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 a clinician can cure when it is found. It is also easy to miss, because its signs can be mild, short-lived or confused with other conditions. A blood test is the way to find out.

This guide covers what the bacterium is, the stages, what syphilis symptoms and the syphilis rash can look like, how testing works, and what treatment involves. It also uses Georgia and Atlanta-area numbers, so you can see why local testing matters. Nothing here can tell you whether you have syphilis. Only a test and a clinician can.

The short answer: is syphilis curable?

Yes. The CDC STI Treatment Guidelines (2021) say syphilis can be cured with the right antibiotic treatment from a clinician. The preferred treatment for every stage is penicillin, given by a health care provider. The type of penicillin and how long treatment lasts depend on the stage, so a clinician decides that after an exam and test results.

Treatment stops the infection. It cannot undo damage the infection has already done, which is one reason earlier testing helps. Being treated once also does not make you immune. Syphilis can be caught again, so testing can be part of routine care for some people.

What causes syphilis: a quick look at the bacterium

Syphilis is caused by a bacterium called Treponema pallidum. It is a spiral-shaped organism, which is why it belongs to a group called spirochetes. According to the CDC, it spreads through direct contact with a syphilis sore, usually during vaginal, anal or oral sex. It can also pass from a pregnant person to a baby during pregnancy.

Because the sores can appear in places a condom or barrier does not cover, and can be painless or hidden, a person may not know they are carrying the infection. That is a matter of biology, not of anyone's choices or character. Syphilis affects people of every gender and orientation.

The stages of syphilis

The CDC describes syphilis in stages. Not everyone moves through each stage in a neat order, and the signs can come and go.

Primary stage

The first sign is usually a sore, called a chancre. The CDC says it is typically firm, round and painless. It shows up where the bacterium entered the body, such as the genitals, anus, rectum or mouth. Because it does not hurt, and may be inside the body, it is easy to overlook. Without treatment, it heals on its own, usually within a few weeks. Healing does not mean the infection is gone.

Secondary stage

Weeks to months later, other signs can appear. The CDC lists a skin rash, swollen lymph nodes, fever, sore throat, patchy hair loss, headaches, tiredness and muscle aches. Some people also develop sores in the mouth or on moist skin. Like the first sore, these signs can fade without treatment.

Latent stage

After the secondary signs fade, the infection can stay in the body without causing any signs. The CDC calls this the latent stage. A person in this stage may feel completely well. A blood test can still detect the infection, and treatment is still recommended by clinicians.

Tertiary stage

In a smaller share of untreated cases, the CDC says serious problems can develop years or even decades later. These can affect the heart, blood vessels, brain and nervous system. This is the stage that early testing and treatment are meant to prevent.

Infection of the eyes, ears or nervous system

The CDC notes that syphilis can reach the eyes (ocular syphilis), the ears (otosyphilis) or the nervous system (neurosyphilis) at any stage. Vision changes, hearing changes, severe headache or changes in thinking or movement are reasons to seek medical care promptly and mention syphilis as a possibility.

Syphilis symptoms: what people notice

Many people have no syphilis symptoms they can recognize. When there are signs, they are often mild and look like other conditions. That is why the CDC emphasizes testing instead of relying on how things look or feel.

A single, painless sore, sometimes more than one, on or near the genitals, anus, rectum or mouth.
A rash that appears days or weeks after the sore heals, or while it is still healing.
Swollen glands, fever, sore throat, tiredness or achy muscles.
Patchy hair loss or sores in the mouth, nose or on moist skin.

Any of these signs can have other causes. A clinician can help sort out which one it is.

What the syphilis rash can look like

The syphilis rash is a hallmark of the secondary stage, but it is easy to mistake for something else. The CDC says it can show up as rough, reddish or reddish-brown spots. It often appears on the palms of the hands and the soles of the feet, but it can also appear on the chest, back or elsewhere, or be so faint that it goes unnoticed.

The rash usually does not itch, though it sometimes can. It can look like rashes from many other causes, including allergic reactions, medication reactions and common skin conditions. That is why a rash alone cannot say whether syphilis is the cause. Someone who notices an unexplained rash can ask a clinician about a syphilis blood test, particularly if there has been a recent sore or a possible exposure.

Why the national rise matters

The CDC's STI surveillance reports show that syphilis cases in the United States have risen in recent years. The increase includes congenital syphilis, which happens when the infection passes to a baby during pregnancy and can cause serious harm. The CDC treats this as a reason to test more broadly, including routine testing during pregnancy.

A rise in cases does not mean any one person is at fault or at high risk. It means the infection is more common in communities than it used to be, so the chance that an untested infection goes unnoticed is higher. For a bacterial infection that has a cure, finding it sooner is the goal.

Syphilis in Atlanta and Georgia: the numbers

Atlanta is mostly in Fulton County, with part of the city in DeKalb County. The figures below are for primary and secondary syphilis, the earlier stages that are most likely to be passed on.

