Ducrey’s Chancre

Ducrey’s chancre is a painful open sore on the genital area that happens because of a sexually transmitted infection called chancroid. The infection is caused by a bacteria named Haemophilus ducreyi. The sore is usually soft, very tender, and has irregular edges, so doctors also call it a “soft chancre.” This sore can be single or multiple and often appears on the penis, vulva, or around the anus after sexual contact with an infected person. Nearby groin lymph nodes can swell, fill with pus, and become very painful; this swollen node is called a “bubo.” MSD Manuals+2MSD Manuals+2

Ducrey’s chancre is an older name for chancroid, a sexually transmitted infection (STI) caused by the bacterium Haemophilus ducreyi. It leads to one or more painful, soft genital ulcers and can cause swollen, tender lymph nodes in the groin called buboes. Chancroid spreads mainly through sexual contact with an infected person’s sores.NCBI+1

The disease is now uncommon in many high-income countries but still occurs in some tropical and low-resource regions, and in people who travel to those areas. Untreated chancroid can cause chronic pain, scarring, and can increase the risk of getting or passing on HIV.PMC+1

Other names for Ducrey’s chancre

Doctors and books use several other names for Ducrey’s chancre. The most common other names are “chancroid,” “soft chancre,” and “ulcus molle,” which all describe the same basic infection and painful genital ulcer. Sometimes it may be described as a “genital ulcer due to Haemophilus ducreyi” or “venereal soft ulcer,” but these longer phrases still refer to the same disease. In everyday medical language, most people simply say “chancroid” when they mean Ducrey’s chancre. Wikipedia+1

Types (clinical variants) of Ducrey’s chancre

Doctors describe several clinical types, or variants, of Ducrey’s chancre. These types help explain how the sores can look different in different patients. Wikipedia+1

1. Typical soft chancre
   This is the classic type, with one or more painful, soft, shallow ulcers on the genital area. The edges are ragged or “scooped out,” and the base is often covered with a gray-yellow material that can bleed easily when touched. Painful swollen lymph nodes in the groin may appear later. MSD Manuals+1

2. Dwarf chancroid
   In dwarf chancroid, the ulcers are smaller and more superficial than usual. They may look like tiny shallow pits or erosions rather than deep ulcers. Because they are small and sometimes less obvious, they can be missed on a quick exam, so careful inspection is important. Wikipedia

3. Giant chancroid
   Giant chancroid happens when a small ulcer enlarges and merges with nearby broken skin or with ulcers that arise from a burst bubo. The sore can become quite large and may extend across part of the genital region. This type is usually very painful and can cause problems with walking, urinating, or sexual activity. Wikipedia+1

4. Follicular chancroid
   This type starts around a hair follicle, usually in areas with pubic hair such as the labia majora in women or the pubic region. It begins as a small pustule at the hair root and then breaks down into a typical chancroid ulcer. Because it looks like infected hair follicles at first, it can be confused with simple folliculitis. Wikipedia+1

5. Transient chancroid
   In transient chancroid, the first small ulcers may heal quickly or become less obvious, but the patient then develops tender, swollen groin lymph nodes that form a bubo. The main complaint may be groin swelling rather than the genital sore. Doctors must think of chancroid when a painful bubo appears in someone with recent genital ulcers. Wikipedia+1

6. Serpiginous chancroid
   This type occurs when several ulcers join together to form a long, snakelike (serpiginous) line of broken skin. The edge of the joined ulcer slowly creeps across the skin, creating an irregular pattern. It is still caused by the same bacteria but simply spreads more across the surface. Wikipedia

7. Mixed chancroid
   Mixed chancroid means chancroid ulcers are present at the same time as another sexually transmitted infection, most often syphilis. A soft, painful ulcer from chancroid can exist beside a firm, usually painless syphilis chancre. Recognizing this mixture is important because both infections need different tests and treatments. Wikipedia+1

8. Phagedenic chancroid
   This severe type happens when the chancroid ulcer becomes secondarily infected with other aggressive bacteria. The ulcer can spread rapidly and destroy more tissue, causing deep, wide wounds and scarring. This form is now less common where early diagnosis and antibiotics are available, but it can still occur in settings with limited medical care. Wikipedia+1

Causes and risk factors of Ducrey’s chancre

1. Infection with Haemophilus ducreyi
   The direct and main cause of Ducrey’s chancre is infection with the bacterium Haemophilus ducreyi. This germ enters through tiny breaks in the skin or mucous membrane during close sexual contact and multiplies locally, causing tissue destruction and ulcer formation. Without this bacteria, Ducrey’s chancre does not occur. MSD Manuals+1

2. Unprotected vaginal, anal, or oral sex
   Having sex without condoms or other barrier protection makes it easy for H. ducreyi to pass from one person to another. Direct skin-to-skin and mucosa-to-mucosa contact with an infected ulcer or secretions is the usual route of transmission. Condoms reduce but do not completely remove the risk if sores are outside the covered area. MSD Manuals+1

3. Multiple sexual partners
   People with many sexual partners have more chances to encounter someone who carries H. ducreyi. This larger number of exposures raises the overall risk of chancroid and other sexually transmitted infections. The risk is even higher when partners’ infection status is unknown. ScienceDirect+1

4. Sex with commercial sex workers
   In some regions where chancroid is more common, commercial sex work networks can have higher rates of H. ducreyi infection. Sex without condoms or with frequent partner changes in these settings increases risk. Public health studies in developing countries have shown strong links between chancroid and such sexual networks. ScienceDirect+1

