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Syphilis Scared Bad

Hello Everyone,

I am from Canada and about 7 weeks ago I had unprotected oral and vaginal intercourse with a woman that I had known from years ago and now I am freaking out. She told me that she had blood testes done last year and that everything with her is fine but she did not tell me exactly which blood tests she had done.  At 2 weeks and 2 days after the exposure I noticed a round red painless and non-itchy spot on the coronal ridge of my penis and got extremely nervous. Close to 3 weeks post exposure it looked like some dry skin like a scab formed on it and I peeled it off. It was and is still a red round spot. It is still there and is not indurated or open looking. No pus or anything oozing out of it either. I still have it and it has not changed much at all. 2 weeks after the spot appeared I went to my GP to have it checked. He told me that to him it did not look like an STI to him and that it just looks like some red irritated skin. When I asked specifically about syphilis he said ''Syphilis does not look like that''.  Then I contacted the local sexual health clinic here and was seen by a Nurse Practioner at 4 weeks and 6 days post exposure. I showed her the red spot and she was not exactly sure what it is. She said that it does not look like a typical syphilis lesion and when I asked her specifically about if it looked like syphilis she said ''I don't think so but we can test for it.'' I had my first VDRL done at 4 weeks and 6 days and the results were negative. At 6 weeks and two days post exposure I noticed a red spot on my inner right thigh that looks like a hickey but it is definitely not a hickey. It does not hurt much and is not itchy. I tested again at 6 weeks and 4 days and the results are negative. The red spot on my thigh looks like it is fading and the outer part of it looks brownish yellow. I plan to test again at 90 days.

My question is;

Are my negative Syphilis VDRL tests at 4 weeks and 6 days and 6 weeks and 4 days good reliable evidence that the symptoms that I have mentioned are likely not from syphilis?
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You did test after 5 or 6 weeks. The test should be conclusive. Move on buddy.
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Thank you. I truly do feel absolutely horrible about this experience. It was a very stupid thing for me to do and I regret it badly.
I agree - since you had symptoms, your test at 6 weeks is conclusive. You don't need to worry about syphilis.

This could be a fungal infection - look up ringworm. It could also be an allergic reaction, dermatitis, etc. If it continues, get it checked by your doctor or see a dermatologist.
Hi again,

Thank you for the answer and comment. I truly do appreciate it.

I plan on testing again soon but I am very nervous about potentially getting a false positive syphilis result on my next VDRL blood test. Yesterday I was working on a wooden dock and I suffered some lacerations on my hand from a rope being squeezed on my hand very hard. I worked through the pain and cuts but I am nervous now as my hands were a bit dirty from handling old water logged dock boards and then washing my hands in Lake water and also under water from a tap that comes from an unfiltered sisturn. The rope also very likely was not all that clean. I am worried about tetanus getting in the small lacerations on my hand either via dirt or the water. I had a tetanus shot about 4 years ago but I have read that tetanus vaccine antibodies can effect a syphilis blood test result by giving false positives? Any advice anyone?
Hey man.  A tetanus shot lasts 10 years, so you don't need another.  And I don't think you have to worry about the vaccine antibodies after 4 years.  If this was a real thing then you would get a warning when you had a syphilis test....as almost everyone has tetanus shots
Have a good look on Google images at syphilis sores on penis, they sure don't look what you're describing here
Totally agree.

If tetanus shots caused false positives, everyone would get false positives. If you get a positive result, it's automatically confirmed with another test before you even see the result.

Are you always this anxious? You should talk to your doctor about it. Your mental health is as important as your physical health.
Thank you all again for the answers and reassurance. I do have another question though unfortunately. It is a hypothetical or theoretical type of question because my mind is going crazy. I hope these questions make sense.

Say an individual has had two possible exposures a few weeks apart to syphilis and tested negative outside of the window period for the first exposure. Could the second possible exposure effect the test negative test result for the first exposure? Or is the negative test result for the first exposure still valid if it is outside of the window period?

I hope the above question makes some sense. Can someone answer please?
Did you have a second exposure?

No, the second one doesn't affect the first.
No I do not think so. My mind has just been creating insane scenarios that very likely are not really based in reality.
A few other questions that I have are about the biological basis of syphilis infection chances once outside of the body.

1.) How long does syphilis survive and remain infectious in semen once outside the body and in something like a kleenex or toilet paper?

2.) Can syphilis survive and remain infectious on a towel after someone with syphilis uses it and then someone else comes in contact with that towel?

3.) Is the syphilis rash infectious if someone has the rash and then sits on a couch or chair with no shirt on and then you sit there a few minutes later?

These are irrational thoughts. Please consider getting some help for this. I say that only with compassion and no judgement at all.

