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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessed online, treated in person. Syphilis is confirmed by a blood test and treated with penicillin injections, both given in person, so the doctor reviews your symptoms or result by video, directs the right test and its timing, and arranges the referral and follow-up.
- What it is: infection by the spiral bacterium Treponema pallidum, passed on by vaginal, anal or oral sex, including contact with a sore, and from mother to baby in pregnancy; reported cases in Europe have risen for a decade, with men who have sex with men most affected.
- Stages: a painless sore appears 10 to 90 days after contact, usually about 3 weeks, and heals in 3 to 6 weeks; the secondary rash, mouth patches and hair loss follow 6 weeks to 6 months later; latent infection is silent, late syphilis comes years on.
- Treatment: early syphilis (under 2 years) is cured by a single long-acting penicillin injection; late or unknown-duration infection needs 3 injections a week apart; a 14 to 28 day doxycycline course is the alternative for penicillin allergy, and neurosyphilis is treated in hospital.
- Follow-up: blood tests at 3, 6 and 12 months show the antibody level falling fourfold, which confirms cure; sex waits until 2 weeks after you and your partner finish treatment, and partners from the past 3 months (primary) or up to 2 years (latent) need testing.
- Emergency: syphilis is never a 112 emergency; new sight loss, hearing loss, severe headache, confusion, weakness or an unsteady walk with a known or possible infection need urgent in-person assessment for neurosyphilis without delay.
Some situations need urgent in-person care, not an online consultation: new problems with your vision or hearing, a severe headache, confusion or weakness (possible neurosyphilis), or being pregnant with a possible or confirmed syphilis infection, which needs same-day treatment to protect the baby. Seek face-to-face care straight away for any of these, and see the referral criteria below.
Can syphilis be treated online?
Not the treatment itself. Syphilis is treated with penicillin injections and monitored with blood tests, both given in person, so it cannot be cured by an online prescription.[1] What an online doctor can do is assess your symptoms or result, direct you to the correct blood test, and arrange treatment and follow-up. The pathway is test first, then treat in person.
The doctors on Mobi Doctor are deliberately clear about this, because being honest about it is the safe thing to do. Syphilis is entirely curable when treated properly, and getting you quickly to the right test and the right treatment is exactly where a fast online assessment helps.
Listen: Syphilis Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with syphilis
- A clear, honest pathway: assessment, then the right blood test, then penicillin treatment given in person, then follow-up. No false promise of an online cure, which for syphilis does not exist.
- Testing directed properly: the doctor explains which blood test you need and where to get it, and how to interpret the result, so you are not guessing.
- A confidential first step: talk it through with a doctor by video from home, usually within 15 minutes, with nothing to explain at a reception desk.
- Partner notification and follow-up: who needs to be told and tested, when you can have sex again, and the repeat blood tests that confirm you are cured.
📷 Photos can help: a clear, well-lit close-up of any sore or rash, taken while it is visible, can help the doctor judge whether it fits syphilis or another cause. Photos are optional, you can upload them securely when booking, and the consultation works without them.
What are the symptoms and stages of syphilis?
Syphilis is caused by the bacterium Treponema pallidum and develops in stages, which is why symptoms come and go and are easily missed.[2] Understanding the stages explains why testing, not symptoms, drives the diagnosis:
Primary syphilis
A single, usually painless sore (a chancre) appears where the infection entered, often on the genitals, anus or mouth, typically two to three weeks after exposure. Because it is painless and can be hidden, it is frequently missed, and it heals on its own within a few weeks even without treatment, which does not mean the infection has gone.
Secondary syphilis
Weeks to months later, the bacteria spread and can cause a rash, classically including the palms and soles, along with flu-like illness, swollen glands, patchy hair loss and mouth or genital sores. These symptoms also settle on their own, and the infection then becomes silent.
Latent syphilis
A stage with no symptoms at all, detectable only by blood test. It can last for years. Latent syphilis is still treatable, and treatment at this stage prevents the serious late complications.
Late (tertiary) syphilis
Years later, untreated syphilis can seriously damage the heart, brain and nerves. Neurosyphilis, affecting the brain and nerves, and ocular syphilis, affecting the eyes, can occur at any stage and are medical emergencies. In pregnancy, syphilis can pass to the baby (congenital syphilis) with severe consequences, which is why testing and prompt treatment in pregnancy are so important.[3]
How is syphilis diagnosed?
Syphilis is diagnosed with a blood test, sometimes alongside a swab taken from a sore.[1] The blood test looks for the body's response to the infection, and a reactive result is confirmed with a second type of test. If you have a sore, a swab can detect the bacteria directly. Because it takes time for tests to become reliable, a blood test is usually dependable from about two to four weeks after a sore appears and is confirmed by around twelve weeks, so a very early negative may need repeating.