5. Living in or visiting endemic areas
   Chancroid is rare in many high-income countries but remains more common in certain low-resource or tropical regions. People who live in or travel to these areas and have unprotected sex are at higher risk of acquiring Ducrey’s chancre. Outbreaks have been documented in parts of Africa, Asia, and Latin America. The Lancet+1

6. Existing tiny skin cuts or abrasions
   Small, often invisible breaks in the genital skin make it easier for H. ducreyi to enter the body. These breaks can be caused by friction during sex, shaving, minor trauma, or other infections. The bacteria use these openings as a doorway to start infection and create an ulcer. Wikipedia+1

7. Lack of condom use or inconsistent use
   Not using condoms, or using them only sometimes, lowers the level of protection against chancroid. Condoms work as a physical barrier that limits contact with infected secretions and sores. However, if ulcers are on uncovered areas like the scrotum, labia, or pubic skin, transmission can still occur. MSD Manuals+1

8. Presence of other sexually transmitted infections (STIs)
   Infections such as HIV, syphilis, herpes simplex virus, or gonorrhea may damage the genital lining or change local immunity. This makes it easier for H. ducreyi to establish infection after exposure. Chancroid itself can also increase the risk of getting or passing on HIV by breaking the skin barrier. ScienceDirect+1

9. Male uncircumcised status
   Some studies suggest that uncircumcised men may have a higher risk of chancroid. The inner foreskin can harbor bacteria and is more easily injured during sex, providing a site for H. ducreyi entry. Good hygiene and safer sex practices can help lower this risk. ScienceDirect+1

10. Poor genital hygiene
    Infrequent washing, especially in hot and humid climates, can allow sweat, secretions, and bacteria to build up in skin folds. This environment may favor the survival and spread of H. ducreyi. Simple steps like regular gentle cleansing of the genital area can help reduce risk. ScienceDirect+1

11. Low socioeconomic and crowded living conditions
    In some regions, chancroid is more common in settings with poverty, crowded living, and limited access to health care. In these conditions, people may have less access to condoms, STI education, and early treatment. This allows transmission chains to continue. The Lancet+1

12. Young age at sexual debut
    Starting sexual activity at a younger age increases the number of years a person is exposed to the risk of STIs, including chancroid. Younger people may also have less information about safe sex or less power to insist on condom use. This can make them more vulnerable to Ducrey’s chancre. Best Practice+1

13. History of previous genital ulcers
    People who have had other genital ulcer diseases, such as herpes or syphilis, may have more scarring or delicate skin in the genital area. Recurrent breaks and inflammation can make it easier for new infections like H. ducreyi to take hold. A history of ulcers often signals higher overall STI risk. AccessMedicine+1

14. HIV infection or weakened immune system
    A weakened immune system, especially from HIV, can reduce the body’s ability to control bacterial infections on the skin and mucosa. People with HIV may have more severe or persistent chancroid lesions. HIV and chancroid have been shown to occur together more often in some high-prevalence settings. ScienceDirect+1

15. Lack of access to health care
    When people cannot easily reach clinics or pay for medical care, early symptoms of chancroid may go untreated. Untreated cases can last longer, spread to more partners, and increase the overall community risk. Delayed diagnosis also increases the chance of complications such as buboes. Illinois Department of Public Health+1

16. Limited STI education and awareness
    If people do not know the signs of STIs or how they spread, they are less likely to use condoms or seek prompt testing. Many may mistake chancroid for other minor skin problems and continue sexual contact. Education programs have been shown to reduce STI spread when they improve safer sex practices. Best Practice+1

17. Substance use during sex (alcohol or drugs)
    Drinking alcohol or using drugs before or during sex can reduce judgment and self-control. This can lead to unprotected sex, multiple partners, or sex with partners whose infection status is unknown. These behaviors raise the chance of exposure to H. ducreyi. Best Practice+1

18. Male–female anatomical differences
    In women, chancroid ulcers may be more hidden in folds of the vulva or inside the vagina, making them harder to see and diagnose early. This hidden location may allow longer undetected infection and increase chance of spread to partners. Women often have more and smaller ulcers than men. DermNet®+1

19. Autoinoculation (self-spread to nearby skin)
    The bacteria can spread from the main ulcer to nearby skin areas if pus or secretions touch small breaks in the skin. This can create “kissing ulcers” on opposite skin surfaces, such as labia touching each other. Autoinoculation does not create a new cause but shows how local spread increases disease burden. Wikipedia+1

20. Delayed or incomplete treatment in a partner
    If an infected partner is not treated, or does not complete treatment, they can keep spreading H. ducreyi. Even after one person is cured, they can become reinfected from an untreated partner. Treating all sexual partners is therefore crucial in stopping the chain of infection. CDC+1

Symptoms and signs of Ducrey’s chancre

1. Painful genital ulcer
   The main symptom is one or more painful open sores on the genitals. The pain often makes walking, sitting, or sexual activity uncomfortable and is the key feature that separates Ducrey’s chancre from the usually painless syphilis chancre. MSD Manuals+1

2. Soft, ragged ulcer edge
   The edge of the sore is soft, undermined, and irregular, rather than firm and smooth. Doctors sometimes describe this as a “scooped-out” or ragged margin, which is typical of chancroid. MSD Manuals+1

3. Dirty-looking or gray-yellow base
   The base of the ulcer often has a gray or yellow-gray material that looks like pus or a film. When this covering is scraped away, the surface underneath may bleed easily. This appearance helps doctors think of chancroid. Wikipedia+1

