Soft Chancre Chancroid

Soft chancre, also called chancroid, is a sexually transmitted infection (STI) that causes very painful sores (ulcers) on the genitals or nearby skin. It is caused by a bacterium called Haemophilus ducreyi, which is a small gram-negative rod. The sores usually start as small red bumps, then turn into open, painful ulcers with soft edges and a dirty-looking base. Nearby groin lymph nodes can swell and may fill with pus (called “buboes”). NCBI+2DermNet®+2

Chancroid is now rare in many rich countries, but it is still seen in some low-resource or tropical areas in parts of Africa, Asia, and the Caribbean. It often affects people with limited access to health care and those with high sexual exposure risk. Because it causes open sores, chancroid makes it easier to catch or pass on HIV and other STIs if preventive steps are not used. NCBI+2MSD Manuals+2

Soft chancre, also called chancroid, is a sexually transmitted infection (STI) that causes painful open sores (ulcers) on the genitals and swollen, tender lymph nodes in the groin. It is caused by a bacterium called Haemophilus ducreyi and spreads mainly through unprotected vaginal, anal, or oral sex with an infected partner. With correct antibiotics and good wound care, chancroid usually heals completely and the infection stops spreading.CDC+1

Other names of soft chancre (chancroid)

Soft chancre has many other names in medical books. Common alternative names include: soft chancre, ulcus molle, Ducrey’s chancre, Ducreyi chancre, chancroidal bubo, soft sore, and Haemophilus ducreyi infection. Some texts also use the French term chancre mou. All these names refer to the same disease caused by Haemophilus ducreyi. MedlinePlus+4DermNet®+4Wikipedia+4

Types and clinical variants

Doctors sometimes describe several clinical “types” or variants of chancroid based on how the ulcers look and behave. These are patterns, not different diseases, but they help in description.

• Classic chancroid
  This is the usual form. One or more painful genital ulcers appear with soft, ragged edges and a yellow-gray base that bleeds easily if touched. Painful swollen groin nodes may appear on one or both sides. MSD Manuals+2MSD Manuals+2

• Dwarf chancroid
  In this type, the ulcer is small, shallow, and may look less dramatic. It can be almost painless or only mildly painful. Because it looks mild, it may be missed unless the genitals are checked carefully. Wikipedia

• Giant chancroid
  Here, a large, destructive ulcer forms, often where an inflamed groin node (bubo) has ruptured onto the skin. The sore can extend widely and cause serious tissue damage if not treated. Wikipedia+1

• Follicular chancroid
  This type begins around a hair follicle, especially on the labia majora or pubic region in females. It starts as a pustule at a hair root and then becomes a typical painful ulcer. Wikipedia+1

• Transient chancroid
  Superficial ulcers appear and may begin to heal quickly, but a typical groin bubo forms later. The early ulcer may be gone by the time the swollen node appears, which can make the diagnosis more confusing. Wikipedia+1

• Serpiginous chancroid
  Multiple ulcers merge together to create a long, snake-like (serpiginous) ulcer with irregular borders. This form can cover a wide area and is usually very painful. Wikipedia

• Phagedenic chancroid
  In this severe type, other bacteria join the infection and create fast-spreading, destructive ulcers. These can cause deep tissue loss and sometimes major damage to the external genitals. Wikipedia+1

• Mixed chancroid
  Here, chancroid ulcers occur together with sores from another STI, most often syphilis. There may be both soft, painful chancroid ulcers and a harder, less painful syphilitic ulcer in the same area. Wikipedia+1

• Chancroidal ulcer (non-H. ducreyi)
  Some ulcers look like chancroid but are caused by other germs. These are called chancroidal ulcers. They are tender and non-hard, but tests do not find H. ducreyi. Doctors must then look for other causes. Wikipedia+1

Causes of soft chancre (chancroid)

The direct cause of chancroid is infection with the bacterium Haemophilus ducreyi. Human beings are the only known natural host. The germ enters through tiny breaks in the skin or mucosa during sexual contact and grows there, causing ulcers and swollen nodes. PMC+3Wikipedia+3NCBI+3

Below are 20 important cause-related and risk-related factors that help this infection spread:

1. Unprotected vaginal, anal, or oral sex with an infected partner
   The main way chancroid spreads is through direct skin-to-skin or mucosal contact with the ulcers or infected secretions of a person who has H. ducreyi. Not using barrier protection greatly increases risk. MSD Manuals+2Minnesota Department of Health+2

2. Multiple sexual partners
   Having many partners increases the chance of meeting someone who carries the infection, especially in regions where chancroid is more common or among high-risk networks. NCBI+1

3. Sex work and clients of sex workers
   Studies show chancroid is often linked to commercial sex, including sex workers and people who buy sex, especially where condoms are not regularly used. Europe PMC+2Restored CDC+2

4. Living in or traveling to endemic areas
   Chancroid remains more common in some low-resource regions of Africa, Asia, and the Caribbean. Travel to these areas and sexual contact there can increase risk. NCBI+2SA Health+2

5. Low socioeconomic conditions and limited health access
   Overcrowding, poverty, and poor access to STI testing and treatment make it easier for H. ducreyi to circulate in communities and remain undetected. Europe PMC+1

6. Lack of circumcision in males
   Research suggests uncircumcised men have a higher risk of chancroid, probably because the foreskin can trap moisture and germs and develop small tears. NCBI+1

7. Tiny skin injuries during sex
   Small, often invisible cuts or abrasions on the genital skin or around the anus act as entry doors for H. ducreyi. Rough or prolonged sexual activity can increase these micro-injuries. Wikipedia+1