An online doctor cannot draw your blood, and an honest service says so plainly. What the doctor does is tell you exactly which test to have and where, then review the result with you and arrange treatment. Because syphilis often travels with other infections, testing for HIV and other STIs at the same time is standard advice, and the doctor can point you to wider STI testing.[4]
How is syphilis treated?
Syphilis is treated with penicillin, given as an injection, and the treatment is given in person.[1][5] The specifics depend on the stage:
- Early syphilis (primary, secondary or early latent) is usually treated with a single injection of long-acting penicillin.
- Late latent syphilis, or infection of unknown duration, usually needs three injections given at weekly intervals.
- Neurosyphilis or ocular syphilis needs hospital treatment with intravenous penicillin.
Because penicillin injections and blood tests are given in person, this is the part of care an online doctor arranges rather than delivers. If you are allergic to penicillin, alternatives or a desensitisation process may be needed, which is decided in person. Shortly after the first injection, some people get a brief flu-like reaction (the Jarisch-Herxheimer reaction) as the bacteria are killed; it is expected and settles. After treatment, repeat blood tests over the following months confirm that the infection has cleared, and this follow-up is an essential part of the plan, not an optional extra.
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Possible exposure or a sore, no test yet | Blood test, plus a swab of any sore | Online assessment and testing direction | Testing is done at a lab or clinic |
| Positive test, early syphilis | Single penicillin injection[1] | Assessment and referral for treatment | The injection is given in person |
| Late latent or unknown duration | Three weekly penicillin injections | Assessment and referral for treatment | Given in person over three weeks |
| Vision, hearing or neurological symptoms | Urgent hospital assessment; intravenous penicillin | No | Urgent in-person hospital care |
| Pregnant, with suspected or confirmed syphilis | Urgent testing and treatment | No | Urgent maternity and specialist care |
Not sure which row is you? A doctor can tell you in one consultation.
See available times →What the doctor checks in an online syphilis consultation
The consultation is structured to get you safely to the right test and treatment. The doctor will typically check:
- Your symptoms and their timing: any sore, rash or flu-like illness, and when the exposure you are worried about was.
- Any test result you already have: a reactive blood test changes the consultation from testing to arranging treatment.
- Red-flag symptoms: vision, hearing or neurological changes, which point to urgent hospital care.
- Pregnancy: because syphilis in pregnancy needs urgent treatment to protect the baby.
- Penicillin allergy and other medicines, which affect how and where treatment is given.
- Other STI risk, so testing for HIV and other infections is arranged alongside.
When syphilis is assessed online, and when you need in-person care
Assessed online: possible symptoms or exposure where you need testing; a positive blood test where you need treatment arranged; questions about results, stages and follow-up; and partner-notification and retesting advice. This is genuinely useful, because it turns an anxious situation into a clear set of steps in one consultation.
In-person care: the penicillin injections and blood tests themselves, which are always given in person; any neurological or eye symptoms, which are emergencies needing hospital treatment; syphilis in pregnancy, which needs urgent maternity and specialist care; and penicillin allergy, where treatment decisions are made in person. Because syphilis treatment is delivered in person, this referral is the centrepiece of the service, not a failure of it. The same test-first approach applies to related infections such as gonorrhoea, and a genital sore can also be genital herpes rather than syphilis, which the doctor helps sort out.
How do I tell my partner about syphilis?
Partner notification is an important part of treating syphilis, because untreated partners can be reinfected or develop serious complications themselves. Recent partners need to be told so they can be tested and treated, and how far back depends on the stage of your infection, which the doctor will help you work out.
It is a factual conversation, not an accusation: partners should test because they may have been exposed, and syphilis is fully curable when caught. Because the infection can be silent for a long time, a diagnosis does not reveal when or from whom it came. Several countries run confidential or anonymous partner-notification services, and the doctor can tell you what is available where you live.
When to get in-person care
Seek urgent in-person care for new problems with your vision or hearing, a severe headache, confusion, weakness or difficulty walking, which can indicate neurosyphilis or ocular syphilis and are emergencies. If you are pregnant with possible or confirmed syphilis, seek same-day care to protect the baby. If you have sudden loss of vision, a severe sudden headache, a seizure, or signs of a serious allergic reaction such as swelling of the face or throat or difficulty breathing, call 112 immediately.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about syphilis: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your plan: the right blood test, treatment arranged in person, and the follow-up bloods that confirm you are cured, or a full refund.
No sign-up needed
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Frequently asked questions about syphilis
What is syphilis, and how do you catch it?
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. You catch syphilis through vaginal, anal or oral sex with someone who has it, usually through direct contact with a sore, which can sit out of sight inside the vagina, rectum or mouth; it also passes to a baby during pregnancy and, rarely, through shared needles. It is not spread by toilet seats, towels or casual contact.
What are the symptoms and stages of syphilis?
Primary syphilis is a single painless sore at the site of contact, 10 to 90 days after sex, that heals by itself within 3 to 6 weeks. Secondary syphilis, 6 weeks to 6 months later, brings a non-itchy rash often on the palms and soles, white mouth patches, wart-like growths, patchy hair loss, fever and swollen glands, which also fade. Latent syphilis is silent, and late syphilis damages the heart, brain, nerves and eyes.