Area (2023)	Primary and secondary syphilis cases	Rate per 100,000 people	Source
Fulton County	425	39.2	Georgia DPH OASIS
DeKalb County	188	24.5	Georgia DPH OASIS
Georgia	2,210	20.0	CDC 2023 STI Surveillance state ranking tables

According to the Georgia Department of Public Health's OASIS data tool, the 2023 Fulton County rate was about double the statewide rate reported by the CDC. The Fulton and DeKalb rates are the sum of the separate primary and secondary stage rates in OASIS. For 2024, Georgia DPH reports 1,842 primary and secondary cases statewide, though no 2024 rate has been published yet because the CDC's 2024 data are provisional.

Congenital syphilis is part of the picture too. The CDC's 2023 state tables list 127 congenital syphilis cases in Georgia, a rate of 100.7 per 100,000 live births. Georgia DPH's 2024 snapshot lists 126 cases. These are numbers about the state as a whole, not about any individual pregnancy, and most of these cases involve infection that could be found with timely testing.

Syphilis also matters for HIV. The CDC says that syphilis sores can make it easier to get or pass HIV. In 2023, Georgia DPH reported 466 new HIV diagnoses in the Fulton health district and 328 in the DeKalb district among people aged 13 and older. Testing for both at the same visit is common.

How syphilis testing works

Syphilis is diagnosed mainly with blood tests. The CDC STI Treatment Guidelines (2021) describe two kinds, and a clinician usually uses both to reach a result.

Non-treponemal tests

These tests, such as the RPR and VDRL, look for substances the body makes in response to damage caused by the infection. They are not specific to the syphilis bacterium, so a clinician confirms a reactive result with another test. They are useful because the result is reported as a number, called a titer, which a clinician can follow over time to see how the body responds to treatment.

Treponemal tests

These tests look for antibodies made against the syphilis bacterium itself. According to the CDC, they tend to stay reactive for life, even after successful treatment. That is why they confirm that someone has had syphilis at some point but do not show whether treatment worked.

Putting the two together

Some laboratories start with a treponemal test and follow with a non-treponemal one. Others do it in the opposite order. The CDC guidelines describe both approaches. In either case, the clinician reads the results together with your history and any exam findings. Occasionally the results do not match, and a clinician may order more testing. That is a normal part of the process, not a sign that something is wrong.

When a sore is present

A clinician may sometimes also take a sample from a sore for lab testing. This does not replace blood testing.

Timing

Blood tests can miss a very recent infection, because the body needs time to make a detectable response. The CDC has not given one window period that fits everyone in the pages relied on here. A clinician can say whether a repeat test is worthwhile based on when a possible exposure happened.

Who is encouraged to test

The U.S. Preventive Services Task Force (USPSTF) recommends syphilis screening for people at increased risk and for all pregnant people. The CDC guidelines also recommend regular screening for some groups, including men who have sex with men and people with HIV, with the frequency set by a clinician. Anyone with a sore, rash or other sign, or whose partner has been diagnosed, can ask a clinician for a test.

Georgia's HIV/Syphilis Pregnancy Screening Act (O.C.G.A. § 31-17-4.2) says a prenatal care provider must test for HIV and syphilis unless the patient refuses. A third-trimester test must be offered at the first exam of that trimester. At delivery, the attending provider must order a test if there is no written evidence of one. Georgia's law is meant to catch congenital syphilis, which can be prevented when the infection is treated during pregnancy.

Treatment: what a clinician prescribes

The CDC STI Treatment Guidelines (2021) name penicillin as the preferred treatment for syphilis at every stage. A clinician chooses the form and the length of treatment based on the stage, and this page does not give doses or schedules. For people who are pregnant, the CDC says penicillin is the recommended treatment, and that those with a penicillin allergy should talk to a clinician about options.

Safety profile and things to tell your clinician

Penicillin allergy. Tell the clinician about any past reaction. Many people who think they are allergic are not, and a clinician can help sort this out. Other antibiotics are sometimes used for people who are not pregnant.
Pregnancy. Let the clinician know if you are or might be pregnant, because it changes the treatment plan.
A reaction in the first day. The CDC describes a short-term reaction, called the Jarisch-Herxheimer reaction, that can cause fever, chills, headache or achiness within about a day of starting treatment. It is usually brief. Anyone who is worried by symptoms after treatment can contact the clinic.
Other medicines and health conditions. Share your full medication list and any health conditions, including HIV status, so the clinician can plan care.

Follow-up blood tests

Treatment is not the last step. According to the CDC guidelines, clinicians repeat the non-treponemal blood test at set points after treatment to see whether the titer falls the way it should. The CDC describes a drop of about fourfold as the expected response. The timing depends on the stage and on HIV status, and a clinician sets it.

A titer that does not drop as expected does not automatically mean treatment failed. Clinicians look at the full picture and may repeat testing or treatment. Because treponemal tests usually stay reactive for life, follow-up relies on the non-treponemal result.

Partners and preventing re-infection

The CDC recommends that sexual partners be told so they can be tested and, where appropriate, treated. Clinics and health departments often help with this. Georgia DPH reports that expedited partner therapy (EPT) services can be found through local public health departments, and the CDC's Legal Status of EPT page covers Georgia's rules. A clinician can explain which infections it applies to.

