Chancroid: Symptoms, Causes and Treatment via UK Online Doctor

Chancroid is a bacterial sexually transmitted infection (STI) caused by the organism Haemophilus ducreyi. Although it is relatively uncommon within the United Kingdom compared to infections like chlamydia or gonorrhoea, it remains a significant cause of genital ulcer disease globally, particularly in parts of Africa, Asia, and the Caribbean.

Unlike syphilis, which typically produces a painless sore (chancre), the hallmark of chancroid is the development of one or more painful ulcers on the genitals. These sores are often accompanied by painful swelling of the lymph nodes in the groin, a condition known as lymphadenitis or 'buboes'. Because the symptoms can mimic other more common conditions, it is essential to seek professional medical advice for an accurate diagnosis.

Symptoms of chancroid usually appear within three to seven days after exposure. The progression of the infection typically follows a specific pattern:

• Initial Bump: A small, red, raised bump appears on the genitals.
• Ulceration: Within a day or two, the bump turns into an ulcer. These ulcers are typically deep, have ragged edges, and are extremely painful to the touch.
• Base of the Sore: The base of the ulcer is often covered with a greyish or yellowish material and may bleed easily if bumped or scraped.
• Swollen Lymph Nodes: In about half of infected individuals, the lymph nodes in the groin become swollen and hard. If left untreated, these can develop into large, pus-filled abscesses (buboes) that may eventually rupture through the skin.

In women, symptoms can sometimes be more subtle or involve internal ulcers that cause pain during urination or bowel movements, making the infection harder to self-identify without a clinical examination.

Chancroid is transmitted through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. The bacteria enter the body through tiny abrasions or micro-tears in the skin or mucous membranes.

As with many other STIs that cause open sores, having chancroid significantly increases the risk of contracting or transmitting other infections, such as HIV. This is because the open ulcers provide an easy entry or exit point for viruses and bacteria into the bloodstream. In the UK, most cases are identified in individuals who have recently travelled to regions where the bacteria is more prevalent, emphasizing the importance of a detailed travel history when speaking with a healthcare professional.

Diagnosing chancroid can be challenging because Haemophilus ducreyi is difficult to grow in a standard laboratory culture. Most UK diagnoses are made based on NICE clinical guidelines, which involve excluding other causes of ulcers, such as genital herpes and syphilis.

A healthcare provider will typically perform a physical examination and take a swab from the base of the ulcer. This swab is then sent for specialised PCR (Polymerase Chain Reaction) testing. Because chancroid is rare in the UK, clinicians will often test for a full panel of STIs simultaneously to ensure no co-infections are missed. If you are experiencing painful sores, it is vital to avoid sexual contact until you have received your results and completed any necessary treatment.

The good news is that chancroid is completely curable with the correct antibiotics. Following NHS guidance, first-line treatments usually involve a single dose of azithromycin or a short course of ciprofloxacin or erythromycin. Your clinician will determine the best medication based on your medical history and any potential allergies.

Key aspects of recovery include:

• Completing the Course: Even if the sores begin to heal quickly, you must finish the entire duration of the prescribed antibiotics.
• Partner Notification: Any sexual partners from the last 10 days should be informed, examined, and treated, even if they do not have symptoms.
• Abstinence: You must avoid all sexual contact until the ulcers have completely healed and your doctor has confirmed the infection has cleared.
• Wound Care: Keeping the area clean and dry helps prevent secondary bacterial infections and promotes faster skin healing.

If you notice any unusual lumps, bumps, or painful sores in your genital area, speaking to a GP online is a discreet and fast way to receive initial medical advice. An online doctor in the UK can help assess your symptoms, discuss your travel history, and advise on the next steps for testing.

While physical swabs must be taken in person at a clinic, an online consultation allows you to share your concerns in a confidential environment, receive a referral to a local sexual health specialist, and understand which medications may be required. If your symptoms are clear and consistent with clinical diagnostic criteria, our doctors can provide the necessary guidance to ensure you access the right care without delay.