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 can be cured. That is the most important fact on this page. It is also an infection that is easy to miss, because its early signs can be painless and can fade without care.

This guide explains what causes syphilis, how the stages look, how the two kinds of blood tests work, what a clinician prescribes, and where people in Columbia can get tested. It is written for anyone, whatever their gender, orientation or relationship status.

Quick answers

Is syphilis curable? Yes. The CDC STI Treatment Guidelines (2021) say syphilis is treated with penicillin prescribed by a clinician.
What are the symptoms? They vary by stage. Some people notice a painless sore, a rash, or flu-like symptoms. Others notice nothing.
How is it found? Most often with a blood test, sometimes with a swab from a sore.
Where can I get tested in Columbia? Several clinics list syphilis testing. They are described below.

What syphilis is: the organism behind it

Syphilis is caused by a bacterium called Treponema pallidum. It is shaped like a thin spiral, which is why microbiologists group it with the spirochetes. The CDC describes it as spreading 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.

One practical detail shapes the whole testing process. According to the CDC, this bacterium cannot be grown in the routine cultures that labs use for many other infections. So diagnosis relies mostly on blood tests that look for the body's response, not on growing the organism itself.

Syphilis symptoms by stage

The CDC describes syphilis as moving through stages. The timing and the signs differ from person to person. Not everyone passes through every stage in a noticeable way.

Primary stage

The first sign is usually a sore, called a chancre. The CDC says it is typically firm, round and painless. It appears where the bacterium entered the body, which can be on the genitals, in the rectum or in the mouth. Because it does not hurt, and may be inside the body, it can go unseen.

The CDC says the sore often appears about three weeks after exposure, though the range is wide. It heals on its own within weeks. Healing does not mean the infection has gone.

Secondary stage

This stage often brings the syphilis rash. The CDC says the rash can look like rough, reddish-brown or pink spots. It may show up on the palms of the hands and the soles of the feet, or elsewhere on the body. It often does not itch, and it can be faint enough to mistake for another skin condition.

Other secondary symptoms listed by the CDC include:

Fever and tiredness
Swollen lymph glands
Sore throat
Patchy hair loss
Headaches and muscle aches
Moist patches in the mouth or on the genitals

These signs also fade without treatment. Many other conditions cause a rash or fever, so a rash alone cannot tell anyone whether syphilis is the cause. A clinician and a test can.

Latent stage

After the secondary stage, the CDC says syphilis can enter a latent stage with no symptoms at all. The infection is still present, and a blood test can detect it. This is a major reason testing matters for people who feel well.

Tertiary stage and other complications

The CDC says that without treatment, a minority of people go on to late complications years later. These can affect the heart, blood vessels, brain and other organs. Syphilis can also reach the eyes, ears or nervous system at any stage. A person with vision changes, hearing changes, a severe headache or confusion should see a clinician promptly and mention any possible syphilis exposure.

Syphilis during pregnancy

The CDC says syphilis in pregnancy can pass to the baby and cause serious harm. Treatment during pregnancy can prevent this. The USPSTF recommends that all pregnant people be screened for syphilis, and it recommends screening for adults and adolescents at increased risk. A clinician can explain what that means for an individual.

Why the national rise matters

The CDC's national surveillance reports have documented a sharp increase in syphilis over the past decade. That includes congenital syphilis, which is syphilis passed to a baby during pregnancy. The CDC has described the rise in congenital cases as a public health concern, because those cases are preventable with timely testing and treatment.

For readers, the takeaway is practical. Syphilis is more common than it was, it is easy to treat when found, and a short blood test is the way to find it. Increased testing is the public health response, not a reason for alarm or blame.

Syphilis in Columbia and South Carolina: the numbers

Local numbers help show why testing is worth a visit. They come with caveats, so here is where each one is from.

Place and year	Primary and secondary syphilis	Source
Richland County, 2021	22.9 per 100,000 people (96 cases)	Stacker, an analysis of CDC county data
South Carolina, 2023	17.3 per 100,000 people (927 cases)	FITSNews, citing CDC 2023 data

Both figures come from news and data-analysis outlets that reworked CDC numbers, not from published South Carolina Department of Public Health (DPH) county tables. They count only primary and secondary syphilis, the early stages. They do not include latent cases or congenital syphilis, and I could not confirm local congenital syphilis figures. For current local data, check with DPH.

Read plainly, the Richland County figure for 2021 sits above the state figure for 2023. The years differ, so the two should not be compared directly. They do suggest that syphilis is present in the Columbia area, which is a good reason for routine testing.