Doxy-PEP and syphilis

In 2024, the CDC issued guidance on doxycycline taken after sex (doxy-PEP) to lower the chance of syphilis, chlamydia and gonorrhea. The CDC guidance is aimed at men who have sex with men and transgender women who have had a bacterial STI in the past year. Whether it is right for you is a decision for a clinician. The Fulton County Board of Health lists DoxyPep among the sexual health services at its 10 Park Place Health Center.

Privacy, consent and reporting in Georgia

Georgia DPH says all physicians, laboratories and other providers must report notifiable conditions. Syphilis is on the list to be reported immediately, while chlamydia, gonorrhea and HIV are reported within 7 days. Reporting goes to public health authorities, who use it to track trends and offer partner services.

For young people, Georgia law (O.C.G.A. § 31-17-7) says a minor who is, or professes to be, affected by a venereal disease may consent to treatment without a parent, guardian or spouse. The statute defines venereal disease as syphilis, gonorrhea and chancroid (O.C.G.A. § 31-17-1). It also says providers may, but need not, tell a parent, guardian or spouse. Guttmacher Institute summarizes Georgia as allowing minors to consent to STI testing and treatment, with parental notification permitted. Ask the clinic about its own practice before the visit.

Georgia law, in O.C.G.A. § 16-5-60, also addresses HIV, not syphilis. If you want to know more about that law, a clinician or legal aid service can help.

Where to get tested in Atlanta

Several places in the city offer syphilis testing or general STI testing. For the full local list with addresses and details, see the clinics we list in Atlanta. For a longer look at cost and what to expect, read our guide to STD testing in Atlanta and what it costs. A few options published by the providers themselves are below.

AID Atlanta Wellness Center

AID Atlanta says on its testing page that free STI screenings for chlamydia, gonorrhea and syphilis are available, along with free HIV tests, and that treatment is free for reactive screening results. It is at 1438 W Peachtree Street NW. Testing hours are Monday to Friday, 9:30 a.m. to 5:30 p.m., and the page says walk-ins are welcome. The STI testing line is (404) 870-7741.

Fulton County Board of Health

The Fulton County Board of Health lists STI screening and treatment at several health centers, with fees on a sliding scale for people without insurance, as described on its sexual health page. Its sexual health clinics serve Fulton County residents ages 14 and up. Ask which tests are included, since the pages do not list syphilis testing by site.

10 Park Place Health Center, 10 Park Place S.E., 5th floor. Phone (770) 520-7500. Monday to Friday, 8:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:30 p.m., with the last walk-in appointment at 3:00 p.m.
Adamsville Regional Health Center, 3700 MLK Jr. Drive S.W. Phone (770) 520-7323. Monday to Friday, same hours, and the Board of Health says appointments are recommended.
Neighborhood Union Health Center, 186 Sunset Avenue N.W. Phone (770) 520-7351. The Board of Health's pages list different days for this site, so call to confirm hours.

The Board of Health's Teen Health Clinic at Adamsville serves people ages 12 to 21, with fees based on income and family size. Its page says no teen is turned away for inability to pay. For the DeKalb part of the city, DeKalb Public Health serves residents of DeKalb County. Check with them directly for services and hours.

Planned Parenthood East Atlanta Health Center

Planned Parenthood lists STD testing and treatment at 440 Moreland Avenue SE, phone 404-688-9300. The health center says insurance is not required and that walk-ins are welcome, though only appointments guarantee service. The page does not list a price or a sliding scale, so ask the health center about cost when you call.

Finding other sites

The CDC runs a testing locator at gettested.cdc.gov that lists sites by ZIP code. Georgia DPH also lists a testing site locator on its STD program page. Call ahead, because hours and services can change.

How to choose a testing site: quality indicators

Because syphilis testing is done in a lab and read by a clinician, a few things signal good care:

A clinician reviews your result. Syphilis results often need to be read together, so look for a site that explains them and sets up follow-up.
Treatment is available or arranged. A site that can treat or refer you quickly saves a second trip.
The site is a public health, clinic or health center operation. These follow CDC guidelines and report to the health department as Georgia law requires.
Costs are stated up front. If a page does not list a price, ask before the visit.

Be cautious with any source that promises certainty from a single test or that skips clinician follow-up. For syphilis, follow-up blood tests are part of the standard of care.

Questions people ask

Is syphilis curable?

Yes. The CDC says a clinician can cure it with penicillin or, in some cases, another antibiotic. Treatment can stop the infection but cannot reverse damage already done, so earlier is better.

Can the rash or sore go away without treatment?

The CDC says the sore and the rash can fade on their own, but the infection stays in the body until it is treated. A blood test is the way to learn more.

Do I need to tell my partners?

The CDC recommends that partners be notified so they can be tested. A clinic or the health department can help with this in a way that keeps your privacy where the law allows.

The takeaway

Syphilis is a curable infection that is more common than it used to be, in Georgia and across the country. It often causes few or no signs, so a blood test and a clinician are the only reliable way to learn more. Free and low-cost testing is available in Atlanta, and the local list is a good place to start.

Syphilis in Atlanta: Symptoms, Testing and Treatment