Chancroid (Soft Chancre)

Chancroid (pronounced “SHANG-kroid”) is a very contagious type of sexually transmitted infection (STI). It occurs when the bacterium Haemophilus ducreyi (H. ducreyi) infects your body.

Chancroid isn’t common in the U.S. Chancroid cases throughout the world seem to be going down. But you may be more likely to get chancroid if you live in or visit areas where it’s more common.

Another name for chancroid is soft chancre (pronounced “SHANG-ker”).

What are the symptoms of chancroid?

The time between when you encounter H. ducreyi and when you develop symptoms is about three to seven days. The early symptom is a small, raised, painful bump on your genitals. The bump grows into a sore (lesion or genital ulcer) with ragged, soft edges about a day later. You may develop other symptoms, including:

• Bleeding
• Discolored (red, purple, brown or black) and shiny skin on the sores
• Enlarged lymph nodes in your groin
• Leaking pus and infectious fluid
• Pain while peeing (dysuria)
• Pain during sexual intercourse (dyspareunia)
• Sores that spread or connect to other sores in a larger area

What does chancroid look like?

Chancroid ulcers range in size, usually from 1/8 of an inch to 2 inches (3-5 millimeters) in diameter. If you have a penis, they typically appear on:

• Below the rounded border at the bottom of the head of your penis (corona of glans penis)
• Foreskin
• Head of your penis (glans)
• Opening of your penis (meatus)
• Penile shaft
• Scrotum

If you have a vagina, chancroid ulcers typically appear on:

• The area of skin between your anus and vagina (perineum)
• Inner thighs
• Inner vaginal lips (labia minora)
• Outer vaginal lips (labia majora)

What is the cause of chancroid?

The bacterium H. ducreyi causes chancroid. It usually spreads through sexual intercourse. But it can also be transferred to someone else if they encounter the infected fluid that leaks from the sore.

Healthcare professionals think H. ducreyi enters your body through tiny tears (abrasions) in your skin during sexual activity because it doesn’t infect skin without abrasions.

Risk factors

Anyone who has unprotected sexual intercourse can get chancroid. But it’s more common if you still have foreskin on your penis (uncircumcised). You’re less likely to have symptoms (asymptomatic) if you have a vagina.

Rates of chancroid in the U.S. and Europe are low. Cases only occur sporadically (outbreaks). But it’s more common in certain areas of the world, including:

• The Caribbean
• Certain regions in Africa
• Southwest Asia

Complications of chancroid

If you have chancroid, it can be easier to transmit HIV.

Without treatment, you’re at a higher risk of:

• Getting a soft tissue infection (suppurative lymphadenitis)
• Developing a tunnel or hole between some of your organs (fistula)
• Genital tissue death (necrosis)

How doctors diagnose this condition

Chancroid can be challenging for healthcare providers to diagnose. That’s because providers sometimes group it together with other conditions under the term “genital ulcer disease (GUD).” Providers also need a special bacteria culture test (nucleic acid amplification test, or NAAT) that detects bacteria’s DNA. The U.S. Food and Drug Administration (FDA) hasn’t approved an NAAT test for H. ducreyi.

Because of these testing difficulties, providers will first rule out other conditions with similar symptoms, including:

• Syphilis
• Herpes simplex virus (HSV)
• Lymphogranuloma venereum (LGV)

They’ll diagnose chancroid if you:

• Have one or more genital ulcers that cause pain
• Have swollen and painful lymph nodes in your groin
• Test negative for a herpes infection and Treponema pallidum (yaws)

Is there a cure for chancroid?

Yes, antibiotics can treat chancroid. Healthcare providers may prescribe one of the following:

• Azithromycin
• Ceftriaxone
• Ciprofloxacin
• Erythromycin

Providers may also recommend therapeutic fine needle aspiration to drain swollen lymph nodes.

Does chancroid go away?

Yes, chancroid can go away without treatment. The sores will likely clear up on their own in a month or two. But you’re at a higher risk of complications if you don’t get treatment.

Recovery time

You should feel better and soft chancres should start to clear up about one to two weeks after getting treatment. If you have a severe case of chancroid, you may have scars where the ulcers formed.

If treatment doesn’t clear your symptoms, healthcare providers will recommend additional tests. There’s a chance you may have another type of infection.

When should I see my healthcare provider?

Schedule an appointment with a healthcare provider if you have any type of sore or pain in your genitals. You should also visit a provider for annual or regular STI tests if you’re sexually active, especially in areas where chancroid outbreaks have occurred.

You may want to ask a provider the following questions:

• If I don’t have chancroid, what other condition could I have?
• How can I prevent chancroid?
• Will chancroid cause any problems in the future?
• How often should I get STI tests?
• Should my sexual partners get tested?
• Are there any side effects to treatment?

Can chancroid be prevented?

You can help reduce your risk of developing or spreading chancroid by:

• Abstaining from sexual intercourse or practicing safe sex, including using condoms that cover any affected areas any time you have oral, vaginal or anal sex
• Having sexual intercourse with only one uninfected partner
• Making sure you or another person doesn’t touch any leaking pus or fluid from an infected area
• Getting annual STI testing, including before having sex with a new partner

What can I expect if I have chancroid?

With proper treatment, your outlook is good. If you don’t get treatment, the sores may heal. But you’re more likely to develop a soft tissue infection.

If you receive a chancroid diagnosis, it’s a good idea to tell anyone you’ve had sexual intercourse with. This includes any sexual partners in the 10 days before you developed chancroid symptoms.

When should I see my healthcare provider?

If you have any type of sore or pain in your genitals, you should talk to a healthcare provider. If you’re diagnosed with a sexually transmitted infection (STI), you should tell anyone you’ve had sex with, especially those people who might’ve been exposed in the 10 days before you developed symptoms.