8. Other genital ulcer diseases (e.g., herpes, syphilis)
   Existing genital ulcers make it easier for H. ducreyi to enter the body and also make it harder to recognize which germ is causing the new ulcers. CDC+2MSD Manuals+2

9. Co-infection with HIV
   HIV weakens the immune system, making it easier to get chancroid and making chancroid ulcers slower to heal. Chancroid also raises the risk of HIV spread. MSD Manuals+2Frontiers+2

10. Poor genital hygiene
    Not cleaning the genital area regularly can allow more bacteria to grow, keep secretions and moisture around ulcers, and delay healing or promote spread to others. IJDVL+1

11. Substance use (alcohol, drugs)
    Heavy alcohol or drug use can lead to unplanned, unprotected sex and poor judgment, which indirectly increases the risk of chancroid and other STIs. Europe PMC+1

12. Lack of STI education and awareness
    People who do not know how chancroid spreads or do not recognize its symptoms are less likely to use protection and more likely to delay seeing a doctor. CDC+1

13. Delayed or no treatment of early ulcers
    If the first small bump or ulcer is ignored, the infection continues and becomes more contagious, and larger ulcers and buboes can form. MSD Manuals+1

14. Limited availability of accurate laboratory tests
    H. ducreyi is hard to grow in standard labs. When good tests are not available, cases may be missed or misdiagnosed, allowing continued spread. NCBI+2ScienceDirect+2

15. Crowded STI clinic settings with poor infection control
    If equipment or surfaces are not cleaned properly, there is a small risk of indirect spread when dealing with ulcer secretions, though direct sex is still the main route. Europe PMC+1

16. Sexual networks with overlapping partners
    When people in a community have overlapping sexual partners, one case of chancroid can circulate quickly and cause small outbreaks. Restored CDC+2Enfermedades Emergentes+2

17. Accidental self-inoculation or hand-to-genital spread
    Rarely, touching an ulcer and then another skin area with small cuts (for example, fingers or inner thighs) can move the germ to that new site. Wikipedia+1

18. Use of non-sterile sexual devices or objects
    Sharing unclean objects that contact genital ulcers can, in theory, move H. ducreyi between partners, although this is less common than direct sex. Europe PMC+1

19. Impaired immune system from other illnesses
    Conditions such as uncontrolled diabetes, malnutrition, or long-term steroid use can weaken immune defenses and may prolong or worsen chancroid infection. Frontiers+1

20. Previous chancroid infection
    People do not develop strong long-lasting immunity after chancroid. A person who has had it before can get it again if exposed to H. ducreyi in the future. Frontiers+1

Symptoms of soft chancre

The time from exposure to symptoms is usually 3–7 days, but it may be a little longer. Early on, a small red bump or pimple appears where the germ entered. This then breaks down into a painful ulcer. Wikipedia+3MSD Manuals+3DermNet®+3

1. Painful genital ulcer
   The main symptom is one or more painful sores on the penis, vulva, vagina, cervix, perineum, anus, or nearby skin. The pain often makes touching, walking, or sitting uncomfortable. MSD Manuals+2DermNet®+2

2. Soft, ragged ulcer edges
   Unlike the firm “hard chancre” of syphilis, chancroid ulcers have soft, undermined, irregular edges. Doctors often use this “soft edge” to suspect chancroid. MSD Manuals+2Wikipedia+2

3. Dirty-looking yellow-gray base
   The base of the ulcer is often covered with a gray or yellowish-gray material and may ooze pus. It can bleed easily if scraped or rubbed. Wikipedia+2MSD Manuals+2

4. Red halo around the ulcer
   A narrow red border often surrounds the ulcer, showing active inflammation, especially in early stages. Delaware Public Health District+1

5. Multiple ulcers (especially in women)
   Many men have a single ulcer, but women often have several ulcers in the vulval, perineal, or perianal area. These can join together into large, irregular sores. Wikipedia+2DermNet®+2

6. Painful swollen groin nodes (buboes)
   About one-third to over half of patients develop swollen lymph nodes in the groin. These are usually very tender and may be bigger on one side. MSD Manuals+2MSD Manuals+2

7. Fluctuant, pus-filled buboes
   Over time, the swollen nodes can fill with pus and feel soft in the center. They may rupture through the skin and leak thick yellow pus unless drained. NCBI+2CDC+2

8. Pain or burning when passing urine (dysuria)
   If the ulcer is near the urinary opening or there is swelling around it, passing urine can cause burning or sharp pain. Wikipedia+1

9. Pain during sexual activity
   Ulcers and swollen nodes can make sexual activity painful, especially when the sore is stretched or rubbed. This often brings patients to the clinic. MSD Manuals+1

10. Bleeding from the ulcer
    Because the base of the ulcer is fragile, small bumps or wiping may cause it to bleed lightly, which can be alarming but is usually not life-threatening. Wikipedia+1

11. Bad smell from the ulcer area
    Ulcers can develop an unpleasant odor if they collect secretions and are secondarily infected by other skin bacteria, especially with poor hygiene. IJDVL+1

12. Fever and feeling unwell (systemic symptoms in some cases)
    Some patients, especially with large ulcers or buboes, may have low-grade fever, tiredness, or general malaise, showing a stronger body response to infection. NCBI+2MSD Manuals+2

13. Difficulty walking or moving legs
    Very large or painful groin nodes can make it hard to walk or move the thighs comfortably, because each step pulls on the tender area. MSD Manuals+2NCBI+2

