Genital Ulcers

What is a genital ulcer?

An ulcer is a slow-healing sore. It typically occurs along your digestive tract, including your stomach. But ulcers can also form in your genital area on the:

• Anus.
• Outer part of your vagina (vulva).
• Penis.
• Skin near these areas.

How do ulcers form?

Ulcers often form due to viruses, bacteria and germs that irritate the genitals’ sensitive tissue. The body responds by releasing special cells that worsen the irritation. This causes small sores to develop. Once you have an ulcer, ongoing bacteria exposure makes it difficult for the ulcer to heal.

Who is more likely to experience genital ulcer disease?

Anyone can get genital ulcers. Sexually transmitted infections (STIs) raise your risk of experiencing genital ulcers.

What causes genital ulcers?

The most common cause is STIs. Ulcers in the genital area can form if you have:

• Chancroid, which is a bacterial disease that causes open sores.
• Chlamydia.
• Genital herpes.
• Human immunodeficiency virus (HIV).
• Syphilis.
• Noninfectious ulcers like aphthous ulcers (like canker sores) or Behçet's disease.

What causes nonsexually acquired genital ulceration?

Causes of genital ulcer disease not due to STIs include:

Viruses

• Cytomegalovirus, which causes viral hepatitis, encephalitis and more.
• Epstein-Barr, which causes mononucleosis (mono).
• Influenza A, which causes the flu.
• Paratyphoid, which causes typhoid fever.
• Varicella zoster, which causes chickenpox and shingles.

Bacteria

• Group A Streptococcus.
• Mycoplasma pneumoniae.

Certain medical conditions, especially ones that cause long-term inflammation

• Behçet's disease.
• Bullous pemphigoid.
• Contact dermatitis.
• Crohn's disease.
• Cyclic neutropenia.
• Erosive lichen planus.
• Pemphigus.
• Vaginal yeast infections.
• Vulvar cancer.

Trauma

• Sexual injury, when aggressive sex or foreign objects (like sex toys) break surface tissue.
• Chemical burns due to a reaction to lotion, hair removal cream or skincare products.
• Constant rubbing, such as undergarments that are too tight.

What do genital ulcers 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 surface tissue. They may also ooze pus or fluid.

What do ulcers in the genital area feel like?

Some genital ulcers cause no symptoms. Others are painful and make it challenging to go about your daily life. You may experience:

• Burning sensation.
• Fever.
• Itchy genitals.
• Painful urination or sexual intercourse.
• Vaginal discharge that may smell bad.

When should I see a healthcare provider about genital ulcer disease?

Talk to your healthcare provider if you experience painful genital ulcers or other symptoms. Ulcers don’t go away on their own. It’s nothing to feel ashamed of or embarrassed about. Abnormal lesions in the genital region are surprisingly common. And your healthcare provider is there to help you.

How are ulcers in the genital area diagnosed?

Since genital ulcer disease has so many causes, it’s important to receive a thorough evaluation. Your 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:

• Biopsy.
• Blood test.
• Urinalysis.

What does genital ulcer treatment look like?

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

How can I prevent genital ulcers?

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

• Avoid tight-fitting pants or underwear.
• Limit intimacy to one person. That person should only be intimate with you as well.
• Practice safe sex by using a condom or dental dam every time.
• Stay on top of therapies for ongoing conditions that can lead to genital ulcers.
• Wash your genital area daily with mild soap.

What is the outlook for people with genital ulcer disease?

If you receive the appropriate therapy, genital ulcer treatment is often successful. It may take a few days for you to feel better. Most people make a full recovery.

If symptoms don’t improve, the therapy you are 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. Also, if you have unprotected sex, you may get another STI, putting you at risk for future ulcers.

Can other therapies help me stay comfortable while the ulcers heal?

Self-care methods often provide quick relief. These include:

• Warm compress for pain or itching: Soak a hand towel in warm water. Wring it out before applying to your skin with gentle pressure.
• Cool compress for swelling: This treatment is like a warm compress but with cool water.
• Sitz bath for general discomfort: Fill a bathtub with enough water that 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 15-30 minutes.

A note from Cleveland Clinic

Genital ulcers are sometimes painful sores that don’t heal on their own. They’re often due to STIs, but there can be many other causes. The sooner you talk to your healthcare provider, the sooner you can get relief. You may need prescription medications or ointment. Although most people make a full recovery, ulcers sometimes come back. With timely genital ulcer treatment, genital ulcer disease will not affect your long-term health.