The syphilis epidemic in the United States is at an all-time high, according to a new report from the Centers for Disease Control and Prevention. Data collected by the CDC shows that cases of syphilis and congenital syphilis increased by nearly 80% between 2018 and 2022. One possible explanation for the increase is that syphilis can often go unnoticed, says registered nurse Lauren Thayer, who adds that “some symptoms are mild or even nonexistent, which is why it’s important to get tested if you suspect you may have an infection.”
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While the highest number of cases were reported in people between the ages of 20 and 34, Dr. Alyssa Dweck, chief medical officer at Bonafide Health, tells us another concerning factor driving the surge in cases she’s seen in her practice is among perimenopausal and menopausal women. “Many women are engaging with new partners due to divorce or being widowed,” she says, noting that since pregnancy is no longer a concern, they may forgo the use of condoms.
If going to your doctor or a clinic to discuss concerns about possible exposure to a sexually transmitted disease (STD) or sexually transmitted infection (STI) is uncomfortable and keeping you from testing, at-home and in-lab syphilis tests and full-panel at-home STD tests are available to discreetly provide you with answers and treatment options without setting foot in a doctor’s office or clinic. “Remote testing is great,” says Dr. Barbara Van Der Pol, director of the UAB STD Diagnostics Laboratory, but it’s important to do your research. “There are some bad actors preying on consumers.”
To help you find the best at-home syphilis test for your needs, our team consulted with a panel of sexual health doctors and medical experts to better understand what to look for in the best syphilis tests and what to avoid. We considered 15 tests from reputable companies and rated each based on ease of use, accuracy, whether the test was fully in-home or required a trip to the lab, cost and if medical consultations with treatment plans were available. Keep reading to learn which four made the cut.
What to consider when buying an at-home syphilis test
When buying an at-home syphilis test, there are several important factors to take into account.
Lab validation: Make sure that the test is analyzed by a reputable lab — meaning one that’s CLIA-certified and/or CAP-accredited. These external sources ensure that labs follow the proper protocols and safety standards for testing.
STI tests offered: Some companies offer individual syphilis tests, while others only offer STD panels that test for multiple STDs and STIs in addition to syphilis. If you are unsure whether you were exposed to more than just syphilis, it will likely be in your best interest to spring for a full-panel test to ensure you know exactly what is going on and what to treat.
Collection method: Some test kits allow you to collect a sample at home, while others require an in-person visit to a testing center. Make sure you choose the option you are most comfortable with.
Time for results: Test results will take anywhere from one day to a full week. If you plan to get tested regularly, you might not mind waiting a little longer, but in some cases, you might want to know as soon as possible. Make sure you fully understand the way the results will be delivered — email, phone call, private portal, app — and in what time frame.
Cost: Depending on the company and STIs being tested, at-home tests can cost between $50 and $300. It’s also important to note that some companies offer subscription options, accept insurance or allow FSA/HSA payments, all of which can lower the price.
Follow-up care: Many at-home testing companies offer doctor consultations for positive results along with options for obtaining treatment and prescriptions. These services are sometimes free with the test, but there may be an additional fee, so make sure you are aware of any extra fees associated with medical consultations and treatment plans.
How we chose the best at-home syphilis test
To find the best at-home syphilis tests on the market, our team first consulted with four sexual health doctors and experts to learn what to look for in an STD test. We then looked at more than a dozen testing companies and compared each based on a variety of factors: whether a test that screened only for syphilis was available or grouped in with an STD and STI panel, if CLIA-certified or CAP-accredited labs processed the results, accuracy, ease of ordering, collection method, time to results, follow-up support and cost.
How do at-home syphilis tests work?
At-home syphilis tests include a sample blood draw that is either done by you in the privacy of your home using materials included with your test that you will mail to a lab for processing using prepaid materials in your test kit, or done by scheduling an appointment with an affiliated lab that works directly with the company you purchased the test from.
It’s actually very simple and follows the same testing practices used in a doctor’s office. In fact, if you opt for an in-person local lab sample draw, it’s possible that it will be the same lab your doctor uses, as many of the labs affiliated with at-home testing companies are with the two largest lab companies in the United States: Quest Diagnostics and Labcorp. The only real variation is the type of test, whether that be a confirmatory test, an RPR test or a Venereal Disease Research Laboratory (VDRL) test, all of which deliver highly accurate results.
Frequently asked questions
What are the symptoms of syphilis?
According to Thayer, syphilis can often go unnoticed. Some symptoms are mild or even nonexistent, which is why it’s important to get tested if you suspect you may have an infection.
The most common initial symptom, though, is a small sore, called a chancre, on the genitals, rectum or mouth. Chancres are usually firm, round and painless.
“Because it’s painless, people may not notice it or think it’s a problem,” says Dr. Yudara Kularathne, consultant physician. However, he stresses that if it’s not treated, it will progress and lead to more serious health problems. Some symptoms that may develop after the initial stage (after the chancre) include a rash on the palms and soles of the feet, fever, swollen lymph nodes, fatigue, weight loss and patchy hair loss.
How is syphilis treated?
While medical intervention is needed, syphilis is easy to treat as long as it’s caught early. The antibiotic penicillin is the most common form of treatment for early intervention. When not caught early, there can be additional complications caused by the syphilis infection that will require a more intensive treatment plan. “Late-stage symptoms can also cause tumors, blindness and/or paralysis,” says Thayer. “It can damage your brain, nervous system and other organs.”
Can having syphilis affect my pregnancy?
Yes, syphilis can have a serious impact on women who are pregnant. “Untreated syphilis can be passed to the baby in the womb, leading to a condition called congenital syphilis,” says Kularathne. Congenital syphilis can cause a host of health issues for the baby — including developmental delays, deformities, seizures, blindness, deafness and jaundice — and there is also an increased risk of stillbirth or miscarriage.
How long does it take for syphilis to show up on tests?
Although it can be detected sooner, syphilis can take up to 12 weeks to show up on a blood test, says Thayer. However, after a chancre appears, the bacteria can be detected in one to two weeks.
Are at-home syphilis tests accurate?
Syphilis tests that use reliable, accredited labs for analysis are generally very accurate. The biggest factor is how the sample is collected, so if you use a self-collected test kit, it’s important to make sure you follow the directions carefully.
False positives and false negatives do occur, though, says Dweck, so she recommends confirmatory testing, particularly before treatment.
Meet our expert panel
Dr. Alyssa Dweck, MS, MD, FACOG, chief medical officer at Bonafide Health
Dr. Barbara Van Der Pol, PhD, MPH, professor of medicine and public health at the University of Alabama at Birmingham, director of UAB STD Diagnostics Laboratory
Lauren Thayer, registered nurse and health care writer at HealthCanal
Dr. Yudara Kularathne, consultant physician and co-founder of HeHealth