4. Easy bleeding from the ulcer
   The ulcer base and edges can bleed with minor trauma, such as wiping, washing, or sexual activity. This easy bleeding reflects fragile new tissue and ongoing inflammation. Wikipedia+1

5. Single or multiple ulcers
   Men often have a single ulcer, but women more commonly have several ulcers at once. Multiple sores may be spread across the labia, perineum, or nearby thigh and can merge into larger lesions. Wikipedia+1

6. Painful swollen groin lymph nodes (inguinal adenitis)
   Many patients develop painful swelling in one or both groins as nearby lymph nodes react to the infection. These nodes can become large and tender and may be felt as lumps in the groin folds. MSD Manuals+1

7. Bubo formation (pus-filled lymph node)
   In some people, a swollen groin node fills with pus and becomes a tense, very painful lump called a bubo. The skin over the bubo can become thin and red, and it may eventually burst, releasing thick pus and creating a secondary ulcer. ScienceDirect+1

8. Red painful lump before ulcer appears
   At the beginning, the site of infection may look like a small red bump or papule. This bump then fills with pus, becomes a tiny pustule, and finally breaks down into the open sore that characterizes Ducrey’s chancre. SA Health+1

9. Painful urination (dysuria)
   If the ulcer is close to the urethral opening, urination can cause burning or sharp pain. Some patients may try to avoid passing urine because of this discomfort, which can lead to holding urine for too long. MSD Manuals+1

10. Pain during sex (dyspareunia)
    Ulcers on the vulva, penis, or around the anus can make sexual intercourse painful. This symptom often leads people to seek medical care, especially if it continues or worsens. Wikipedia+1

11. Local redness, warmth, and swelling
    The skin around the ulcer usually looks red and feels warm and swollen because of inflammation. These changes show that the immune system is reacting to the bacteria in the area. MSD Manuals+1

12. Foul-smelling discharge from ulcer or bubo
    When secondary bacteria join the infection, pus from the ulcer or bubo can have an unpleasant smell. This foul odor is more common in neglected or long-standing cases or in phagedenic chancroid. Wikipedia+1

13. Difficulty walking or moving the legs
    Very tender groin buboes may cause pain when a person moves their hips or walks. People may walk with their legs apart or move slowly to avoid pressure on the groin. This symptom reflects the severity of lymph node involvement. ScienceDirect+1

14. Mild fever and feeling unwell
    Some patients may have low-grade fever, tiredness, or a general feeling of being unwell, especially when the infection is advanced or when buboes are present. These symptoms are usually not very high or dramatic but add to overall discomfort. MSD Manuals+1

15. Scarring after healing
    After proper treatment, the ulcers usually heal, but they can leave behind thin, pale scars on the genital skin. Large or deep ulcers, especially giant or phagedenic chancroid, are more likely to cause noticeable scarring. Wikipedia+1

Diagnostic tests and evaluations for Ducrey’s chancre

1. Full medical history and sexual history (clinical evaluation)
   The doctor asks detailed questions about when the sore started, sexual partners, condom use, travel to high-risk areas, and history of other STIs. This history provides important clues and helps narrow the list of possible causes of genital ulcers. CDC+1

2. General physical examination (physical exam test)
   A full body exam, including measurement of temperature and vital signs, helps the doctor look for other infections or signs of illness. The doctor checks the skin, mouth, and other areas for additional sores or rashes that might suggest syphilis, herpes, or other diseases. MSD Manuals+1

3. Detailed inspection of genital ulcers (physical exam test)
   The doctor closely looks at the ulcers, noting their number, size, shape, depth, borders, and base. Painful, soft, ragged-edge ulcers with a dirty-looking base point strongly toward chancroid when other causes are excluded. MSD Manuals+1

4. Palpation of inguinal lymph nodes (physical exam test)
   The doctor feels the groin region for enlarged, tender lymph nodes or buboes. The combination of painful genital ulcers and tender inguinal lymphadenopathy is very suggestive of chancroid. MSD Manuals+1

5. Examination for extra-genital or perianal ulcers (physical exam test)
   The doctor checks around the anus, inner thighs, and nearby skin for additional ulcers or “kissing ulcers.” Finding multiple nearby lesions can support the diagnosis and show how far the infection has spread. Wikipedia+1

6. Bimanual pelvic examination in women (manual test)
   In women, the doctor may perform a bimanual pelvic exam, placing one hand in the vagina and the other on the abdomen. This test helps assess pain, swelling, and involvement of deeper structures and checks for other gynecologic problems that could mimic chancroid. DermNet®+1

7. Digital rectal examination when perianal lesions are present (manual test)
   If ulcers are near the anus, a gentle finger exam of the rectum can help identify internal lesions, tenderness, or other causes of pain. This test also helps rule out other conditions such as fissures or inflammatory bowel disease. MSD Manuals+1

8. Fluctuation test of groin nodes (manual test)
   When the doctor presses gently on a swollen groin lymph node, they check if it feels “fluctuant,” meaning it is filled with fluid or pus. A fluctuant node suggests a bubo that may need aspiration or drainage as part of management. ScienceDirect+1

9. Gentle probing of ulcer base (manual test)
   Using a sterile cotton swab or probe, the doctor may gently touch the ulcer base to judge depth and tenderness. In chancroid, this often causes marked pain and may reveal a soft floor with fragile granulation tissue. This should be done carefully to avoid unnecessary trauma. MSD Manuals+1