How syphilis is tested: the two kinds of blood tests

The CDC STI Treatment Guidelines (2021) describe two families of blood tests. Clinicians use them together because each answers a different question.

Treponemal tests

These tests look for antibodies made specifically against the syphilis bacterium. Research summarized by the CDC suggests these antibodies usually stay detectable for life, even after successful treatment. So a treponemal test can tell a clinician that a person has been exposed at some point, but it cannot say whether the infection is recent or treated.

Non-treponemal tests

These tests, which include the RPR and VDRL, detect antibodies to lipid material released from damaged cells and from the bacterium. The test result is reported as a number called a titer. The CDC says titers tend to rise with active infection and fall after effective treatment. That is why these tests are used to follow a person's response to treatment.

Why two tests

The CDC explains that a single test can occasionally give a result that does not match the true picture. A non-treponemal test can read positive for reasons other than syphilis. Using both types, in either order, helps a clinician interpret the pattern. Many labs now start with the treponemal test, and some start with the non-treponemal one. The clinician will explain which approach applies.

Swabs and other tests

If there is an open sore, a clinician may take a sample from it for lab analysis. If there are symptoms involving the eyes, ears or nervous system, a clinician may order further evaluation. These decisions belong to the clinician.

Timing of testing

The CDC notes that very early after an exposure, antibody tests may not yet show a result. A clinician can advise on when to test and whether to repeat a test. The CDC guidance for this infection does not reduce it to one simple number for everyone, so ask the clinic about timing for your situation. A negative result means no infection was detected on that day. It does not predict the future.

Syphilis treatment: is syphilis curable?

Yes. Syphilis treatment centers on penicillin, a long-established antibiotic in the beta-lactam family. The CDC STI Treatment Guidelines (2021) name penicillin as the preferred treatment at every stage. A clinician decides the specific form and schedule, based on how long the infection may have been present and whether it involves the nervous system, eyes or ears. Dosing is not something to work out from a website, and this page does not give it.

The CDC says treatment stops the infection and prevents further damage. It cannot reverse damage that has already occurred. That is one more reason earlier detection is better.

Follow-up blood tests

After treatment, the CDC guidelines call for repeat non-treponemal blood tests over the following months, and sometimes longer. The clinician compares the titer to the earlier one. Research summarized in the CDC guidelines suggests that a sustained drop in titer is the usual sign that treatment is working. Because treponemal antibodies usually stay positive for life, follow-up uses the non-treponemal test.

Sexual partners may also need testing and treatment. The CDC guidelines give clinicians a framework for deciding this, and a clinic or the health department can help with notifying partners. South Carolina's Expedited Partner Therapy interpretation, per the CDC's legal-status page for South Carolina, applies to chlamydia and gonorrhea, so ask a clinician how partners of someone with syphilis should be handled.

Prevention research: doxy-PEP

In 2024, the CDC issued guidance on doxycycline taken after sex (doxy-PEP) to lower the chance of syphilis, chlamydia and gonorrhea. It is aimed at gay, bisexual and other men who have sex with men, and transgender women, who have had a bacterial STI in the past year. Research suggests it reduces these infections in that group. It is prescribed by a clinician, who will discuss whether it fits a person's situation. CAN Community Health and PALSS list doxy-PEP among their services.

Safety profile and contraindications

The medicines and tests used for syphilis are well studied. A few points are worth knowing before an appointment.

Penicillin allergy. Tell the clinician about any past reaction to penicillin or related antibiotics. The CDC says many people who believe they are allergic are not, and a clinician can assess this. If someone truly is allergic, the clinician chooses another approach.
Pregnancy. The CDC guidelines say penicillin is the only recommended treatment for syphilis in pregnancy. A pregnant person with a confirmed penicillin allergy is typically referred for desensitization so penicillin can be used. Tell the clinician about a pregnancy or a possible pregnancy.
Short-term reactions. The CDC describes a reaction called the Jarisch-Herxheimer reaction. It can bring fever, chills, headache and muscle aches within about a day of starting treatment, and it usually passes. A clinician can explain what to expect and what to do.
Other medicines. Share any medicines and health conditions. A clinician reviews these before prescribing.

Sourcing and quality indicators: how to judge information and care

Syphilis is a topic where unreliable advice circulates. A few markers help.

Source. Good information names the CDC, the USPSTF or the state health department, and says what each one found.
Treatment language. Anything that promises a cure without a clinician's prescription is a warning sign. The CDC says syphilis is treated with prescribed antibiotics.
Test explanation. A good clinic explains which tests it runs, what results mean, and what follow-up comes next.
Privacy and respect. Care should be nonjudgmental and confidential.
Verified listings. The CDC's testing locator at gettested.cdc.gov lists clinics by ZIP code, including their services.

