Chancroid

Chancroid usually causes one or more painful sores or ulcers on the genitals that develop a few days after exposure.

Common symptoms include:

• Painful, soft genital sores with ragged edges and a grey or yellow base
• Sores that may bleed easily if touched
• Swollen and tender lymph nodes in the groin, often on one side
• Pain during urination or bowel movements, depending on where the sores are located

Because these symptoms can resemble other sexually transmitted infections, any new genital sores or painful lumps should be assessed by a healthcare professional.

Yes. Although chancroid usually causes painful genital sores, some people have no noticeable symptoms.

Even without symptoms, the bacteria can still be passed on to sexual partners.

If you think you may have been exposed or have had contact with someone diagnosed with chancroid, clinical assessment and appropriate investigations is recommended.

Without treatment, chancroid can cause painful complications and increase the risk of other infections.

Possible complications include:

• Large, painful swollen lymph nodes (buboes) that may rupture and drain pus
• Scarring of the genital ulcers after they heal
• Tightening of the foreskin in uncircumcised men, making it difficult to retract
• An increased risk of acquiring or transmitting HIV due to open genital sores

Early diagnosis and antibiotic treatment can prevent most complications.

Symptoms of chancroid typically develop 3–7 days after exposure, although they can appear as early as 1 day or take up to 2 weeks or longer.

The first sign is usually a small red bump on the genitals that quickly develops into a painful open sore. Swollen and tender lymph nodes in the groin may also occur.

Because similar symptoms can be caused by other conditions, prompt assessment and testing for other STIs (particularly herpes, syphilis and HIV) are recommended for an accurate diagnosis and appropriate treatment.

Chancroid is caused by the bacterium Haemophilus ducreyi.

It is spread through direct skin-to-skin contact during vaginal, anal, or oral sex. The bacteria enter the body through tiny breaks in the skin or mucous membranes, leading to painful genital sores and, in some cases, swollen lymph nodes in the groin.

Although chancroid is rare in the UK, prompt diagnosis and antibiotic treatment can effectively clear the infection.

The main risk factor for chancroid is having sexual contact with an infected person.

Other factors that increase the risk include:

• Having sex without a condom
• Having multiple sexual partners
• Travelling to or having sexual contact in regions where chancroid is more common, such as parts of Africa, Asia, and the Caribbean
• Having other sexually transmitted infections that may make the skin more vulnerable to infection

If you develop painful genital sores or swollen groin glands, seek a sexual health assessment.

Using condoms consistently and correctly is the best way to reduce the risk of chancroid, although they cannot provide complete protection.

You can also lower your risk by:

• Avoiding sexual contact with anyone who has genital sores or ulcers
• Avoiding sex if you develop unexplained genital symptoms until you have been assessed
• Having regular sexual health check-ups if you have new or multiple partners

Yes. Condoms significantly reduce the risk of chancroid but do not eliminate it.

The infection spreads through direct contact with infected sores. If a sore is located on skin that is not covered by a condom, such as the base of the penis, scrotum, or surrounding genital area, transmission can still occur.

If you develop painful genital sores or think you may have been exposed, arrange a sexual health assessment.

It is very unlikely.

Chancroid is almost always spread through direct contact with infected sores during vaginal, anal, or oral sex. Transmission through kissing would only be possible if an active sore were present on the mouth or lips, which is extremely rare.

If you have painful sores or ulcers in the genital area, seek medical assessment for an accurate diagnosis.

No. Chancroid is not spread through sharing towels, clothing, toilet seats, or other personal items.

The bacteria do not survive well outside the body and are transmitted almost exclusively through direct contact with infected sores during sexual activity.

No. Chancroid is not transmitted through blood transfusions.

Haemophilus ducreyi causes a local infection of the skin and mucous membranes and is not transmitted through donated blood. It is primarily spread through direct sexual contact with infected sores.

Chancroid is diagnosed through a physical examination and laboratory testing.

A healthcare professional will examine any genital sores and may take a swab from the ulcer or fluid from a swollen lymph node. The sample is tested for Haemophilus ducreyi, the bacterium that causes chancroid. Because the infection is rare in the UK, tests for other causes of genital ulcers, such as herpes and syphilis, are usually performed at the same time.

The most common test is a PCR (polymerase chain reaction) test, which detects the genetic material of Haemophilus ducreyi from a swab taken from a genital ulcer.

Depending on your symptoms, other tests may include:

• Swabs for herpes simplex virus
• Blood tests for syphilis
• A sample from a swollen lymph node if significant swelling is present

Testing for multiple infections helps ensure an accurate diagnosis and appropriate treatment.

A correct diagnosis is based on your symptoms, medical history, and laboratory test results.

Important factors include:

• The presence of painful genital ulcers
• Swollen and tender lymph nodes in the groin
• Recent travel to regions where chancroid is more common
• Swab results confirming Haemophilus ducreyi
• Tests that rule out other conditions such as herpes or syphilis

Considering all of these factors helps distinguish chancroid from other causes of genital sores.

Yes. Several conditions can cause similar symptoms and may be mistaken for chancroid.

