Chancroid is treated with antibiotics, and there are four options: a single oral dose of azithromycin, a single ceftriaxone injection, a short course of ciprofloxacin pills, or a week of erythromycin. A single-dose regimen cures most cases, and your clinician re-checks the ulcers a few days after you start CDC, 2021.
with the right treatment
testing, not symptoms, decides
| Item | Value |
|---|---|
| Curable? | yes — with the right treatment |
| Tested by | exam + lab |
| If you may have it | get tested — testing, not symptoms, decides |
What chancroid actually is
Chancroid is a bacterial sexually transmitted infection caused by Haemophilus ducreyi, and its calling card is one or more painful genital sores. The bacteria enter through tiny breaks in the skin during sexual contact, multiply at the site, and trigger an ulcer that erodes the surface tissue. In the United States it's now rare, and most American clinicians may go years without seeing a case. It still circulates in parts of the world and shows up in travelers and their partners.
It matters out of proportion to how common it is because an open, raw ulcer is a doorway. Chancroid sores make it easier both to acquire HIV and to pass it on, so a single painful ulcer can carry a much larger health consequence than the sore itself.
Symptoms — and what the sore actually feels like
The hallmark is one or more deep, painful genital ulcers. They typically have ragged, undermined edges and a soft, often pus-coated base, and they hurt. That pain is the most useful clue for telling chancroid apart from syphilis, whose classic sore (the chancre) is firm and painless. Many people also develop tender, swollen lymph nodes in the groin that can fill with pus and, if untreated, rupture and drain.
Because the ulcer is painful, chancroid is rarely silent the way chlamydia or gonorrhea often are, and people usually notice and seek care. Still, a sore on its own doesn't tell you which infection caused it, so the full picture and lab work matter. If you want the longer breakdown of how the ulcer looks and progresses, see our guide to chancroid symptoms.
How chancroid spreads
Chancroid spreads through sexual contact, when the bacteria pass from an infected person's ulcer or secretions to a partner's skin or mucous membranes. There's no airborne, toilet-seat, or casual route. Anyone sexually active can get it, but uncircumcised men appear to be more susceptible and may not respond to treatment as well, and people living with HIV can also respond less completely. Both groups sometimes need closer follow-up.
How chancroid is tested and diagnosed
Diagnosis is part exam, part ruling out the lookalikes. Most clinicians make a probable diagnosis when someone has painful genital ulcers with the typical appearance and tests come back negative for syphilis and for herpes, the two infections most easily mistaken for it. A definitive diagnosis means actually growing H. ducreyi, which requires special culture media that few labs stock, so confirmation isn't always practical.
In practice, getting checked is straightforward: an exam of the sore plus blood or swab samples to exclude syphilis and herpes. Sampling for STIs is usually quick — a urine cup, a self-collected swab, or a brief exam — with results typically back in a few days, and it's free or low-cost at health departments, Planned Parenthood, and Title X clinics. If you're not sure how soon a test will be reliable after a possible exposure, read when to test after exposure, and you can get tested or compare testing providers to find an option near you.
The 4 treatment options for chancroid
Chancroid is curable with antibiotics, and current CDC guidance lists four regimens. Two are single-dose, with nothing to remember after you leave, and two are short courses you finish at home.
| Regimen | How it's given | Schedule |
|---|---|---|
| Azithromycin 1 g | By mouth | Single dose |
| Ceftriaxone 250 mg | Injection into muscle (IM) | Single dose |
| Ciprofloxacin 500 mg | By mouth | Twice daily for 3 days |
| Erythromycin base 500 mg | By mouth | Three times daily for 7 days |
Whichever you and your clinician choose, you should be re-examined three to seven days after starting therapy to confirm the ulcer is improving, since it should start to heal within that window. If it isn't, reconsider the diagnosis, check for HIV, or account for the slower response seen in uncircumcised men and people with HIV.
A few practical notes. If you're given pills, finish the entire course even after the sore feels better, because stopping early invites the infection to come back. And ask about your partners directly: anyone you had sex with in the ten days before your symptoms began should be examined and treated, even if they have no sores, both to protect them and to keep you from getting reinfected.
What happens if chancroid goes untreated
Left alone, chancroid doesn't reliably clear on its own, and the consequences compound. The groin lymph nodes can swell into a fluctuant, pus-filled mass (a bubo) that may rupture through the skin and leave a draining sore that's slow to heal. The genital ulcers themselves can enlarge, merge, and destroy tissue, sometimes needing drainage. The most serious downstream risk is HIV: an untreated ulcer markedly raises the chance of acquiring HIV during sex and of transmitting it to a partner, so treating chancroid is also HIV prevention.
How to prevent chancroid
The same fundamentals that lower risk for other sexually transmitted infections apply here. Condoms used every time reduce risk, though a sore outside the area a condom covers can still transmit, so they help most when the ulcer is on the covered skin. Avoid sexual contact with anyone who has visible genital sores until they've been evaluated. And because partners may carry the bacteria without symptoms, treating recent partners is part of stopping the chain.
- Use condoms consistently to lower the risk of transmission.
- Hold off on sex when you or a partner has an unexplained genital sore until it's checked.
- Make sure partners from the ten days before your symptoms started are examined and treated.
- Keep up routine STI testing, which catches the infections that show no symptoms at all.
When to see a clinician
See a clinician promptly for any painful genital sore, especially with tender, swollen lumps in the groin, since that combination is what chancroid produces and it's worth ruling out syphilis and herpes at the same visit. Go sooner if a sore is enlarging, draining, or not healing, or if you've had a partner with similar symptoms. A diagnosis here is common, treatable, and handled at clinics every day; it says nothing about you as a person, and the sooner it's treated the lower the HIV risk that rides along with it.