Genital Ulcers

A genital ulcer is a slow-healing sore that develops on or around your genitals. It can appear on your penis, vulva, anus or nearby skin.

Ulcers often form due to viruses and bacteria that irritate the sensitive skin around your genitals. Your body responds by releasing special cells that worsen the irritation. This causes small sores to develop. Once you have an ulcer, ongoing bacterial exposure makes it difficult for the ulcer to heal. Sexually transmitted infections (STIs), trauma or injury, and certain health conditions can also cause genital ulcers.

Symptoms of genital ulcers

Some genital ulcers cause no symptoms. Others are painful and make it hard to go about your daily life. You can have symptoms like:

• Itchiness or burning around your genitals
• Fever
• Pain when you pee or have sex
• Vaginal discharge that may smell bad

What do they look like?

In early stages, ulcers in your genital area may look like small bumps or a rash. You may also notice swollen lymph nodes in your groin. Ulcers worsen over time, leading to small breaks in your skin. They may also ooze pus or fluid.

Genital ulcers causes

The most common cause is STIs. Ulcers can form if you have:

• Chancroid (a bacterial disease that causes open sores)
• Genital herpes
• Human immunodeficiency virus (HIV)
• Syphilis

Causes not due to STIs

Certain viruses, bacteria and medical conditions can cause genital ulcers, too. Some examples of causes that aren’t related to sex are:

• Inflammatory diseases, like Behçet's disease or Crohn's disease
• Autoimmune diseases, like pemphigus or bullous pemphigoid
• Skin conditions, like contact dermatitis and lichen planus
• Viruses, like cytomegalovirus and varicella-zoster virus
• Allergic reactions or irritation from soap or personal hygiene products
• Injury or trauma from aggressive sex or friction from your clothes on your genitals
• Benign aphthous ulcers

Are they contagious?

STI-related ulcers are contagious and can spread through sexual contact. Genital ulcers caused by systemic diseases, allergic reaction or injuries aren’t contagious.

Risk factors

Anyone can get genital ulcers. STIs raise your risk of experiencing genital ulcers.

How to lower your risk

There are steps you can take to lower your risk of certain causes of genital ulcers. These include:

• Practice safe sex by using a condom or dental dam and limiting sexual partners.
• Stay on top of treatment for health conditions that can lead to genital ulcers.
• Avoid tight-fitting pants or underwear.
• Wash your genital area daily with mild soap.

How are ulcers in the genital area diagnosed?

As genital ulcers have so many causes, it’s important to receive a thorough evaluation. A healthcare provider will start by learning more about your medical history and lifestyle. They may ask you about sexual activity to determine STI risk.

The evaluation will include a physical exam. Your healthcare provider will look at the ulcers and nearby skin. They may also examine other areas of your pelvis, such as the lymph nodes in your groin.

You may need lab tests to determine the cause of the ulcers. These may include:

• Vaginal swap for viral infections
• Biopsy
• Blood test
• Urinalysis

How is a genital ulcer treated?

The treatment that’s right for you depends on the cause. Many people feel better with medications that help their body clear viruses and infections. These include antibiotics for bacterial infections or antiviral medications for viral infections. Genital ulcer treatment may also include steroid ointment that you apply to the sores to promote healing.

For genital ulcers not due to STIs, it may help to see a specialist for further evaluation. A dermatologist can determine the cause of skin sores. You may need to see an infectious disease doctor for ulcers due to rare viruses. This specialist can also conduct advanced testing for ulcers that don’t respond to standard treatments.

What can help me stay comfortable while the ulcers heal?

Self-care methods often provide relief. These include:

• Warm compress for pain or itching: Soak a washcloth in warm water. Wring it out before applying to your skin.
• Cool compress for swelling: This treatment is like a warm compress but with cool water.
• Sitz baths: Fill a bathtub with enough water so it covers your hips when you sit in it. Warm but not hot water may feel best. Soak a few times a day for at least 15 to 30 minutes.
• Pain medication (oral medication or topical lidocaine)

When should I see a healthcare provider about genital ulcers?

Talk to your healthcare provider if you experience painful genital ulcers or other symptoms. Some ulcers get better on their own and some ulcers need medication to get better. It’s important to seek medical attention so you have a diagnosis. It’s nothing to feel ashamed of or embarrassed about. Your healthcare provider is there to help you.

What can I expect if I have this condition?

With the right treatment, you should feel better soon. It may take a few days, but most people make a full recovery.

If symptoms don’t improve, the treatment you’re using might not be the right one. Additional testing can determine which treatment you need. It’s also important to remember that genital ulcers can come back after treatment. Remember, having unprotected sex increases your risk of getting another STI, which can cause new ulcers or infections.