10. Pain scoring and functional assessment (manual / clinical test)
    The doctor may ask the patient to rate the pain and describe how it affects walking, urination, or sex. This simple “functional test” helps assess severity and guides the urgency of treatment. Best Practice+1

11. Gram stain of ulcer exudate (lab and pathological test)
    A swab of material from the ulcer is placed on a slide and stained. Under the microscope, H. ducreyi sometimes appears as short chains or “schools of fish,” though sensitivity is limited. This test can give rapid but not definitive support for chancroid. NCBI+1

12. Culture of Haemophilus ducreyi on special media (lab and pathological test)
    Swabs from the ulcer or bubo aspirate are cultured on enriched media such as chocolate agar with special conditions of temperature and carbon dioxide. A positive culture confirms infection, but culture is technically difficult and sensitivity is often below 80%. MSD Manuals+2IJDVL+2

13. Polymerase chain reaction (PCR) for H. ducreyi (lab and pathological test)
    PCR detects the genetic material (DNA) of H. ducreyi from ulcer or bubo samples. It is more sensitive and specific than culture and can give results more quickly, although not all regions have routine access. Some labs use in-house PCR assays validated by research. PMC+2ScienceDirect+2

14. Serologic tests for syphilis (lab test to exclude other causes)
    Blood tests such as VDRL or RPR and treponemal tests are done to rule out syphilis as a cause of the genital ulcer. A negative syphilis test at least seven days after the ulcer appears supports the diagnosis of chancroid when the clinical picture fits. CDC+2DermNet®+2

15. Tests for herpes simplex virus (HSV) from the ulcer (lab test to exclude other causes)
    Swabs from the ulcer can be tested by HSV PCR or culture to rule out genital herpes, another common cause of painful genital ulcers. Excluding HSV is part of the standard work-up when diagnosing chancroid. DermNet®+1

16. HIV testing (lab test for co-infection)
    Because genital ulcers increase the risk of HIV transmission and chancroid often co-exists with HIV in some regions, HIV testing is recommended. Knowing HIV status is important for counseling, prognosis, and planning treatment and prevention. ScienceDirect+1

17. Additional STI screening (lab tests for gonorrhea, chlamydia, etc.)
    People with one STI often have others at the same time. Tests such as NAATs for chlamydia and gonorrhea may be done from urine or swabs. Detecting and treating all STIs reduces symptoms, complications, and further spread. Best Practice+1

18. Complete blood count and basic blood tests (lab and pathological tests)
    A complete blood count can show signs of infection or anemia, and other basic tests can help assess general health. These tests are not specific for chancroid but provide useful background information when planning care. MSD Manuals+1

19. Electrodiagnostic tests (rare and usually not needed)
    Nerve conduction studies or electromyography are not routine tests for Ducrey’s chancre and do not diagnose chancroid. They might only be considered in rare, complex patients who have unusual nerve symptoms suggesting another disease, not because of chancroid itself. It is important to understand that electrodiagnostic tests are normally unnecessary for this condition. MSD Manuals+1

20. Ultrasound of inguinal lymph nodes and soft tissues (imaging test)
    Ultrasound can be used to visualize swollen groin lymph nodes and detect fluid collections inside them. This imaging helps confirm the presence of buboes and guides needle aspiration or drainage if needed. Imaging is supportive, not diagnostic by itself, but can be very helpful in complicated cases. ScienceDirect+1

Non-pharmacological treatments (therapies and others)

1. Patient education and counseling
Education helps the person understand that Ducrey’s chancre is an STI, how it spreads, and why full treatment is needed. The purpose is to improve adherence to antibiotics, avoid sex until healed, and protect partners. Counselors or clinicians explain the disease in simple words and answer questions. This reduces fear, shame, and confusion and supports safer choices in the future.NSW Health+1

2. Temporary abstinence from sexual activity
People with chancroid are usually advised to avoid any sexual contact (oral, vaginal, anal) until all ulcers and buboes have fully healed. The purpose is to stop passing the infection to others and to prevent re-infection from untreated partners. The mechanism is simple: no contact with sores means no spread of the bacteria. This is a core part of all STI guidelines.CDC+1

3. Partner notification and examination
Sex partners within the last 10 days before symptoms started should be contacted, examined and treated, even if they have no symptoms. The purpose is to stop a “ping-pong” effect where partners keep passing the infection back and forth. The mechanism is public-health control: testing and treating the whole sexual network breaks the chain of transmission.CDC+1

4. Local wound hygiene
Gentle washing of the genital area with mild soap and clean water helps remove pus and secretions. The purpose is to reduce the number of bacteria on the skin surface and prevent secondary infection with other germs. The mechanism is simple mechanical cleaning; harsh scrubbing, alcohol, or perfumed products should be avoided because they can irritate the ulcers and delay healing.MSD Manuals

5. Warm sitz baths or warm compresses
Sitting in a basin of warm water or applying warm, clean compresses to the genital area can ease pain and improve blood flow. The purpose is comfort and better drainage of mild swelling. Increased circulation helps the body’s immune cells reach the area and may support faster healing when combined with antibiotics.MSD Manuals

6. Avoiding tight or irritating clothing
Loose, breathable cotton underwear and clothing reduce friction on ulcers and buboes. The purpose is to prevent rubbing and maceration of the skin. The mechanism is mechanical protection: less pressure and moisture means less pain, fewer small skin cracks, and lower risk of secondary infection.Pulsenotes