14. Scarring or deformity after healing
    In advanced, untreated cases, ulcers and buboes can heal with scars or small fistulas (abnormal openings), sometimes changing the shape of the foreskin or genital skin. MSD Manuals+2MSD Manuals+2

15. Asymptomatic or mild cases (especially in women)
    Some women may have small, hidden cervical or vaginal ulcers without clear pain, or only mild discomfort. This makes chancroid harder to spot and can delay diagnosis. DermNet®+2MSD Manuals+2

Diagnostic tests for soft chancre (chancroid)

Because H. ducreyi is hard to grow in routine labs and other infections (like syphilis and herpes) can look similar, chancroid is often diagnosed by a mix of history, physical exam, and tests to confirm or exclude other causes. In many clinics, the diagnosis is “presumptive” when other major causes of genital ulcers are ruled out and the picture fits chancroid. BMJ Best Practice+3NCBI+3CDC+3

Below are important tests, grouped by category. Electrodiagnostic and imaging tests are rarely needed and mainly used for complications or to rule out other problems, but they are included here for completeness.

Physical examination–based tests

1. Detailed medical and sexual history with genital symptom review
   The doctor asks about recent sexual partners, travel, condom use, previous STIs, and the timing of symptoms. Matching the story (short incubation, painful ulcers, groin swelling) with risk factors is the first “test” that raises suspicion for chancroid. NCBI+2MSD Manuals+2

2. Visual inspection of genital and perianal ulcers
   The clinician carefully looks at the genital, perineal, and anal areas to see the number, size, shape, and edges of ulcers and whether they are painful and soft. The classic soft, ragged, purulent ulcer strongly suggests chancroid but must be confirmed by other tests or exclusion. DermNet®+2MSD Manuals+2

3. Palpation (feeling) of ulcers for induration and tenderness
   By gently touching the ulcer, the doctor checks how soft or firm it is and how painful it feels. A very tender, non-hard (non-indurated) ulcer points more toward chancroid than syphilis, which usually has a firm, painless chancre. MSD Manuals+2Wikipedia+2

4. Palpation of inguinal lymph nodes
   The doctor examines lymph nodes in both groins to see if they are swollen, tender, or fluctuant (soft in the center, suggesting pus). Unilateral, painful buboes are common in chancroid and support the diagnosis. NCBI+2MSD Manuals+2

Manual bedside tests

5. Pain response test to light touch or swab
   Gently touching the ulcer with a cotton swab helps confirm that the lesion is truly painful, which is more typical for chancroid than for a primary syphilitic chancre. This simple bedside test supports the clinical impression. Wikipedia+2Wikipedia+2

6. Speculum examination of the vagina and cervix in females
   Using a speculum, the clinician can look inside the vagina and at the cervix to find hidden ulcers that might not be visible externally. This is important because women can have deep cervical chancroid ulcers with few external signs. DermNet®+2BMJ Best Practice+2

7. Bimanual pelvic examination
   With one hand on the abdomen and one or two fingers in the vagina, the doctor checks for tenderness, masses, or pain that might suggest spread of infection or associated pelvic disease. Although not specific for chancroid, it helps rule out other causes of pelvic pain. BMJ Best Practice+1

8. Digital rectal examination (when perianal lesions are present)
   If ulcers or pain are near the anus, a gloved finger exam of the rectum can check for internal ulcers, tenderness, or masses and helps exclude other conditions such as fissures, abscesses, or rectal tumors. BMJ Best Practice+1

Laboratory and pathological tests

9. Gram stain of ulcer exudate
   A sample from the ulcer is smeared on a slide, stained, and examined under a microscope. H. ducreyi may appear as short gram-negative rods often arranged like “school of fish” or “railroad tracks.” This test is not perfect but can support the diagnosis in experienced hands. Europe PMC+2Wikipedia+2

10. Culture of Haemophilus ducreyi
    Ulcer material or pus from a bubo is put onto special culture media and incubated under controlled conditions. Growing H. ducreyi gives a definite diagnosis, but the test is difficult, not widely available, and not very sensitive. Wikipedia+3Europe PMC+3ScienceDirect+3

11. Polymerase chain reaction (PCR) or NAAT for H. ducreyi
    PCR or nucleic acid amplification tests detect H. ducreyi DNA directly from ulcer swabs or pus. These tests are sensitive and specific, but in many countries they are not FDA-approved or not widely available, so they are mainly used in research centers. Enfermedades Emergentes+2PMC+2

12. Serologic tests for syphilis (e.g., VDRL/RPR and treponemal tests)
    Blood tests for syphilis are done in almost all patients with genital ulcers. A positive result suggests that syphilis is present, though the person may also have chancroid at the same time. Ruling out syphilis is an important part of chancroid diagnosis. CDC+2BMJ Best Practice+2

13. Tests for genital herpes (HSV PCR or culture)
    Samples from ulcers are tested for herpes simplex virus. If HSV is found, herpes becomes the likely cause of the ulcers. If HSV and syphilis tests are negative and the ulcer fits the picture, chancroid becomes more likely. CDC+2BMJ Best Practice+2

14. HIV antigen–antibody testing
    Because chancroid increases the risk of HIV and often occurs in high-risk groups, HIV testing is usually recommended. Finding HIV does not prove chancroid but helps plan care and explains slow healing if it occurs. MSD Manuals+2Frontiers+2

15. NAATs for other STIs (chlamydia and gonorrhea)
    Swabs from the cervix, urethra, or urine can be tested for Chlamydia trachomatis and Neisseria gonorrhoeae. Many patients with chancroid have more than one STI, so screening is important for full treatment. CDC+2BMJ Best Practice+2