These include:

• Genital herpes
• Syphilis
• Lymphogranuloma venereum (LGV)
• Granuloma inguinale
• Certain inflammatory skin conditions or genital ulcers caused by non-infectious conditions

Because the treatments differ, clinical assessment and appropriate laboratory testing are important for an accurate diagnosis.

Laboratory testing is the preferred method, but diagnosis may also involve clinical assessment and ruling out other conditions.

In some cases, a bacterial culture may be attempted, although Haemophilus ducreyi is difficult to grow in the laboratory. If test results are unavailable or inconclusive, a healthcare professional may consider your symptoms, examination findings, and travel history when deciding on treatment.

No. A physical examination can suggest chancroid, but it cannot confirm the diagnosis.

Many sexually transmitted infections cause similar genital sores, so laboratory testing is needed to identify the underlying cause and ensure the correct treatment is given.

No. Chancroid cannot be reliably diagnosed at home.

Painful genital sores can be caused by several different conditions, including herpes and syphilis, which require different treatments. If you notice any new genital ulcers, sores, or swollen groin glands, you should seek a sexual health assessment for examination and appropriate testing.

The long-term outlook for chancroid is excellent when it is diagnosed and treated promptly with antibiotics.

Most people make a full recovery without lasting health problems. If left untreated, chancroid can cause scarring, painful abscesses in the groin, and an increased risk of acquiring or transmitting HIV due to open genital sores.

Once the infection has cleared, there are no known long-term effects on general health or fertility.

No. Having chancroid once does not provide immunity.

Although antibiotics cure the current infection, you can become infected again if you are exposed to Haemophilus ducreyi in the future. Using condoms, avoiding sex until treatment is complete, sores have fully healed, and ensuring recent sexual partners are treated can help reduce the risk of reinfection.

Chancroid does not usually recur once it has been successfully treated, so prevention focuses on avoiding reinfection.

You can reduce your risk by:

• Completing your full course of antibiotics
• Avoiding sexual contact until treatment is complete and sores have healed
• Ensuring recent sexual partners are tested and treated
• Using condoms consistently during vaginal, anal, and oral sex
• Having a sexual health check-up if you develop new symptoms or have been exposed

Yes. Recent sexual partners should be informed so they can be assessed and treated if necessary.

A person with chancroid can pass the infection on even if symptoms are mild or have not yet developed. Partner notification helps prevent reinfection and reduces further spread of the infection.

Avoid sexual contact until both you and your partner(s) have completed treatment and any sores have fully healed.

Yes. The best way to prevent transmission is to avoid sexual contact until you have completed treatment and all sores have healed.

You should also:

• Complete the full course of antibiotics.
• Inform recent sexual partners so they can be assessed and treated where appropriate.
• Use condoms to reduce the risk of future transmission, recognising they may not protect skin that is not covered.
• Wash your hands after touching affected areas to avoid spreading bacteria to other parts of the body.

Following these steps helps protect both you and your sexual partners.

Current evidence suggests that chancroid is not typically transmitted to a baby during pregnancy or childbirth.

However, any genital sores or ulcers during pregnancy should be assessed promptly, as other infections with similar symptoms, such as herpes or syphilis, can affect the baby and require different management.

If chancroid is diagnosed, it can be treated safely with appropriate antibiotics during pregnancy.

Chancroid is not known to cause direct complications for the developing baby or to affect pregnancy outcomes.

The main concerns are for the pregnant person, including:

• Painful genital ulcers
• Swollen or infected lymph nodes that may require treatment
• An increased risk of acquiring or transmitting other sexually transmitted infections, including HIV

Prompt diagnosis and treatment help relieve symptoms and reduce the risk of complications.

Chancroid is very rare in the UK, including during pregnancy.

Most cases are associated with travel to regions where the infection is more common, such as parts of Africa, Asia, and the Caribbean. It is not routinely screened for during pregnancy.

If you develop genital sores, ulcers, or swollen groin glands while pregnant, you should seek medical assessment regardless of the cause.

Yes. Chancroid can be treated with antibiotics that are considered safe during pregnancy.

Treatment may include:

• Azithromycin (single oral dose)
• Ceftriaxone (single injection)
• Erythromycin (7-day course)

Prompt treatment helps clear the infection, relieve symptoms, and reduce the risk of complications. Antibiotics should always be prescribed by a healthcare professional, as some medications used for chancroid are not recommended during pregnancy.

The best way to reduce the risk of chancroid during pregnancy is to practise safer sex and seek early assessment for any symptoms.

This includes:

• Using condoms during vaginal, anal, and oral sex
• Seeking medical advice for any genital sores, ulcers, or lumps
• Informing healthcare providers about recent travel to areas where chancroid is more common
• Ensuring sexual partners are assessed and treated if an infection is diagnosed

Early treatment helps protect your health and reduces the risk of reinfection.

Yes, chancroid can affect postpartum recovery by causing painful genital ulcers that may make healing after childbirth more uncomfortable.

However, the bacteria that cause chancroid are not known to be transmitted through breast milk. The antibiotics prescribed will be selected to ensure they are appropriate for breastfeeding where applicable.

If you develop genital sores or unusual symptoms after giving birth, seek medical advice promptly to ensure appropriate treatment and support.