7. Non-drug pain-relief strategies
Simple methods such as rest, deep-breathing exercises, distraction (music, reading), and cool or warm packs around, but not directly on, open sores can help pain. The purpose is to reduce discomfort and anxiety without relying only on medicines. These methods work by calming the nervous system and muscles and by gently changing local temperature.NCBI

8. Screening for other STIs (including HIV and syphilis)
Anyone with Ducrey’s chancre should be tested for other STIs, especially syphilis, gonorrhea, chlamydia and HIV, because co-infections are common. The purpose is complete health care, not just treating one infection. The mechanism is early detection: finding and treating other STIs reduces long-term complications and further spread.NCBI+1

9. Psychological and emotional support
STIs can cause shame, fear, or relationship stress. Talking with a trusted health professional or counselor can help. The purpose is to support mental health and encourage treatment completion. When anxiety is lower, people are more likely to follow medical advice and return for follow-up visits.MSD Manuals

10. Public-health contact tracing
Local health departments may help with confidential partner tracing. The purpose is to find other people who may have Ducrey’s chancre but have not yet been diagnosed. The mechanism is community-level prevention: early treatment in contacts lowers the total number of cases and protects the wider population.Ohio Department of Health+1

11. Safe-sex education and condom skills training
Teaching correct and consistent condom use, and explaining that condoms must cover the ulcer area when possible, helps prevent future STIs. The purpose is long-term prevention. The mechanism is physical barrier protection; good instruction reduces condom breakage and misuse.SA Health+1

12. Smoking and alcohol reduction
Smoking and heavy alcohol use can weaken the immune system and slow wound healing. The purpose of cutting down or stopping is to give the body a better chance to fight infection. The mechanism is biological: better blood flow, improved immune function, and fewer harmful by-products in the body.MSD Manuals

13. Adequate sleep and stress management
Good sleep and stress-reduction techniques like relaxation, gentle stretching, or mindfulness support immune function. The purpose is overall body recovery. Chronic stress hormones can interfere with immunity; lowering stress can help the body clear infection more efficiently.NCBI

14. Nutritional support
Eating a balanced diet with enough protein, fruits, vegetables, and fluids helps tissue repair. The purpose is to provide the vitamins, minerals, and amino acids the body needs to rebuild damaged skin and mucosa. The mechanism is improved wound healing and immune defense through better nutrition.MSD Manuals

15. Careful shaving or hair removal (or avoiding it)
People are usually advised not to shave near the ulcers until they have healed, because shaving can cut the skin and spread bacteria. The purpose is to avoid extra trauma. The mechanism is preventing micro-cuts and new entry points for infection.Pulsenotes

16. Regular follow-up visits
Guidelines advise a review visit about 3–7 days after starting antibiotics to check if ulcers are improving. The purpose is to make sure the diagnosis is correct and the medicines are working. If there is no progress, the clinician re-checks for other STIs, resistance, or poor adherence.CDC+1

17. Care for sexual partners during follow-up
Partners may also need repeated visits to confirm healing and get extra counseling. The purpose is to keep both partners healthy and prevent reinfection. The mechanism is synchronized care: everyone is treated and followed together, reducing ongoing transmission.MSD Manuals+1

18. Gentle management of buboes before procedures
If buboes are present but not yet ready for drainage, rest, elevation of the groin area, and avoiding trauma can reduce pain. The purpose is to prevent spontaneous rupture of the swollen nodes. This protects the overlying skin and avoids messy open cavities.MSD Manuals+1

19. Infection-control measures in clinics
Health-care workers use gloves, safe handling of dressings, and proper disposal of contaminated materials. The purpose is to protect staff and other patients. The mechanism is standard infection control: barriers and hygiene reduce spread of blood and body fluids.NCBI

20. Community awareness campaigns
In areas where chancroid is still present, public-health campaigns can explain symptoms and encourage early care. The purpose is to reduce stigma and delay in seeking treatment. The mechanism is increased awareness: people recognize ulcers earlier and go to clinics before complications occur.CDC+1

---

Drug treatments

Important safety note: Only a qualified doctor should choose and prescribe medicines for Ducrey’s chancre (chancroid). Do not use the information below to self-medicate. Doses and duration are examples from guidelines and FDA labels and must be adjusted by a clinician.

Evidence-based antibiotics for chancroid

1. Azithromycin
Azithromycin is a macrolide antibiotic often used as a single-dose oral treatment for chancroid in adults. It blocks bacterial protein production so the bacteria cannot grow. The purpose is to cure the infection, speed ulcer healing, and stop transmission. CDC guidelines and many reviews list azithromycin as a first-line option for chancroid. Common side effects include nausea, stomach upset, and, rarely, heart-rhythm changes in at-risk people.CDC+2NCBI+2

2. Ceftriaxone
Ceftriaxone is a third-generation cephalosporin antibiotic given as a single injection in muscle for chancroid. It works by blocking bacterial cell-wall synthesis, causing bacterial death. The purpose is rapid cure with a one-time dose supervised in clinic, which helps people who may not manage multi-day pills. Side effects can include pain at the injection site, diarrhea, or allergic reactions, especially in people with beta-lactam allergy.CDC+2MSD Manuals+2

3. Erythromycin
Erythromycin is an older macrolide antibiotic used as a multi-day oral regimen when azithromycin or ceftriaxone cannot be used (for example, pregnancy in some settings). It blocks bacterial protein synthesis. The purpose is to clear Haemophilus ducreyi over several days. Side effects often include stomach cramps, nausea, and diarrhea; it can also interact with other medicines, so doctors check the full drug list.FDA Access Data+3IUSTI+3NCBI+3

