Syphilis Treatment in Bangkok | Same-Day Testing & Penicillin Cure

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum, and rates have been climbing globally for more than a decade. The good news is that early-stage syphilis is curable with a single intramuscular injection of long-acting penicillin, and our Bangkok clinic provides confidential testing, same-day treatment, and partner notification support for residents, expats, and travelers.

At Take Care Clinic on Sukhumvit Soi 13, our family medicine doctors run the same blood tests used by the world’s leading sexual health clinics, treat all stages of syphilis according to CDC and WHO protocols, and coordinate follow-up serology to confirm cure. If you have noticed a painless sore, an unexplained rash on the palms or soles, or you have had a recent unprotected exposure, walk-in and same-day appointments are available seven days a week, and a doctor hotel visit can be arranged anywhere in central Bangkok.

Why syphilis testing matters for visitors to Bangkok

Thailand sees a substantial number of sexually transmitted infection cases each year, and syphilis is one of the fastest-growing. The disease is spread through direct contact with a syphilitic sore during vaginal, anal, or oral sex, and a single exposure is enough. Most early sores are painless, hide inside the vagina, mouth, or anus, and disappear without treatment after a few weeks. That is why so many people only discover the infection on a routine blood test, or years later when complications appear.

If you are visiting Bangkok and have had unprotected sex, a quick syphilis blood test, often bundled into a full comprehensive sexual health screening, will give you peace of mind before you fly home. Travelers without health insurance back home often find that getting tested here is faster, cheaper, and far more discreet than waiting until they return.

Symptoms of syphilis at each stage

Syphilis progresses through four stages if it is not treated. Knowing which stage you are in matters because it determines how long the penicillin course needs to be and how soon you can expect to be non-infectious.

Primary syphilis

The first sign is a single, firm, round, and usually painless sore called a chancre. It appears around three weeks after exposure, on the genitals, anus, rectum, lips, or inside the mouth. Because it does not hurt, many people never notice it. The sore heals on its own within three to six weeks, but the bacteria are still in the body and continue to spread.

Secondary syphilis

A few weeks after the chancre disappears, a non-itchy rash often develops on the trunk, palms of the hands, and soles of the feet. Other symptoms include flu-like fever, swollen lymph nodes, sore throat, patchy hair loss, weight loss, and tiredness. These can come and go for up to two years and are easily mistaken for a viral illness.

Latent syphilis

If untreated, the infection enters a latent phase that can last for years. There are no symptoms, but the bacteria remain in the body and can be detected on a blood test. Early latent syphilis (within the first year after infection) is still considered infectious to sexual partners.

Tertiary syphilis

Without treatment, up to one in three people develop serious complications years or even decades later, including damage to the brain, nerves, eyes, heart, blood vessels, and bones. This stage can be fatal. Tertiary syphilis is now rare in places where testing and treatment are accessible, which is why early diagnosis matters.

How we test for syphilis at our Bangkok clinic

Syphilis testing is a simple blood draw with results back the same day or the following morning. We use a two-step protocol recommended by the CDC, WHO, and BASHH.

The first test is a treponemal test (chemiluminescence immunoassay or rapid plasma reagin) that detects antibodies the body produces against the bacterium. If this is reactive, we run a confirmatory non-treponemal test (RPR or VDRL) that gives a titer used to monitor response to treatment. We typically also offer simultaneous testing for HIV, hepatitis B and C, gonorrhea, and chlamydia because co-infection is common and partners who have one sexually transmitted infection are far more likely to have another.

The window period for syphilis serology is approximately three weeks. If your exposure was more recent than that, we will advise you on when to retest. For people with a known recent exposure, we can start PEP for HIV at the same visit if the timing fits.

Syphilis treatment in Bangkok

Penicillin G benzathine is the gold-standard treatment and has been since the 1940s. The bacterium has never developed resistance. The regimen depends on the stage.

For primary, secondary, and early latent syphilis, a single intramuscular injection of 2.4 million units of benzathine penicillin G clears the infection in most patients. For late latent syphilis, syphilis of unknown duration, or tertiary syphilis without neurological involvement, the same dose is repeated weekly for three weeks. Neurosyphilis and ocular syphilis require intravenous penicillin for ten to fourteen days, which we coordinate with a partnered hospital.

If you are allergic to penicillin, doxycycline 100 mg twice daily for fourteen days (28 days for late latent) is the standard alternative, supported by both CDC and BASHH guidelines. Azithromycin is no longer recommended due to documented resistance in many regions.

After treatment, we recheck the RPR titer at six and twelve months for early syphilis, and at six, twelve, and twenty-four months for late or unknown-duration disease. A fourfold drop in titer indicates successful treatment.