16. Complete blood count (CBC) and inflammatory markers
    Blood tests like CBC, C-reactive protein, or ESR are not specific for chancroid but can show signs of systemic infection or inflammation, such as raised white blood cells. They help judge severity and look for other conditions. NCBI+1

17. Fine-needle aspiration of buboes
    A thin needle is used to withdraw pus from a swollen groin node. The pus can be examined with Gram stain, culture, or PCR. Aspiration both helps diagnosis and can relieve pain by reducing pressure in the bubo. NCBI+2CDC+2

Electrodiagnostic tests

Electrodiagnostic tests are not routine for chancroid itself, because chancroid mainly affects the skin and lymph nodes, not the nerves or muscles. However, in complex cases with unexplained nerve-type symptoms, doctors might use these tests to rule out other diseases, not to prove chancroid.

18. Nerve conduction studies (NCS)
    NCS measure how fast and how strongly nerves carry electrical signals. If a person with genital ulcers also has numbness or weakness in the legs, NCS can check for nerve damage due to other conditions such as diabetes or spinal disease. Chancroid itself does not typically change these tests. BMJ Best Practice+1

19. Electromyography (EMG)
    EMG records electrical activity in muscles to look for nerve or muscle disorders. Again, this is not a test for chancroid but may be used in rare situations where doctors suspect an additional neuromuscular disease that could explain unusual symptoms. BMJ Best Practice+1

Imaging tests

Imaging is usually not needed for simple chancroid, but it can help in complicated cases, especially when large buboes or deep infections are suspected.

20. Ultrasound of inguinal lymph nodes and surrounding tissues
    Ultrasound uses sound waves to show if groin nodes are solid or filled with fluid (abscess). In patients with very large or deep buboes, ultrasound helps decide whether needle aspiration or surgical drainage is needed and helps exclude other groin masses such as hernias or tumors. MSD Manuals+2MSD Manuals+2

21. CT or MRI of the pelvis or perineum (for severe complications)
    In rare, severe cases with suspected deep abscesses, fistulas, or very extensive tissue damage, CT or MRI scans may be ordered. These images show the extent of infection and help surgeons plan any needed drainage or reconstructive procedure. They are not standard tests but are useful when simple exam and ultrasound are not enough. MSD Manuals+2MSD Manuals+2

Non-pharmacological Treatments (Therapies and Others)

1. Sexual rest (no intercourse during treatment)
Avoiding all sexual contact, including vaginal, anal, and oral sex, while ulcers are present and for at least 7 days after finishing antibiotics, reduces the risk of passing chancroid to partners and prevents re-injury of the sores. This “genital rest” also allows the skin and mucosa to heal more quickly and lowers friction-related pain. Most guidelines advise no sex until ulcers are fully healed.CDC+1

2. Consistent condom use after healing
When a person becomes sexually active again, using condoms correctly with every partner and every sex act lowers the chance of future chancroid and other STIs. Condoms act as a physical barrier between genital skin and genital fluids where bacteria and viruses live. They are not perfect, but they significantly reduce STI transmission when used regularly and correctly.CDC+1

3. Gentle daily cleansing of ulcers
Washing the genital area once or twice daily with clean water and a mild, non-perfumed soap helps remove pus, crusts, and sweat from the ulcers. This basic hygiene reduces bacterial load on the surface, decreases smell, and supports the effect of antibiotics. Rubbing hard or using harsh chemicals should be avoided because it can worsen tissue damage and slow healing.IUSTI+1

4. Warm sitz baths
Sitting in a basin or tub of comfortably warm water for 10–15 minutes can ease pain, relax nearby muscles, and help soften crusts around ulcers. This therapy is especially helpful when ulcers are near the anus or in skin folds. Warm water improves local blood flow, which brings more immune cells and oxygen to the area, supporting natural healing.IUSTI+1

5. Loose, breathable clothing and underwear
Wearing loose cotton underwear and trousers or skirts reduces friction and moisture around the sores. Tight synthetic clothes trap sweat and increase rubbing, which can reopen healing ulcers. Dry, well-ventilated skin makes it harder for bacteria to grow and lowers irritation, so healing can progress faster and pain is less intense during movement.IUSTI+1

6. Local wound dressings when needed
In some patients, a nurse or doctor may apply simple sterile dressings or gauze over larger ulcers to protect them from rubbing and contamination by stool or urine. A non-stick dressing absorbs discharge and prevents the wound edges from sticking to clothes. This physical protection supports tissue repair and lowers the risk of secondary bacterial infection.IUSTI+1

7. Careful shaving or avoiding shaving
If hair is present near the ulcers, rough shaving may cut the skin and spread bacteria to new micro-wounds. Many clinicians advise avoiding shaving around the affected area until full healing. If shaving is necessary for hygiene or surgery, it should be done gently with clean tools to prevent additional trauma and auto-inoculation of H. ducreyi to nearby skin.IUSTI+1

8. Smoking reduction or cessation
Smoking weakens the immune system and reduces small blood vessel flow in the skin, which can slow healing of ulcers of any cause. Reducing or stopping smoking during treatment helps the body clear infection and repair damaged tissue more effectively. This general wound-healing benefit is seen in many infectious and surgical conditions, not only chancroid.CDC+1

9. Limiting alcohol intake
Heavy alcohol use can interfere with immune function, cause dehydration, and make it harder to follow the full course of antibiotics. Reducing or avoiding alcohol during treatment supports liver function, improves adherence to medication schedules, and lowers risky sexual behaviour that could cause reinfection or spread to others.CDC+1