4. Ciprofloxacin
Ciprofloxacin is a fluoroquinolone antibiotic sometimes used as a short multi-day oral course in adults, but it is not suitable for children, teens, pregnant people, or some others. It stops bacterial DNA replication. The purpose is to offer an oral option where macrolides or ceftriaxone are not appropriate. Important side effects can include tendon problems, nerve issues, and effects on blood sugar, so strict medical supervision is needed.FDA Access Data+3CDC+3NCBI+3

Symptom-relief and supportive medicines

5. Paracetamol (acetaminophen)
Paracetamol is a pain-relief and fever-reduction medicine often used for genital ulcer pain. It works in the brain to reduce pain signaling and temperature. The purpose in Ducrey’s chancre is better comfort and sleep, not cure of infection. When used in correct doses, it is usually safe, but taking too much can harm the liver, so dosing must follow medical advice and package guidance.MSD Manuals

6. Ibuprofen or other NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen reduce pain and inflammation around ulcers and buboes. They block cyclo-oxygenase enzymes involved in prostaglandin production. The purpose is to ease swelling and tenderness. Side effects can include stomach irritation, kidney strain, and bleeding risk, especially in people with ulcers or kidney disease, so they should be used carefully under guidance.MSD Manuals

7. Topical anesthetic gels (for example, lidocaine gel)
A doctor may advise a local anesthetic gel around, but not deep into, the ulcers. These gels temporarily numb the skin by blocking nerve signals. The purpose is short-term pain relief during urination, cleaning, or dressing changes. Overuse can cause local irritation or, rarely, systemic side effects, so they should be used exactly as directed.NCBI+1

8. Topical barrier ointments (such as petroleum jelly)
Simple barrier ointments can be applied around, but not sealing over, ulcers to reduce friction and moisture damage. The purpose is to protect nearby healthy skin from maceration and irritation from discharge. The mechanism is forming a protective film; clinicians make sure the area still allows drainage and does not trap pus.MSD Manuals

9. Antihistamines (for itch or discomfort)
If there is itch or general discomfort, oral antihistamines may be used. They block histamine receptors that drive itch pathways. In chancroid this is supportive only; the purpose is to stop scratching that could tear fragile skin and spread bacteria. Drowsiness is a common side effect with older antihistamines.MSD Manuals

10. Stool-softening agents (if pain affects bowel movements)
If ulcers or buboes make bowel movements painful, especially with perianal lesions, a doctor may recommend mild stool-softening medicines. These draw water into the stool or lubricate it so less straining is needed. The purpose is to prevent extra tearing and pain around affected skin.MSD Manuals

11. Anti-nausea medicines
Some people feel sick from strong antibiotics. Short-term anti-nausea drugs can help them keep medicines down. The purpose is better adherence to the full antibiotic course, which is essential to cure. These medicines act on brain centers controlling nausea or on gut motility.NCBI+1

12. Probiotic preparations (as medications or supplements)
Probiotic capsules or sachets containing Lactobacillus or Bifidobacterium species are sometimes used during or after antibiotic courses to help restore normal gut flora. The purpose is to reduce antibiotic-associated diarrhea and support gut health. Evidence is mixed but suggests benefit for some people.NCBI+1

13. Topical antiseptic solutions (used with care)
Dilute antiseptic solutions recommended by a clinician may be used around, but not aggressively inside, ulcers. They reduce surface bacterial load. The purpose is to prevent secondary skin infection, not to treat the underlying Haemophilus ducreyi, which still needs systemic antibiotics. Overuse can delay healing, so professional advice is important.MSD Manuals+1

14. Simple oral rehydration solutions
If pain, fever, or associated illness reduce fluid intake, oral rehydration solutions can be used. They replace water and electrolytes. The purpose is to prevent dehydration, especially in hot climates. Good hydration also supports circulation and immune function.MSD Manuals

15. Antidepressants or anti-anxiety medicines (in selected cases)
In people with significant anxiety, depression, or trauma related to the STI diagnosis, mental-health professionals may prescribe appropriate medicines. The purpose is to support mental health and improve overall functioning, which in turn helps adherence to treatment and prevention steps.MSD Manuals

16–20. Other medicines
Depending on the person, clinicians may use drugs for co-existing conditions (HIV antiretrovirals, diabetes medicines, blood-pressure drugs). Treating these conditions helps the body heal chancroid. These are not specific chancroid treatments but are important for whole-person care, and their choice is highly individual.NCBI+1

---

Dietary molecular supplements

There is no supplement proven to cure Ducrey’s chancre. Supplements below may support general immune and skin health. Always discuss with a doctor, especially if you take other medicines.