1.) How long does syphilis survive and remain infectious in semen once outside the body and in something like a kleenex or toilet paper?

Syphilis isn't in semen. It's on the skin, and to get it, you have to have direct contact with a sore.

2.) Can syphilis survive and remain infectious on a towel after someone with syphilis uses it and then someone else comes in contact with that towel?

No.

3.) Is the syphilis rash infectious if someone has the rash and then sits on a couch or chair with no shirt on and then you sit there a few minutes later?

No.

Syphilis is a sexually transmitted infection. To get it, you have to have some sort of sexual activity - either oral to genital, genital to genital, or genital to anal. Everyone involved has to be unclothed, and there needs to be some rubbing.

So I did a little digging. I don't know where you are in Canada, but I searched "syphilis Canada", and there are all these reports of increasing rates of syphilis, and OH THE ALARM.

Yes, it is concerning that rates are rising. Some perspective though:

https://www.catie.ca/en/pif/fall-2018/fast-facts-sexually-transmitted-infections-canada

These are 2016 stats (it's not easy finding Canadian stats, apparently):

121,244 – The number of reported cases of chlamydia in 2016. (This seems like a really low number. I'd guess many aren't reported.)

23,708 – The number of reported cases of gonorrhea in 2016. (This also seems low.)

5,369 – The number of reported cases of infectious syphilis in 2016.

For reference, the US:

In 2017, a total of 1,708,569 chlamydial infections were reported to CDC in 50 states and the District of Columbia. (See why I think Canada's numbers are so low?)

In 2017, a total of 555,608 cases of gonorrhea were reported in the United States.

In 2017, a total of 30,644 cases of P&S syphilis were reported in the United States.

(This is all from https://www.cdc.gov/std/stats17/default.htm)

If syphilis were that easy to get, far more people would have it.

I'm not sure why you're focused on this. Chances of you getting it are really low. I know you had the symptoms, but syphilis sores don't appear until a minimum of 3 weeks has passed. The average is 6 weeks. Your symptoms were too early.

Please, get some counseling.
Thank you very much. Yes I do think that I need some counseling to help me with this. My thoughts truly have become irrational I think. The Doctors that I have talked to including Dr. Handsfield told me that my symptoms did not seem much like syphilis at all. Your answers truly have provided some comfort to me though and for that I am grateful.

Now my last question on this. I went for my last VDRL syphilis blood test last Thursday. That is 8 weeks and 5 days since my exposure. I am waiting for the results still. I work full time in a Nursing Home where I help elderly and sick people with their daily needs. There has been a Gastro-Intestinal outbreak in the home now for about a week. People have fevers and are vomiting and have diarrhea. Last night an individual on the floor that I work on vomited and I had to clean it up. I wore a gown, mask and gloves and then washed my hands thoroughly.  I did not clean my shoes though which I now realize I should have. Currently I have no symptoms of Gastro-Intestinal. If I have contracted this Gastro-Intestinal sickness would that increase the chances by much of my VDRL syphilis test that I took last Thursday being a false positive?

You talked to Dr. Handsfield? He's one of the very best, and you can trust what he says. I would definitely trust him with my sexual health.

No, a GI illness wouldn't affect the VDRL. If you were ill last Thursday when you took the test, you'd have gotten symptoms by now.

I sure hope that illness clears up - it doesn't sound fun.

And find a counselor today. It's time.

Thank you very much again. You are truly helping me through this.

I called the clinic today to see if my next VDRL results from last Thursdays test are in. They are not yet unfortunately which concerns me. Last time then were in within just 4 days. Tomorrow will be 5 days this time. I have read that positive tests take longer to come back. Although I have also heard that all tests can take 5 business days or more to come back. Since it seems slower this time to get my results back does that make it likely it will be positive do you think? I hope it's negative!
Try not to worry about the length of time, I've had negative tests for STDs take 2 days and some take 10.  It's just about how busy the labs are, nothing else
I just called the clinic. The VDRL syphilis test that I took last Thursday is negative!!!!! Woohooo!...That test was at 8 weeks and 5 days since my exposure.
Congrats!

I'm happy to hear this (though not surprised). Please work on your mental health now. It's just as important as your physical health.

:)
Thank you very much for all of your help! :)



I am curious about the Prozone Phenomenon for the VDRL test. I have read that it can cause a false negative result. I have read that the Prozone Phenomenon can happen because of Secondary Syphilis, Pregnancy or HIV con-infection. Are there any other known causes for the Prozone Phenomenon for the VDRL Syphilis test?
Dude.

The prozone phenomenon refers to a false negative response resulting from overwhelming antibody titers. The prozone effect is most often associated with secondary syphilis, Human immunodeficiency virus (HIV) co-infection, and pregnancy.[1] Published reports document the incidence of prozone phenomenon to be between 0.2 and 2%. This is believed to be higher in the HIV population.[2]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139290/

First, you aren't in secondary syphilis, as you don't have the rash.