10. Partner notification and counselling
Telling recent sexual partners (usually those within 10 days before symptoms) that you have chancroid allows them to be examined and treated early, even if they have no symptoms. This “contact tracing” breaks the chain of transmission and prevents repeated infection within the same couple or network. Counselling also offers education on safer sex and other STIs.CDC+1

11. Screening for other STIs, including HIV and syphilis
Because chancroid often co-exists with syphilis, gonorrhoea, chlamydia, and HIV, testing for these infections at the same visit is strongly recommended. Genital ulcers greatly increase the risk of acquiring and transmitting HIV during sex. Detecting and treating co-infections improves overall health and reduces future complications.CDC+2CDC+2

12. Education on avoiding self-medication and home “cures”
Some people try to use harsh chemicals, herbal pastes, or unregulated creams directly on ulcers. These methods can burn the skin, introduce new infections, and delay proper diagnosis. Clear education that chancroid is best treated with proven antibiotics and gentle care helps patients avoid harmful practices and seek evidence-based medical help.CDC+1

13. Pain-coping strategies (relaxation, breathing, distraction)
Pain from ulcers and swollen groin nodes can cause anxiety and poor sleep. Relaxation techniques, deep breathing, and distraction activities (such as music or reading) can complement pain medicines. Reducing stress-related muscle tension may lower perceived pain levels and help patients complete exams and dressings more easily.Medscape eMedicine+1

14. Psychological support and stigma reduction
Having a genital STI can be emotionally stressful and can trigger shame or fear of relationship conflict. Supportive counselling from health workers or trusted people helps patients cope, continue treatment, and avoid hiding symptoms. When stigma is reduced, people are more likely to come early for care, which improves outcomes and limits spread in the community.CDC+1

15. Rest and adequate sleep
The immune system works best when the body is not exhausted. Simple rest, taking time off heavy physical work when feasible, and getting enough sleep at night allow immune cells to function efficiently. This supports the effect of antibiotics and speeds tissue repair of chancroid ulcers and inflamed lymph nodes.CDC+1

16. Good hydration
Drinking enough safe water helps maintain blood volume and circulation, bringing nutrients and immune cells to the infected area. Hydration also supports kidney function, which is important when taking systemic antibiotics. Patients are often advised to sip water regularly throughout the day unless they have another medical reason to restrict fluids.CDC+1

17. Blood sugar control in people with diabetes
If a person with chancroid also has diabetes, keeping blood sugar levels well controlled is critical because high sugar levels delay wound healing and increase infection risk. Working with a clinician to adjust diet or diabetes medicines during treatment can significantly improve ulcer healing and reduce complications.CDC+1

18. Avoiding over-the-counter steroid creams on ulcers
Topical steroid creams can suppress local immunity in the skin and may worsen bacterial infections when used directly on open sores. For chancroid ulcers, guidelines recommend against steroid creams unless specifically prescribed for another reason. Avoiding them lets the body’s defences and antibiotics work properly.CDC+1

19. Regular follow-up visits
Review visits, often 3–7 days after starting antibiotics, allow the clinician to check that ulcers are shrinking and pain is improving. If healing is slow, they can look for reasons such as wrong diagnosis, co-infection, drug resistance, or poor adherence. Early correction of problems prevents chronic ulcers and scarring.CDC+1

20. Public health reporting where required
In some countries or regions, chancroid is a reportable disease. This means cases are notified to public health authorities so they can monitor outbreaks and offer partner services. Reporting does not name and shame the patient but helps design community prevention strategies and resource planning for STI clinics.CDC+1

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Drug Treatments

Important note: Only a small number of antibiotics are strongly supported by high-quality evidence for curing chancroid. Creating 20 different “curative” drugs would be misleading. Below are the key evidence-based antibiotics and some common supportive medicines used for pain and associated problems. Exact dosing must always be confirmed by a doctor; do not self-medicate.CDC+1

1. Azithromycin
Azithromycin is a macrolide antibiotic widely used for many bacterial infections. For chancroid, a common regimen in guidelines is a single oral dose of 1 g, which is easy to give and helps adherence. It works by blocking bacterial protein synthesis, so H. ducreyi cannot grow and eventually dies. Side effects can include nausea, diarrhoea, abdominal pain, and rarely heart rhythm changes. FDA labelling describes its broad antibacterial activity and safety profile in detail.CDC+2PubMed+2

2. Ceftriaxone
Ceftriaxone is a third-generation cephalosporin antibiotic usually given as a single intramuscular (IM) injection, often 250 mg for chancroid in many protocols. It blocks bacterial cell wall synthesis, causing the bacteria to burst and die. It is very useful when adherence to oral therapy is uncertain. Common side effects include injection-site pain, allergic reactions, and mild diarrhoea. FDA labels stress its use only for proven or strongly suspected bacterial infections.CDC+2FDA Access Data+2

3. Ciprofloxacin
Ciprofloxacin is a fluoroquinolone antibiotic used in adults; some guidelines list 500 mg by mouth twice daily for 3 days as an option for chancroid, though it should not be used in pregnancy and is generally avoided in people under 18 because of risks to joints and tendons. It works by blocking bacterial DNA replication enzymes. Side effects include nausea, diarrhoea, tendon problems, and effects on the nervous system; FDA warnings highlight these risks.CDC+2FDA Access Data+2

