Chancroid: What is it, symptoms and treatment

If you are sexually active, you should be aware of the various sexually transmitted infections. The spotlight is usually on syphilis, gonorrhoea and chlamydia. That’s probably because they are more common across the globe. However, you should also be aware of chancroid, which is a rare, but painful sexually transmitted infection. This infection can lead to ulcers down there, and can increase the risk for Human immunodeficiency virus or HIV transmission. The good news is that there are antibiotics that can help to treat it.

What is chancroid?

It is a sexually transmitted infection (STI) caused by the bacterium Haemophilus ducreyi, which infects the skin and mucous membranes of the private parts. “It leads to painful genital ulcers and swollen lymph nodes in the groin,” says obstetrician and gynaecologist Dr Chetna Jain. Chancroid is rarely seen in America, but there may be cases in some areas of Africa, the Caribbean and Asia, as per research published in the International Journal Of Dermatology in 2007.

“It can spread by having unprotected vaginal, anal, or oral sex with an infected person. The bacteria can also enter a person through small cuts or abrasions in the skin,” says the expert. Poor genital hygiene can increase the risk, and sharing contaminated towels, underwear, or sex toys may spread the bacteria. It can also increase the chances of developing HIV infection by 50- to 300-fold per each unprotected encounter of vaginal sex, as per research published in StatPearls in 2023.

What are the symptoms of chancroid?

The symptoms of chancroid usually appear 3 to 10 days after the infection, and include:

• Soft, open sores with irregular edges and a greyish-yellow base on the genitals.
• The ulcers bleed easily and may also release pus.
• Groin lymph nodes become enlarged, tender, and may form pus-filled lumps.
• The skin over swollen nodes can turn red and warm, sometimes leading to rupture and pus drainage.
• Burning sensation or pain during sexual activity or urination, especially if the ulcers are near the urethra or vagina.

How is chancroid diagnosed?

Chancroid is diagnosed based on clinical examination and a few tests to confirm the presence of Haemophilus ducreyi.

• During physical examination, the doctor will check for painful genital ulcers with irregular edges and a soft base.
• A swab from the ulcer will be cultured to check for Haemophilus ducreyi.
• A smear of ulcer pus will be examined under a microscope.

“Since chancroid symptoms are similar to other STIs like syphilis, which can lead to painless sores and a rash down there, doctors may tell you take the syphilis test,” says Dr Jain. A ample of blood or a swab of fluid may be taken from one of the sores to check if you have syphilis or chancroid.

How to treat chancroid?

The bacterial sexually transmitted infection can be treated in the following ways:

1. Antibiotics

It can be treated effectively with antibiotics that kill Haemophilus ducreyi. According to the US Centres for Disease Control and Prevention, the following antibiotics can help:

• Azithromycin (1 gram orally as a single dose)
• Ceftriaxone (250 mg intramuscular injection as a single dose)
• Erythromycin (500 mg orally, three times a day for seven days)
• Ciprofloxacin (500 mg orally, twice a day for three days)

Note: No medication should be taken without the consultation of a doctor.

“Resistance to antibiotics is uncommon but can occur, especially in people with weakened immune systems like people who are HIV-positive,” says Dr Jain. In most cases, the antibiotics can reduce the symptoms and speed up ulcer healing.

2. Treatment for swollen lymph nodes

If the lymph nodes are swollen and filled with pus, a doctor may drain them with the help of a needle or go for a small incision. “This prevents the formation of abscess or buildup of a pus), and speeds up healing,” says the expert.

3. Care at home

Apart from medical treatment, keep the ulcers clean by washing with mild soap and water every single day. “Avoid sex until you full recovery so that you don’t spread the infection. Also, maintain a healthy diet to support healing,” says the expert. Go for protein-rich foods like eggs, chicken and lentils to help with tissue repair. “Also, avoid smoking and alcohol, which are bad habits that can slow down healing,” says the expert. Make sure to get adequate sleep and proper hydration, as these can help to promote faster recovery.

“With treatment, you will notice the ulcers healing within 3-7 days and fully resolve in 2 weeks,” says the expert. Swollen lymph nodes may take longer time to heal, especially if they needed drainage.

You should regularly go for STI check-ups, especially if your are sexually active and have multiple partners. “Also, any of your recent sexual partners should be tested and treated for this infection, even if they don’t show symptoms,” suggests the expert.

Chancroid is a rare sexually transmitted infection that can be treated with proper antibiotic therapy and care. If left untreated, it can lead to painful sex, and increase the risk for HIV transmission.