Second, this happens .02-2% of the time.

Third, syphilis is uncommon.

You've seen 2 doctors who have said your symptoms don't look like syphilis, including one at an STD clinic who would know what syphilis looks like.

You've had 3 negative tests.

You've talked to us here, and Dr. Handsfield.

You've asked about toilet paper, towels and furniture. You've asked about tetanus and GI infections.

You started with asking about false positives, and are now asking about false negatives.

This is irrational. I understand that you had symptoms of something, and that's scary, but it's not syphilis. I have no other way to say it. You need to seek some counseling for this.
Okay thank you again. My irrationality really is getting out of control I know. I'm sorry for this.

So the Prozone Phenomenon  only happens .02-2% of the time even among people with Secondary Syphilis, HIV co-infection and pregnant women? That is even among people with those conditions it only occurs .02-2% of the time?
Yes, you have to have secondary syphilis and one of those conditions to have it happen.

You don't have any of that.

Have you found a counselor yet? Talked to your doctor about your anxiety? Do that today. You deserve to find peace with this.
My main question was that even among people that have secondary syphilis, HIV co-infection or pregnant women the Prozone Phenomenon still only happens 0.2-2% of the time among those people with those conditions?


I saw a Nurse Practioner about my anxiety and she told me for now to practisce deep breathing and other stress relief exercises.
I honestly don't know what your asking differently than what I answered.

It doesn't matter how many people who have secondary syphilis and who have an HIV co-infection or are pregnant have this phenomenon, because YOU don't have any of those things. It only happens to .2-2% of those who have those things. You don't have any of those things.

That's all the NP said? She didn't suggest counseling? Meds?

You do not have syphilis. Again, you've seen 2 doctors who have said your symptoms don't look like syphilis, including one at an STD clinic who would know what syphilis looks like.

You've had 3 negative tests.

You've talked to us here, and Dr. Handsfield.

You've asked about tetanus, GI illness, false negatives, false positives, toilet paper, furniture and towels.

You have to let this go. I don't know what is making you hold on to it, but whatever caused your symptoms, it wasn't syphilis. Science says you don't have it.
I was on Wellbutirin before for a while but it did not help much so I stopped taking it. She did not suggest any new meds or counseling no.

You are right I do need to let this go.
There are other meds that could help, but that's a discussion for you to have with your doctor. You can also ask about counseling.

I really just hope you find peace. There are treatments for anxiety. It may not cure it, but it can help.
Thank you again.

I am at the 12 week mark now since my exposure. I am going to do one more VDRL test and I also ordered a home test kit from the company called Let's Get Checked. I have not done either test yet. I asked a nurse from Let's Get Checked about the kind of Syphilis test they use and she had this to say.

"Our Syphilis test is an electrochemiluminescence immunoassay (ECLIA) to detect antibodies against t. pallidum (syphilis) infections. It's a treponemal assay."

I then asked her if there is anything that can cause a false positive or a false negative with that kind of test and she told me that it is an extremely sensitive test and other blood components can react with it that is why if you receive a reactive result you need to follow up with a physician for an RPR confirmatory test.

Is she right about that? I thought that treponemal assay type tests only looked for the very specific Syphilis antibodies?
Is it a blood test or a urine test?

I don't know a lot about Let's Get Checked, but did find this about the ECLIA -

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478324/

https://www.sciencedirect.com/science/article/abs/pii/S1341321X18302381

https://jcm.asm.org/content/54/9/2330.short

It is very sensitive, but any positive syphilis test needs to be confirmed. That's standard of care protocol. If you start with a tremonemal assay, you confirm with a nontreponemal. I don't know why she suggested getting it confirmed with an RPR, but maybe she assumed that's what a doctor would do. A positive RPR would be confirmed automatically.

Why are you still testing? You've already had 3 VDRLs (also nontreponemal), all negative, up to 8+ weeks. You have a few doctors (including Dr. Handsfield) tell you it doesn't sound and/or look like syphilis. Now you want to test twice, with another VDRL AND an ECLIA?

Your issue isn't syphilis, hon. It's anxiety. This is not a reaction that is in proportion to the issue.
I am still testing because the  local STI/STD clinic told me that I need to test out to 12 weeks for Syphilis, HIV, and Hep C and B. From all that I have read and been told it seems that since I received a negative VDRL Syphilis test at 8+ weeks testing at 12 weeks is "overkill". For some reason the clinic here suggests three months. Maybe they are overly conservative? I don't know really.

I ordered that home test weeks ago when I was really racked with anxiety. Maybe it was a waste of money at this point unfortunately.
So officially, the guidelines say 90 days.