4. Erythromycin
Erythromycin is another macrolide antibiotic; a typical chancroid regimen is 500 mg orally four times daily for 7 days. Like azithromycin, it stops bacterial protein synthesis. This multi-day course can be harder to complete but is useful when other drugs are not available or suitable. Side effects often include stomach upset, nausea, and, rarely, effects on heart rhythm or liver function, as described in FDA product information.PubMed+2FDA Access Data+2

5. Doxycycline (for co-infections, not primary chancroid drug)
Doxycycline is a tetracycline antibiotic used for chlamydia and some other STIs. It is not a first-line drug to cure chancroid but may be added when syndromic management is used and co-infection is suspected. A common regimen is 100 mg orally twice daily for 7 days in adults. It acts by inhibiting bacterial protein synthesis. Side effects can include photosensitivity, stomach upset, and risk in pregnancy or young children.CDC+1

6. Paracetamol (Acetaminophen)
Paracetamol is an analgesic and antipyretic medicine used to relieve pain and fever but it does not kill the chancroid bacteria. Typical adult doses are 500–1000 mg orally every 4–6 hours, not exceeding the maximum daily dose given by local guidelines. It works mainly in the central nervous system, reducing pain perception and temperature. Overdose can seriously damage the liver, so dosing must be careful.CDC+1

7. Ibuprofen
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammatory pain from ulcers and swollen groin lymph nodes. Adults often use 200–400 mg orally every 6–8 hours with food, within safe daily limits. It works by blocking prostaglandin production, which lowers pain and swelling. Side effects can include stomach irritation, ulcers, kidney issues, and increased bleeding risk, especially with long use.CDC+1

8. Topical lidocaine gel
Lidocaine gel can be applied around, but not deep inside, ulcers to reduce local pain, especially before urinating or during dressing changes. It blocks nerve conduction temporarily in the skin, so pain signals are not sent to the brain. It is used in thin layers a few times a day as directed. Overuse, especially on large broken surfaces, can cause systemic toxicity (dizziness, heart rhythm problems).IUSTI+1

9. Simple antiseptic solutions (e.g., dilute chlorhexidine)
Mild antiseptic solutions may be used by clinicians to gently clean the wound area and lower surface bacterial counts. They act by disrupting bacterial membranes and proteins. Strong solutions or frequent use can irritate delicate genital skin, so concentration and frequency should be guided by a professional. Antiseptics support, but never replace, systemic antibiotics.IUSTI+1

10. Stool-softening agents (if ulcers near anus)
If chancroid ulcers are located near the anus, passing hard stool may cause intense pain and re-open healing wounds. Short-term use of stool softeners or mild laxatives, combined with fluid and fibre, can make bowel movements easier. These agents draw water into stool or reduce stool firmness. Misuse can cause diarrhoea or electrolyte changes, so medical advice is needed.CDC+1

(The truly evidence-based “curative” therapy for chancroid relies on the first four systemic antibiotics above. Other medicines are supportive and should only be used under medical guidance.)

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Dietary Molecular Supplements

Dietary supplements can support immunity and wound healing, but they do not replace antibiotics. Always discuss supplements with a doctor, especially if you take other medicines or have chronic illnesses.

1. Vitamin C
Vitamin C is a water-soluble vitamin important for collagen formation and immune defence. Typical supplemental adult doses range from 200–1000 mg per day, often in divided doses. It acts as an antioxidant and co-factor for collagen-building enzymes, helping skin and mucosa repair. Very high doses can cause diarrhoea and kidney stone risk in prone individuals, so moderate dosing is safer.CDC+1

2. Zinc
Zinc is a trace mineral that plays a key role in immune cell function and wound healing. Oral supplement doses are commonly 10–30 mg elemental zinc per day for short periods. Zinc assists DNA synthesis, cell division, and enzyme activity in regenerating tissue. Excess zinc can cause nausea, interfere with copper absorption, and, in very high amounts, weaken immune function, so dose and duration must be limited.CDC+1

3. Vitamin A (within safe limits)
Vitamin A is needed for healthy skin and mucous membranes and normal immune function. It influences how epithelial cells grow and repair. Supplementation is usually modest (for example, up to the recommended daily allowance), because high doses can be toxic, especially in pregnancy or liver disease. It supports barrier integrity and may help ulcers heal but must be used cautiously under medical advice.CDC+1

4. Vitamin D
Vitamin D contributes to immune regulation and has roles in skin health. Typical safe supplemental doses vary by region but often range from 600–2000 IU daily in adults, depending on baseline levels. Vitamin D receptors on immune cells help modulate responses to infection. Excessive intake over time can cause high blood calcium and damage kidneys, so blood levels should be monitored if long-term supplementation is used.CDC+1

5. Omega-3 fatty acids (fish oil)
Omega-3 fatty acids such as EPA and DHA have anti-inflammatory effects. Supplement doses often range from 250–1000 mg combined EPA/DHA daily. They are incorporated into cell membranes and can reduce production of pro-inflammatory mediators. This may modestly help pain and swelling around ulcers, but they can also increase bleeding tendency at high doses or with blood thinners.CDC+1

6. Probiotics
Probiotic supplements contain live beneficial bacteria (for example Lactobacillus or Bifidobacterium species) and are typically taken once or twice daily in capsule or yogurt form. They help maintain a healthy gut microbiome, which may indirectly support systemic immunity and reduce antibiotic-associated diarrhoea. They do not directly treat chancroid but can improve overall comfort during antibiotic therapy.CDC+1

7. L-arginine
L-arginine is an amino acid sometimes used for vascular and wound-healing support. Typical supplement doses range from 1–3 g per day in divided doses. It serves as a substrate for nitric oxide production, which can improve blood vessel dilation and local circulation. Some people may experience gastrointestinal upset or interactions with blood-pressure medicines, so supervision is needed.CDC+1