1. Vitamin C – An antioxidant vitamin that supports collagen formation and immune cell function. It may help wound healing and protect tissues from oxidative stress. It is usually taken once or several times per day in modest doses, with higher amounts found naturally in fruits and vegetables like citrus, guava, and peppers.MSD Manuals

2. Vitamin D – Important for immune regulation and barrier function of skin. Many people have low vitamin D, especially with limited sun exposure. Correcting deficiency may help overall infection resistance, but it does not specifically treat chancroid.MSD Manuals

3. Zinc – A trace mineral vital for skin repair and white-blood-cell activity. Zinc deficiency is linked to poor wound healing. Short-term supplementation in deficient people can support repair of ulcers, but high doses or long use can cause copper deficiency and stomach upset.MSD Manuals

4. Selenium – A trace element involved in antioxidant enzymes. Adequate selenium may support immune responses and lessen oxidative damage. It is usually obtained from foods like nuts, fish, and whole grains; supplements should stay within recommended limits to avoid toxicity.MSD Manuals

5. Omega-3 fatty acids (fish-oil) – Omega-3s have anti-inflammatory effects and may support heart and immune health. In the context of Ducrey’s chancre, they might modestly help with systemic inflammation, but they are not a substitute for antibiotics.MSD Manuals

6. B-complex vitamins – B vitamins are needed for energy metabolism, nerve function, and cell division. Good levels support tissue repair and resilience under stress. People with poor diets or alcohol misuse may particularly benefit from dietary correction or supervised supplements.MSD Manuals

7. Iron (only if deficient) – Iron is needed for red blood cells and some immune functions. If blood tests show iron-deficiency anemia, iron therapy can improve energy and support healing. However, unnecessary iron can be harmful, so it should be used only after testing.MSD Manuals

8. Probiotic supplements – As mentioned above, probiotics can help restore gut balance during antibiotic therapy. This may reduce diarrhea and support nutrient absorption, indirectly aiding immune function.NCBI+1

9. L-arginine (with caution) – L-arginine is an amino acid involved in nitric-oxide production and blood flow. In theory it could support circulation and healing, but evidence for STI-specific benefit is limited, and it may not be suitable for everyone (for example, some heart conditions).MSD Manuals

10. Curcumin (turmeric extract) – Curcumin has anti-inflammatory and antioxidant properties in laboratory and some clinical studies. As part of a healthy diet, turmeric may support general health, but curcumin supplements can interact with medicines and should be used carefully.MSD Manuals

---

Immune-support, regenerative and “stem-cell-type” drugs

At present, there are no approved “stem cell drugs” or special regenerative medicines specifically for Ducrey’s chancre. Management focuses on standard antibiotics plus good general health.

1. Optimized HIV treatment (if co-infected) – In people living with HIV, effective antiretroviral therapy improves immune function and can help ulcers heal better.CDC

2. Treatment of diabetes and other chronic diseases – Good control of diabetes and similar conditions improves wound healing and infection resistance.MSD Manuals

3. Vaccinations (HPV, hepatitis B, etc.) – These do not treat chancroid but protect against other infections that can complicate sexual health.CDC

4. Granulocyte colony-stimulating factor (G-CSF) in severe neutropenia – Very rarely, if a person has a serious blood problem and repeated infections, hematologists might use growth-factor drugs to raise white blood cells. This is not standard for simple chancroid.CDC

5. Intravenous immunoglobulin (IVIG) in special immune disorders – IVIG can support the immune system in selected autoimmune or immunodeficiency states, again not routine for chancroid.CDC

6. Research-level stem-cell therapies – Stem-cell approaches are being studied for some chronic wounds and immune diseases but are not routine, approved treatments for Ducrey’s chancre. Any claims online about stem cells curing chancroid should be viewed very skeptically.CDC

---

Surgical treatments

1. Needle aspiration of buboes
When groin lymph nodes fill with pus and become very painful, doctors may insert a needle through healthy skin and draw out the pus. The purpose is to relieve pain and reduce tension, while the person is already on antibiotics. Aspiration avoids big open wounds but sometimes has to be repeated.CDC+2MSD Manuals+2

2. Incision and drainage of buboes
For very large or tense buboes, small surgical cuts may be made to drain pus. The purpose is to prevent spontaneous rupture and large skin loss. Studies show incision and drainage can be effective and may require fewer repeat procedures than aspiration, though wounds need careful aftercare.PubMed+2CDC+2

3. Debridement of necrotic tissue
If ulcers become very deep or secondarily infected, a surgeon may carefully remove dead tissue. The purpose is to leave healthy, bleeding tissue that can heal better and reduce bacterial load. Debridement is done under proper anesthesia and only together with antibiotics.MSD Manuals+1

4. Reconstructive surgery or skin grafting
In rare, severe cases with large scars or deformity, reconstructive surgery or skin grafts may be considered after infection is completely cured. The purpose is to restore function and appearance, which can improve quality of life and sexual comfort.MSD Manuals+1

5. Repair of fistulas or strictures
Long-standing, complicated disease may rarely cause abnormal tracts (fistulas) or narrowing (strictures) of nearby structures. Urologic or gynecologic surgeons may repair these problems to restore normal passage of urine or other functions.MSD Manuals+1

---

Prevention

1. Correct and consistent condom use during all sexual activity.Illinois Department of Public Health+1

2. Limiting the number of sexual partners and avoiding overlapping partners.Illinois Department of Public Health+1

3. Avoiding sex with anyone who has visible genital sores, discharge, or unexplained pain.Erie County Health+1

4. Getting tested for STIs regularly if sexually active, especially with new partners.CDC+1

5. Rapid medical review if any genital ulcer or unusual symptom appears.MSD Manuals+1

6. Ensuring partners are tested and treated if chancroid is diagnosed.CDC+1

7. Avoiding sharing sex toys or cleaning them properly between users.CDC

8. Good genital hygiene, using mild soap and water only.SA Health+1

9. Vaccination for other STIs where available (for example, HPV, hepatitis B).CDC

10. Community education programs to reduce stigma and encourage early care.CDC+1

---

When to see a doctor

You should see a doctor or sexual-health clinic as soon as possible if you notice:

• Any painful or painless sore, ulcer, or lump on the genitals, anus, or nearby skin.DermNet®+1

• Painful swollen lumps in the groin area (possible buboes).Wikipedia+1

• Fever, feeling very unwell, or spreading redness around ulcers.MSD Manuals

• A partner is diagnosed with chancroid or any STI.Illinois Department of Public Health+1

Emergency care is needed if you have very strong pain, cannot pass urine, very high fever, or signs of severe infection like confusion or breathing problems.