Those are mostly for people with a known syphilis exposure, though. The vast majority of people will develop antibodies by 6 weeks, especially those who've had symptoms.

Since you need the confirmation to ease your mind, do the testing. You absolutely don't need it, but I don't think you'll let it go unless you do.

And who are these people you're talking to? Hep C is almost never transmitted sexually, and when it is, it's by unprotected anal sex.

I don't know how old you are, but you've probably been vaccinated for hep B. Instead of testing for hep B, ask for a test to show if you have immunity. That will show if you've been vaccinated or not. If you haven't been, get the vaccine.

What kind of HIV testing have you had? If you had a 4th generation DUO test at 28 days, that's conclusive. If it was a regular antibody test, it was probably conclusive by 6 weeks, but most people don't have HIV, and it's not common for men to be infected by females (not impossible, but quite unlikely).

This clinic is way too alarmist.
Yeah I ended up going for my 12 week test a few hours ago. After this I need to let this go and move on with my life. Like you say I likely dis not even really need to do it but I am doing it for my own peace of mind.

I told them at the clinic that I wanted to be tested for everything that is probably why Hep C is on there. You are right I have been vaccinated for Hep B. I remember that now. I think that the HIV test is a standard antibody test.

I am going to do my best to relax now.
A good clinic would take your history, and help you determine the "everything" you needed to be tested for, and not just throw in one of everything from the menu for fun upon request.

Take the weekend, stay off the internet - like really stay off it - and do something really fun, whatever that is for you. :)
Okay thank you. I woke up with a pain in my mouth this morning and it feels like a canker sore. I very rarely get these. Could it be related to Syphilis?
I'm sorry to jump in here, but no, this canker sore thing is not related to the syphilis you don't have. It is related to your irrational anxiety about this. Your mission is to seek mental health care now.
Go ahead and jump in, SkaterDave. :)

He's right - canker sores aren't syphilis, which you don't have, and can absolutely be caused by stress.

He's also absolutely right that it's your mission to seek mental health care now. It's past time that you do that.
Thank you again to you all. I am calling my GP today to see about getting in for my anxiety issues and getting them addressed. This has gone on for too long.

Now my 12 week VDRL Syphilis test result is not in yet but if I receive a negative result on this test do I even need to do that home ECLIA Syphilis test?  
No, you don't need to do the other test.

I'm happy to hear you're going to call your doctor. I hope you can get in soon. :)
Okay thank you. I got through to my Doctor's office and I have an appointment early next week for my anxiety issues which is good news.

I know deep down that my thoughts must be irrational but I have a very hard time controlling my anxiety when it flares up as you know by my posts on here.

I feel like a walking infection still even though I have had three negative VDRL syphilis tests so far.
I'm glad to hear it. :)

Okay, so I have herpes. I've had it for 15+ years. I'm not a walking infection. Even if you had syphilis, which clearly you don't, you wouldn't be either. People who have STDs aren't any different than anyone else. The only difference between syphilis and strep throat is the mode of transmission.

I'm quite sure you didn't mean anything bad by that, but I just want to help clear up the stigma that you seem to be buying into.
I did not mean anything bad by saying I feel like a walking infection no. It is just my mental state which currently unfortunately is not the best.  You are a good person for helping me through this and for that I am thankful. :)

I have had two separate infections of HPV and this second round has lasted much longer than the typical outbreak.  I don't know if it's both strains of the HPV I have coming out or what.  When I first got HPV and when I exceeded the normal flare-up time for the second round, I got really anxious and had all sorts of racing thoughts and anxiety.  I've seen many, many people come and go on this website over the last 12 years who have HPV or think they may, and the vast majority of them are really, really freaking out (with understandable cause!) to the point where they are borderline irrational with their fear.  From where I stand with my experience here, you are in the top few percent of irrational fear reaction to your sexual experience.  Please, and take this from someone who is medicated for anxiety and loves his meds, please understand that your issue isn't a sexually transmitted disease but your super extreme reaction to the fearful idea you had and your refusal to be able to naturally let it go.  From this point forward, even if you have recurring thoughts about what if this or what if that about syphilis, you must recognize and categorize those thoughts as your irrational process.  Seek help for this and do everything in your power to promote mental well-being.  This includes thinking through any future sexual experiences you engage in.  Take it from me, someone with and STD and pretty severe General Anxiety Disorder (GAD), you're worth it.  Peace be with you brother.  After you reply here, I'd consider this thread closed.  That'll be a sign of your progress.  Take care and good luck.
I know you didn't mean anything by that, Scared_Bad. I just wanted to gently correct the notion that people with STDs are some kind of walking biohazards. It's all good.

SkaterDave, I'm applauding your answer.
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