Special situations: pregnancy, HIV, and neurosyphilis

Untreated syphilis in pregnancy causes stillbirth, neonatal death, or congenital syphilis in up to 80 percent of cases. Every pregnant woman in Thailand is screened at the first antenatal visit, and we re-test in the third trimester for women at ongoing risk. Penicillin is the only safe and effective treatment in pregnancy. Women who are allergic are desensitised in a hospital setting and then treated with penicillin.

People living with HIV may have atypical presentations and a higher risk of neurosyphilis. We test cerebrospinal fluid in any patient with neurological symptoms, eye involvement, or treatment failure. Ocular syphilis can present as blurred vision or uveitis and is a medical emergency.

Partner notification and follow-up

All sexual partners from the past three months (for primary syphilis), six months (for secondary), or twelve months (for early latent) should be tested and offered presumptive treatment, even if their serology is negative. We provide partner letters in English and Thai and can coordinate testing for partners who are also in Bangkok. Counseling is confidential, and we never disclose your name without consent.

Avoid sexual contact until the treatment course is complete and any sores or rashes have fully healed, usually two weeks after the final injection. Condoms reduce but do not eliminate transmission because chancres can occur outside the area a condom covers. The best prevention strategy combines consistent condom use, regular screening every three to six months for anyone with new or multiple partners, and HIV PrEP for higher-risk groups.

Cost of syphilis testing and treatment in Bangkok

Walk-in syphilis serology costs are modest compared with private clinics in Europe, North America, or Australia. A combined panel including HIV, syphilis, hepatitis B and C, gonorrhea, and chlamydia is the most cost-effective option for travelers. Penicillin G benzathine injection is widely available in Thailand and inexpensive. Most international travel insurance plans cover sexually transmitted infection testing and treatment when symptomatic, and we provide itemised English-language receipts and an ICD-10-coded medical report on request.

Hotel visit and discreet care

If you would prefer not to attend the clinic in person, our doctors offer discreet hotel visits across central Bangkok. Blood draws, intramuscular injections, and follow-up consultations can all be done in your room, and results are delivered by encrypted email or LINE. This is a popular option for visitors who want absolute privacy or have a packed schedule.

Related sexual health services

If you are concerned about syphilis you may also benefit from testing or counseling for related conditions. We treat gonorrhea, chlamydia, HPV, and hepatitis C at the same clinic, and we offer HIV testing, PrEP and PEP, and full STD treatment. For women with discharge that is not syphilis, we also treat bacterial vaginosis and yeast infections.

Frequently asked questions

How soon after a possible exposure should I be tested?

The blood test becomes reliably positive about three weeks after exposure. If your exposure was more recent, we can do a baseline test now and repeat at three weeks and three months. If you have any symptoms, come in straight away.

Will my insurance cover syphilis treatment in Bangkok?

Most international travel and expat policies cover diagnostic blood work and treatment for symptomatic sexually transmitted infections. Routine screening without symptoms is sometimes excluded. We provide English-language receipts and ICD-10-coded medical reports that work for almost every major insurer.

Can a doctor come to my hotel for syphilis testing?

Yes. Our doctors do hotel visits across central Bangkok, including Sukhumvit, Silom, Sathorn, Asoke, and the riverside. Blood draws and the penicillin injection can both be done in your room, and we deliver results by encrypted email or LINE.

Is syphilis really curable with one injection?

For primary, secondary, or early latent syphilis, a single intramuscular dose of 2.4 million units of penicillin G benzathine cures the infection in more than 95 percent of patients. Later-stage disease needs three weekly injections. We monitor the RPR titer at six and twelve months to confirm cure.

Do I need to tell my sexual partners?

Yes. Partner notification is essential because syphilis can be infectious even when the source has no symptoms. We provide partner letters and can coordinate testing if your partners are also in Bangkok. Conversations are confidential and we never disclose names.

What about congenital syphilis if I am pregnant?

Untreated syphilis in pregnancy is dangerous to the baby. Penicillin is safe and effective and the only treatment proven to prevent congenital syphilis. If you are allergic to penicillin and pregnant, you must be desensitised in a hospital so you can still receive it. We arrange this with partnered tertiary centers.

References

1. Workowski KA et al. Sexually Transmitted Infections Treatment Guidelines, 2021. CDC MMWR Recomm Rep.
2. World Health Organization. WHO Guidelines for the Treatment of Treponema pallidum (Syphilis). WHO 2016.
3. Kingston M et al. UK National Guidelines on the Management of Syphilis 2015 (revised 2024). BASHH.
4. Hook EW 3rd. Syphilis. N Engl J Med 2017;376:1635-1644.
5. Ghanem KG et al. The Modern Epidemic of Syphilis. N Engl J Med 2020.
6. Mayo Clinic. Syphilis – Diagnosis and Treatment. Mayo Clinic 2024.

Medically reviewed by Dr Ponlawat Pitsuwan, MD.