Can syphilis be treated online?
The treatment itself cannot, and the honest answer matters: syphilis is treated with penicillin injections and monitored with blood tests, both done in person. What the doctor does by video is assess your symptoms or result, direct you to the right blood test at the right time, arrange the referral for treatment, advise on partners and plan the follow-up. A prescription is never issued without a consultation.
Can I get a syphilis test through Mobi Doctor?
The video consultation does not include a blood test, and an honest service says so. What the doctor does is tell you exactly which syphilis test you need and where to have it where you live, whether a laboratory, a sexual health clinic or a validated self-sampling kit, and when to take it, since a test before 12 weeks can miss an early infection; then reviews the result and arranges the treatment it calls for.
How soon after sex should I test for syphilis?
Syphilis antibodies take time to appear: a blood test can be positive from about 3 to 6 weeks after exposure, and a negative result is only conclusive at 12 weeks, so a test done earlier is repeated. A sore can be tested directly by swab much sooner. If a partner has confirmed syphilis, treatment is often given at once without waiting for your own result, because early treatment is simple and reliable.
Is syphilis curable?
Yes, completely, at every stage, with penicillin. Treated early, syphilis leaves no lasting damage; treated late, it is still cured, but harm already done to the heart, nerves, eyes or brain may not reverse, which is why early testing matters. Cure gives no immunity, so you can catch syphilis again, and antibody tests may stay faintly positive for life, which is normal and does not mean the infection is back.
How is syphilis treated?
Syphilis is treated with penicillin given by injection in person: a single long-acting dose for infection caught within the past two years, and three doses a week apart for late or unknown-duration infection. People allergic to penicillin take doxycycline tablets for 14 or 28 days; neurosyphilis is treated in hospital. A flu-like reaction with fever and aches in the first 24 hours after the injection is common, harmless and settles with paracetamol.
Do I have to tell my partner about syphilis?
Yes. Partners need testing and often treatment, and how far back to go depends on your stage: about three months before a primary sore, six months for secondary syphilis, and up to two years for latent infection. The doctor helps you work it out, and sexual health clinics in most countries can notify partners anonymously. Telling people protects them from a disease that is silent for years and curable in one visit.
How long does syphilis take to cure, and when can I have sex again?
The syphilis bacteria are killed within days of the penicillin injection, and a sore or rash fades within one to two weeks. Cure is confirmed by blood tests at 3, 6 and 12 months showing the antibody level falling fourfold. Wait two weeks after you and your partner have both finished treatment before any sex, including oral sex, and keep every follow-up test: a level that does not fall means reinfection or re-treatment.
What can I do myself if I think I have syphilis?
Nothing cures syphilis at home, and leftover antibiotics can blunt the blood test without clearing the infection. What helps is getting the test at the right time, avoiding all sex until you and your partner have been treated and cleared, keeping a sore clean and dry and not touching it, photographing a sore or rash before it fades, noting recent partners, and asking for HIV, chlamydia and gonorrhoea tests at the same time.
How can I prevent syphilis?
Prevent syphilis by using condoms for vaginal and anal sex and condoms or dams for oral sex with new partners, knowing that a sore outside the covered area can still pass it on; testing with new partners and regularly if you have several, every three months for men who have sex with men with new partners; avoiding sex with anyone who has a genital, anal or mouth sore; and never sharing needles.
Is syphilis different in pregnancy?
Yes, and it is urgent. Syphilis in pregnancy passes to the baby in most untreated cases, causing miscarriage, stillbirth, premature birth or congenital syphilis with lifelong damage, which penicillin given early in pregnancy prevents almost entirely. Every pregnant woman is offered a syphilis blood test at booking, and a positive result or any new sore in pregnancy needs in-person treatment without delay through the maternity team, not an online consultation alone.
Is it syphilis or something else?
A syphilis sore is usually single, firm and painless, which sets it apart from genital herpes (clusters of painful blisters), chancroid (soft, painful ulcers), an ingrown hair or a shaving cut; the secondary rash is mistaken for pityriasis rosea, psoriasis, a drug rash or hand, foot and mouth disease, and wart-like growths for genital warts. Because syphilis mimics so much, a blood test is taken for any unexplained genital sore or palm-and-sole rash.
- European guideline on the management of syphilis, IUSTI Europe (International Union against Sexually Transmitted Infections), 2020.
- Syphilis fact sheet, World Health Organization (WHO), 2024.
- Syphilis: facts and guidance, European Centre for Disease Prevention and Control (ECDC), 2024.
- Sexually transmitted infections (STIs): fact sheet, WHO, World Health Organization, 2025.
- WHO guidelines for the treatment of Treponema pallidum (syphilis), WHO, World Health Organization, 2016.
- Syphilis, NHS, National Health Service (UK), reviewed March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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