8. B-complex vitamins
B vitamins (B1, B2, B6, B12, folate, and others) support energy metabolism, nerve function, and red blood cell production. A standard B-complex tablet once daily often covers daily needs. They act as co-factors in many biochemical reactions, helping the body respond to stress and repair tissues. Very high doses of some B vitamins can cause side effects, such as nerve issues with excess B6.CDC+1

9. Selenium
Selenium is a trace mineral involved in antioxidant enzymes such as glutathione peroxidase. Supplements are usually 50–100 mcg per day. Adequate selenium supports immune responses, but too much can cause hair loss, nail changes, and nerve problems. Because it has a narrow safety margin, it should be used carefully and often is not needed if diet is adequate.CDC+1

10. Protein supplements (whey or plant-based)
If a person has poor appetite, a protein supplement (such as whey or soy protein, 20–30 g per serving) can help reach daily protein needs. Protein provides amino acids for building new tissue, antibodies, and immune cells. Meeting protein requirements supports faster healing of ulcers and recovery from infection, especially in undernourished individuals.CDC+1

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Immune-Support and Regenerative / Stem-Cell–Related Drugs

For chancroid, there are currently no standard or approved “stem cell drugs” or specific regenerative medicines. Management relies on antibiotics and good general care; the body’s own repair systems heal the ulcers. Some immune-modulating or regenerative therapies are being studied for other chronic wounds or infections, but they are not routine or necessary for chancroid, which usually heals well with conventional treatment.CDC+1

Because of this, doctors focus on:

1. Choosing the right antibiotic regimen (azithromycin, ceftriaxone, ciprofloxacin, or erythromycin).

2. Correcting underlying problems like uncontrolled diabetes, malnutrition, or HIV infection when present.

3. Using general measures that boost natural immunity, such as vaccines for other infections when indicated, healthy diet, and stopping smoking.

Any “immune-booster drug” or stem-cell–based therapy advertised for chancroid outside a clinical trial should be viewed with great caution, as it is not evidence-based and may be unsafe or a scam.CDC+1

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Surgical Procedures

1. Needle aspiration of fluctuant buboes
When groin lymph nodes become very enlarged, soft, and filled with pus (“fluctuant buboes”), a doctor may use a sterile needle to aspirate (draw out) the pus. This reduces pain and pressure, helps skin avoid breaking on its own, and speeds recovery when combined with antibiotics. Aspiration is usually done under local anaesthetic in a clinic.CDC+2IUSTI+2

2. Incision and drainage of buboes
If buboes are too large or thick for needle aspiration alone, a small sterile cut may be made to drain pus, followed by gentle irrigation and dressings. This procedure prevents spontaneous rupture, which can create large, difficult-to-heal ulcers and significant scarring. It is usually reserved for advanced cases and always combined with systemic antibiotic therapy.CDC+2IUSTI+2

3. Surgical debridement of necrotic tissue
In rare, severe cases where ulcers become deep with dead (necrotic) tissue, a surgeon may gently remove non-viable tissue to create a clean wound bed. Debridement helps healthy tissue grow and reduces bacterial load. It is followed by careful dressings and continued antibiotics. This is not needed in most chancroid cases, which usually heal with medical therapy alone.IUSTI+1

4. Circumcision (selected male patients)
If a male patient has repeated foreskin problems, phimosis (tight foreskin), or chronic scarring related to chancroid ulcers, circumcision may be considered after the active infection has been fully treated. Removing the foreskin can improve hygiene, reduce friction, and lower risk of future ulcers or infections in some men. This is a long-term structural measure, not an acute treatment.IUSTI+1

5. Reconstructive surgery for severe scarring or fistulas
Very rarely, untreated or advanced chancroid can cause genital scarring or abnormal tracts (fistulas) between the genital area and nearby structures. In such cases, plastic or reconstructive surgery may be used to restore normal anatomy and function. These operations are complex and are only considered after infection has been fully cured and tissues are stable.CDC+2IUSTI+2

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Prevention Tips

1. Use condoms correctly every time during vaginal, anal, and oral sex.

2. Limit the number of sexual partners and avoid overlapping relationships.

3. Have regular STI check-ups if you are sexually active, especially with new or multiple partners.

4. Seek medical care quickly if you notice any genital sore, ulcer, or unusual discharge.

5. Do not have sex if you or your partner has visible sores or feels unwell from a possible STI.

6. Avoid sharing sex toys, or clean and cover them properly between partners.

7. Discuss STI history openly with partners and encourage mutual testing.

8. Reduce alcohol and drug use that may lead to unprotected sex.

9. Get recommended vaccines (for example hepatitis B and HPV) to reduce other STI risks.

10. Follow public health advice during local outbreaks and support STI education in your community.CDC+2CDC+2

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When To See a Doctor

You should see a doctor or sexual health clinic as soon as possible if you notice a painful genital ulcer, especially if it has soft, ragged edges or is accompanied by swollen, tender groin lymph nodes. Seek urgent care if you have fever, spreading redness, very severe pain, difficulty urinating, foul-smelling discharge, or if ulcers do not improve within a week of starting treatment. Also see a doctor if a partner is diagnosed with chancroid or another STI, even if you feel well, so you can be tested and treated early.CDC+2DermNet®+2

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What To Eat and What To Avoid

Helpful foods (what to eat)

