Man experiencing genital pain and in need of chancroid treatment

Chancroid Treatment: What You Need To Know

Written on August 23, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Chancroid is a highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi.

Chancroid causes ulcers, usually of the genitals. Swollen, painful lymph glands, or inguinal buboes, in the groin area are often associated with chancroid. Left untreated, chancroid may facilitate the transmission of HIV. This article will cover chancroid: why you need to know about it and how to treat it.

How Do People Get Chancroid?

Chancroid is transmitted in two ways:

  • Sexual transmission, through skin-to-skin contact with open sore(s)
  • Non-sexual transmission when pus-like fluid from the ulcer is moved to other parts of the body or to another person

A person is considered to be infectious when ulcers are present. There has been no reported disease in infants born to women with active chancroid at the time of delivery.

How Common Is It?

The prevalence of chancroid has declined in the United States. When infection does occur, it is usually associated with sporadic outbreaks. Worldwide, chancroid appears to have declined as well, although infection might still occur in some regions of Africa and the Caribbean. Chancroid, as well as genital herpes and syphilis, is a risk factor in the transmission of HIV infection.

Why Worry?

Chancroid has been well established as a cofactor for HIV transmission. Moreover, persons with HIV may experience slower healing of chancroid, even with treatment, and may need to take medications for a longer period of time. Complications from chancroid include:

  • In 50% of cases, the lymph node glands in the groin become infected within five to eight days of the appearance of initial sores.
  • Glands on one side become enlarged, hard, and painful and fuse together to form a bubo (BEW-bo)—an inflammation and swelling of one or more lymph nodes with overlying red skin. Surgical drainage of the bubo may be necessary to relieve pain.
  • Ruptured buboes are susceptible to secondary bacterial infections.
  • In uncircumcised males, new scar tissue may result in phimosis (constriction so the foreskin cannot be retracted over the head of the penis). Circumcision may be required to correct this.

What Are The Signs Or Symptoms Of Chancroid?

Here are some chancroid symptoms to look out for [1]:

  • Symptoms usually occur within four days to 10 days from exposure. They rarely develop earlier than three days or later than ten days.
  • The ulcer begins as a tender, elevated bump, or papule, that becomes a pus-filled, open sore with eroded or ragged edges.
  • The ulcer is soft to the touch (unlike a syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
  • The ulcers can be very painful in men, but women are often unaware of them.
  • Because chancroid is often asymptomatic in women, they may be unaware of the lesion(s).
  • Painful lymph glands may occur in the groin, usually only on one side; however, they can occur on both sides.

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How Is Chancroid Diagnosed?

It’s somewhat difficult to diagnose chancroid. Scientists can use a test with specialized media to find H. ducreyi, but the media isn’t widely available, and the test isn’t 100% accurate.

Also, the U.S. Food and Drug Administration (FDA) hasn’t approved any polymerase chain reaction (PCR) tests for chancroid. This type of test finds genetic material from an organism like a virus if you have the virus at the time of the test or fragments even after you’re no longer infected.

Your healthcare provider will want to rule out syphilis, herpes, or lymphogranuloma venereum.

Because of the difficulties with testing, your healthcare provider will diagnose chancroid if:

  • You have one or more genital sores (ulcers) that are causing pain.
  • You have swollen and painful lymph nodes in your groin.
  • You test negative for infection with the herpes simplex virus and Treponema pallidum.

How Is Chancroid Treated?

Your healthcare provider will give you antibiotics to treat chancroid, prescribing one of the following:

  • Azithromycin, 1 gram taken orally. This is a one-time dose.
  • Ceftriaxone, 250 milligrams (mg), taken as an intramuscular shot. This is a one-time dose.
  • Ciprofloxacin, 500 mg, taken orally two times per day for three days. You shouldn’t take this if you’re pregnant or breastfeeding.
  • Erythromycin, 500 mg, taken orally three times per day for seven days.

How Long Does It Take To Recover From Treatment For Chancroid?

You should be feeling better after one to two weeks. Your soft chancres should also start to clear up. If the case was very bad, you might have scars where the ulcers were.

If treatment isn’t successful, your healthcare provider will order additional tests. There’s a chance the diagnosis was wrong or that there’s another viral infection involved.

Another thing to consider is that genital ulcer disease, including chancroid, can make it easier to transmit human immunodeficiency virus (HIV).

How Can I Reduce My Risk Of Developing Chancroid?

There are some things you can do to reduce your risk of developing chancroid, including [2]:

  • Abstaining from sex completely.
  • Having sex with only one uninfected partner.
  • Having safer sex by using condoms for oral, vaginal, and anal sex. The condoms must cover any infected area.
  • Making sure pus from any infected area doesn’t touch you. If you have a soft chancre, make sure you don’t transfer any pus to another place on your body or to another person.

To discuss questions and possible medications for STD treatment with a healthcare provider, consider the Everlywell telehealth option for STD treatment online.

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  1. Chancroid. Illinois Department of Health. . Accessed on August 10, 2023.
  2. Chancroid (Soft chancre). Cleveland Clinic. Last reviewed on February 4, 2022. Accessed on August 10, 2023.
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