Where to get tested in Columbia

These Columbia clinics list syphilis or STI testing in public directories. Hours and services change, so call before going. For a fuller comparison, see our guide to STD testing in Columbia, including where to go and what it can cost, and the local clinic list.

CAN Community Health

1911 Hampton St., Columbia, SC 29201. Phone (803) 849-8430. The clinic's page lists syphilis, chlamydia, gonorrhea, herpes, hepatitis and HIV testing, with treatment on site. It says walk-ins are accepted during regular hours, and that sliding-scale fees and grant funding may be available. It accepts Medicare, Medicaid and most insurance. Its listed hours are Monday to Thursday 8:30 a.m. to 5:30 p.m. and Friday 8:30 a.m. to 12:30 p.m., with some extended hours on select dates. The CDC directory lists an appointment as required, so call to confirm.

PALSS (Palmetto AIDS Life Support Services)

2638 Two Notch Rd, Ste 108, Columbia, SC 29204. Phone (803) 779-7257. The CDC's NPIN listing shows free HIV, hepatitis and STI tests, and says insurance and Medicaid are accepted. Listed hours are Monday to Friday 8:30 a.m. to 5 p.m., with walk-in testing Tuesday 3 to 8 p.m. and Thursday 3 to 7 p.m. The CDC's GetTested listing says an appointment is required, so confirm by phone.

Planned Parenthood South Atlantic, Columbia Health Center

2712 Middleburg Dr, Ste 107, Columbia, SC 29204. Phone (803) 256-4908. The CDC NPIN listing shows syphilis, chlamydia, gonorrhea, herpes, hepatitis B and rapid HIV tests, and says insurance and Medicaid are accepted. It says an appointment is required, but you are welcome to walk in during open hours to book or ask about same-day openings. Ask the center about cost and eligibility.

Cooperative Health

Two sites share the address 1228 Harden St, Columbia, SC 29204. The Five Points Walk-In Center (Ste A, phone (803) 722-1565) is listed by the CDC as no appointment required. The Waverly Family Practice (Ste C, phone (803) 748-1181) is listed as appointment required. Both list syphilis testing and sliding-scale fees, and accept insurance, Medicaid and Medicare. The CDC listings do not give hours, so call first.

AHF Healthcare Center, Columbia

4100 N Main St, Suite 102, Columbia, SC 29203. Phone (803) 223-9895. The CDC's GetTested page lists syphilis, chlamydia, gonorrhea and rapid HIV tests, and a free HIV test, with an appointment required. It does not list hours. Ask the clinic about eligibility and cost for other tests.

Richland County Health Department (SC DPH)

2000 Hampton St., Columbia, SC 29204. According to SC DPH, STD, HIV and hepatitis C services continue at this site. DPH says it may later move to the former Columbia Place Mall site. The DPH page does not list a clinic phone number, hours or fees. To book an appointment, call the DPH Care Line at 1-855-472-3432. For questions about STDs, the DPH STD/HIV Hotline is 1-800-322-2437.

Syphilis testing is not part of South Carolina's free in-home HIV test program, which covers HIV only, according to SC DPH. Ask a clinic about syphilis testing directly.

South Carolina laws that may matter

Minors. South Carolina Code § 63-5-350 says health services may be given to minors of any age without parental consent when the provider considers them necessary. The statute does not name STDs, and the Guttmacher Institute lists South Carolina as allowing minors to consent to STI services. Ask the clinic about its own policy.
Pregnancy. South Carolina Code § 44-29-120 requires a physician attending a pregnant woman to take a blood sample at the first examination, or within three days after, for syphilis and other tests. It includes an exemption by sworn affidavit of religious objection. The statute as read does not require a later test, so ask your prenatal clinician whether more testing is advised.
Reporting. South Carolina Code § 44-29-10 requires physicians to report certain infectious diseases on the DPH list to the county health department. A clinician can explain what this means for a person's case.

What to do next

A syphilis test is brief, and treatment is straightforward when the infection is found. A person who has had a new partner, a partner who tested positive, a sore or rash they cannot explain, or who is pregnant can ask a clinician about testing. The same is true for anyone who just wants to know. Free or low-cost options exist in Columbia, and the CDC's locator at gettested.cdc.gov can help find more.

Questions to ask at an appointment:

Which syphilis tests do you run, and when will results come back?
What does the visit cost, and is there a sliding scale?
If treatment is needed, can it be given here?
What follow-up blood tests will I need?
How do I let partners know, and can you help?

Syphilis in Columbia: Symptoms, Testing and Treatment