1. Fresh fruits rich in vitamin C (oranges, guava, berries) to support collagen and immunity.

2. Colourful vegetables (spinach, carrots, tomatoes) for vitamins, minerals, and antioxidants.

3. Lean proteins (fish, eggs, pulses, skinless chicken) to provide building blocks for tissue repair.

4. Whole grains (brown rice, oats, whole-wheat bread) for steady energy and fibre.

5. Fermented foods or yogurt with live cultures to support gut health, especially during antibiotics.

Foods and substances to limit or avoid
6. Very sugary drinks and sweets, which may impair immunity and worsen blood sugar control.
7. Deep-fried and very fatty fast foods that add little nutrition and may increase inflammation.
8. Excessive alcohol, which harms immune function and may interact with medicines.
9. Tobacco in any form, as it reduces blood flow and slows wound healing.
10. Unregulated “miracle” herbal products claiming to cure STIs, which may be unsafe or delay proper care.CDC+1

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Frequently Asked Questions (FAQs)

1. Is chancroid curable?
Yes. Most cases of soft chancre are completely curable with the correct antibiotic regimen and good wound care. Healing of ulcers usually begins within a few days and continues over 1–2 weeks, although some scarring may remain in advanced cases. Early treatment gives the best results and prevents spread to partners.CDC+2DermNet®+2

2. Can I treat chancroid at home without seeing a doctor?
No. Because genital ulcers can be caused by several infections, including syphilis and herpes, only a trained clinician can make the correct diagnosis. Home remedies, over-the-counter creams, or antibiotics taken without guidance can hide symptoms, make diagnosis harder, and increase complications. Professional assessment and laboratory testing are strongly recommended.CDC+2DermNet®+2

3. How long after starting antibiotics am I no longer infectious?
Guidelines suggest that when the right antibiotic is used and taken correctly, infectivity drops quickly, often within a few days, but you should still avoid sex until ulcers have fully healed and your clinician confirms it is safe. Having sex too early can risk transmission or re-injury of healing tissue.CDC+1

4. Do both partners need treatment?
Yes. Recent sexual partners (usually within the last 10 days before symptoms) should be examined and treated even if they do not have obvious sores, because people can carry H. ducreyi without symptoms. Treating partners prevents reinfection and protects the wider community.CDC+1

5. Can chancroid increase my risk of HIV?
Yes. Any genital ulcer makes it easier for HIV to enter the body or be passed on, because the protective skin barrier is broken and inflammatory cells are concentrated in the area. Treating chancroid quickly and practising safer sex reduces this added risk.CDC+2DermNet®+2

6. How is chancroid different from syphilis and genital herpes?
Chancroid ulcers are usually very painful, have soft, ragged edges, and may be multiple; syphilis ulcers often start as a single, firm, painless sore, and herpes causes clusters of small blisters that burst into shallow painful ulcers. Laboratory tests are needed because clinical appearance alone is not always reliable.CDC+2DermNet®+2

7. What if my ulcers do not improve after treatment?
If there is no clear improvement within 3–7 days, you should return to your doctor. Possible reasons include wrong diagnosis, co-infection, resistant bacteria, poor adherence, or immune problems such as HIV. The clinician may repeat tests, change antibiotics, or look for other causes.CDC+2Medscape eMedicine+2

8. Can I get chancroid again after being cured?
Yes. Previous infection does not give reliable long-term immunity. You can become infected again if you have unprotected sex with someone who has chancroid. Safer-sex practices, partner treatment, and regular STI screening are important even after a successful cure.CDC+2DermNet®+2

9. Is chancroid common today?
In many high-income countries, chancroid has become rare, but it may still occur in some regions and in certain populations with limited access to STI care. Because it is now uncommon in many places, it can be misdiagnosed or missed without proper testing.IUSTI+1

10. Can I go to school or work if I have chancroid?
Yes, chancroid is not spread by casual contact, shared toilets, or normal social activities. You can usually continue school or work if you feel well enough. However, you should avoid sexual activity until your doctor says it is safe, and follow all treatment and follow-up instructions carefully.CDC+1

11. Will chancroid affect my ability to have children later?
Chancroid mainly affects external genital skin and lymph nodes. When treated promptly, long-term fertility problems are unlikely. However, repeated STIs or severe scarring can sometimes have indirect effects on sexual function and relationships, so early diagnosis and safer sex are still very important.CDC+2DermNet®+2

12. Is there a vaccine for chancroid?
At present, there is no vaccine specifically for Haemophilus ducreyi or chancroid. Prevention relies on safer-sex practices, prompt diagnosis, partner treatment, and strong STI services. Research into vaccines for various STIs is ongoing, but nothing is yet available for chancroid.CDC+1

13. Can I use over-the-counter antibiotic creams on the ulcers?
Over-the-counter topical antibiotic creams are not enough to treat chancroid, because the infection is deeper in the skin and systemic. Using them without systemic therapy can delay proper treatment and sometimes cause allergic reactions or resistance. Systemic antibiotics prescribed by a clinician are essential.CDC+2IUSTI+2

14. What should I tell my healthcare provider during the visit?
You should describe your symptoms fully, including when they started, any sexual partners in the last weeks, previous STIs, allergies, and all medicines or supplements you take. Honest information helps the clinician choose the safest and most effective tests and treatments, and all information is usually kept confidential.CDC+1

15. How can I protect myself in the future?
Use condoms correctly every time, limit partners, get regular STI screening, avoid sex when either partner has sores, keep good general health through diet and sleep, and seek medical advice early if you notice genital changes. Encouraging partners to do the same creates a safer environment for everyone.CDC+2Mission MRCog+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.