is needed at this time.