---

What to eat and what to avoid

1. Eat: Fresh fruits and vegetables rich in vitamins (especially C and A) to support immune and skin health.

2. Eat: Adequate protein from beans, lentils, fish, eggs, or lean meat to help tissue repair.

3. Eat: Whole grains (brown rice, oats, whole-wheat) for energy and micronutrients.

4. Eat: Healthy fats (nuts, seeds, olive or mustard oil, fatty fish) for cell membranes and anti-inflammatory effects.MSD Manuals

5. Avoid or limit: Very sugary drinks and sweets, which can worsen blood-sugar control and inflammation.

6. Avoid: Excess alcohol, which harms liver, immunity, and judgment about safer sex.

7. Avoid: Smoking and smokeless tobacco, which slow wound healing and damage blood vessels.MSD Manuals

8. Limit: Deep-fried, highly processed, and very salty foods; they add calories but few nutrients.

9. Avoid: Unproven “miracle” herbal cures sold online that claim to replace antibiotics. They can delay proper care and sometimes be toxic.MSD Manuals+1

10. Do: Drink plenty of safe fluids (water, soups, oral rehydration) to stay well-hydrated while healing.MSD Manuals

---

Frequently asked questions

1. Is Ducrey’s chancre the same as chancroid?
Yes. Ducrey’s chancre, soft chancre, and chancroid all refer to the same infection caused by Haemophilus ducreyi.Wikipedia+1

2. How is Ducrey’s chancre different from syphilis?
Classically, chancroid ulcers are painful, soft, and have ragged edges, whereas syphilitic chancres are often painless and firm. However, appearance can overlap, so lab tests are needed; many guidelines recommend treating for multiple possible causes of genital ulcers.PMC+1

3. Can Ducrey’s chancre go away without treatment?
Ulcers may partly improve, but the infection can persist, cause scarring, and increase HIV risk. Antibiotics are strongly recommended in all confirmed or suspected cases; do not wait for it to “go away”.CDC+1

4. Is it dangerous for teenagers to have this infection?
Chancroid is serious at any age. In teenagers it raises concerns about consent, safety, and risk of other STIs. It must be treated promptly by qualified clinicians, and safeguarding laws may apply in some countries.NCBI+1

5. Can I treat Ducrey’s chancre with home remedies only?
No. Home care (hygiene, rest, good food) can support healing but cannot kill Haemophilus ducreyi. Only proper antibiotics from a doctor can cure the infection.CDC+1

6. How long does healing take after starting antibiotics?
Guidelines note that pain often improves within about 3 days and ulcers usually begin to shrink within about a week. Large ulcers may take more than 2 weeks to fully heal, and buboes can take even longer.CDC+1

7. Do I need to be tested for HIV or other STIs?
Yes. Everyone with Ducrey’s chancre should be tested for syphilis, HIV, and other STIs, because co-infection is common and chancroid can make HIV transmission easier.NCBI+1

8. Can I have sex while being treated?
It is safest to avoid sex until all ulcers have completely healed and your doctor confirms it is okay. Even with condoms, contact with sores may still spread infection.Illinois Department of Public Health+1

9. Will there be scars?
Small ulcers often heal with minimal marks, but larger or deeply infected ulcers and drained buboes can leave noticeable scars. Early treatment reduces this risk. In severe cases, reconstructive surgery may help.MSD Manuals+1

10. Can I get Ducrey’s chancre again after treatment?
Yes. Treatment cures the current infection but does not give lifelong immunity. You can be re-infected from an untreated or new infected partner. Safer-sex practices and partner treatment are essential.Illinois Department of Public Health+1

11. Are the antibiotics safe?
The main recommended antibiotics (azithromycin, ceftriaxone, erythromycin, ciprofloxacin) are widely used and generally safe when prescribed correctly. They can cause side effects and may not suit everyone, so your doctor will choose the best option for you.FDA Access Data+4CDC+4NCBI+4

12. Do I need to be in hospital?
Most people can be treated as outpatients with oral medicines or a single injection. Hospital care may be needed if there are severe complications, very large buboes, or other serious illnesses.NCBI+1

13. Can pregnancy be affected?
Current data suggest chancroid itself does not usually harm the fetus, but all genital infections in pregnancy need careful management. Some drugs, such as ciprofloxacin, are usually avoided; doctors choose safer options like erythromycin or ceftriaxone.CDC+1

14. What if treatment does not work?
If ulcers are not improving after about a week, doctors re-check the diagnosis, test for other STIs, ask about medication adherence, and consider drug resistance or HIV co-infection. A different antibiotic or longer course may be needed, guided by specialist advice.CDC+1

15. Where should I go for help?
You should attend a sexual-health or STI clinic, dermatology/venereology clinic, or a general practitioner who can refer you. Public-health websites and hotlines from your local health department often list nearby STI services.Utah Epidemiology+2Queensland Health+2

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: December 21, 2025.