Chancroid symptoms are one or more deep, painful genital ulcers along with tender, swollen lymph nodes in the groin that can fill with pus. The ulcers are soft and ragged, and they hurt, which sets chancroid apart from the painless sore of early syphilis. It's caused by bacteria and is now rare in the United States.
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 is chancroid?
Chancroid is a bacterial sexually transmitted infection caused by Haemophilus ducreyi, a classic cause of painful genital ulcers CDC, 2021. The bacteria enter through tiny breaks in the skin during sexual contact, then multiply at the site and trigger an inflammatory sore. In the U.S. it has become uncommon, so most American clinicians see it rarely, and at first glance it's easy to mistake for herpes or syphilis. It remains more frequent in parts of Africa, the Caribbean, and Asia, so a travel or partner history can be the clue that points a clinician toward it.
What are the symptoms of chancroid?
The hallmark is a painful ulcer. Within a few days of exposure a small tender bump appears, then breaks down into an open sore with a soft, undermined edge and a grayish or yellowish base that may bleed when touched. You can have one ulcer or several. They're frequently described as exquisitely tender, and touching, urinating near them, or sex can be sharply painful.
The second classic feature is bubo formation. The lymph nodes in the groin on the same side as the ulcer swell, become tender, and can fill with pus; if a node ruptures, it drains and leaves an open, slow-healing wound. A painful soft ulcer plus a painful, swollen groin node is the textbook picture clinicians look for.
With chancroid the trap is misreading it rather than missing it. Because the ulcers hurt, people tend to notice them, but they're easy to write off as a herpes outbreak or an ingrown irritation, and the buboes can be mistaken for a swollen gland from another cause. Anyone with painful genital sores should get them looked at rather than guessing.
Soft chancre vs. hard chancre: chancroid vs. syphilis
The single most useful distinction is pain. The chancroid ulcer, the "soft chancre," is painful, soft to the touch, and often comes with tender groin nodes. The syphilis ulcer, the "hard chancre," is usually painless, firm and rubbery at the edge, and typically appears as a single sore. Herpes, the third common cause of genital ulcers, tends to start as a cluster of small painful blisters that crust over.
| Feature | Chancroid (soft chancre) | Syphilis (hard chancre) | Genital herpes |
|---|---|---|---|
| Pain | Painful | Usually painless | Painful |
| Edge / texture | Soft, ragged, undermined | Firm, clean, raised | Shallow, follows blisters |
| Number | One or several | Often single | Multiple, clustered |
| Groin nodes | Tender, may turn to pus (buboes) | Firm, non-tender | Tender, no pus |
| Cause | Bacteria (H. ducreyi) | Bacteria (T. pallidum) | Virus (HSV) |
How does chancroid spread?
Chancroid spreads through sexual contact, when the bacteria pass from an infected person's ulcer or skin to a partner's genital skin or mucosa. Direct contact with an open sore is the main route, so partners of someone with active ulcers are at clear risk. Open ulcers of any kind also make the surrounding tissue more vulnerable, and chancroid sores are a recognized risk factor for both catching and passing on HIV, since the breaks in the skin give the virus an easier entry and exit point.
How is chancroid tested and diagnosed?
Diagnosis is usually clinical and works by exclusion. A clinician makes a probable diagnosis when you have painful genital ulcers with the typical appearance, the groin nodes that go with it, and your syphilis and herpes tests come back negative. A definitive diagnosis means growing H. ducreyi, which requires special culture media that most labs don't carry, so the bacteria are often not formally confirmed even when the picture is convincing.
Evaluating a genital ulcer is straightforward and not painful in itself: a clinician examines the sore, swabs it or nearby tissue, and orders blood and swab tests to rule out the look-alikes. Most STI testing is done from a simple sample, a urine cup, a self-collected swab, or a quick exam, with results usually 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 sore could show up after contact, see when to test after exposure. When you're ready, you can get tested or compare testing providers to find an option that fits.
How is chancroid treated?
Chancroid is curable with antibiotics, and some regimens work in a single dose. The CDC lists a single oral dose of azithromycin or a single ceftriaxone injection as first-line, with a few-day course of ciprofloxacin or a one-week course of erythromycin as alternatives. Your clinician will plan a recheck a few days after you start, both to confirm the ulcer is improving and to drain a large bubo if needed.
Finish every dose even after the pain eases, and ask whether your partner needs treating so you don't pass it back and forth. Healing can be slower in uncircumcised men and in people with HIV, who sometimes respond less well and may need closer follow-up or a longer course. For the full breakdown, see the 4 possible treatment options for chancroid std bacteria.
Treating partners is part of the cure. Anyone you had sex with in the days before your symptoms began should be examined and treated even if they feel completely fine, since an untreated partner can reinfect you or carry the infection forward silently.
What happens if chancroid is left untreated?
Without treatment, the ulcers can persist and deepen, and the swollen groin nodes can progress to large, fluctuant buboes that rupture and drain, leaving open wounds that scar and heal slowly. Because the sores breach the skin barrier, untreated chancroid raises the risk of acquiring and transmitting HIV, with the inflamed, ulcerated tissue acting as both a gateway for the virus and a source of it. Don't wait and watch a painful genital sore.
How do you prevent chancroid?
Because chancroid spreads by direct sexual contact, the same basics that protect against other STIs apply here.
- Use condoms every time. They lower risk for the sexually transmitted infections, though they can't cover every sore.
- Avoid sexual contact with anyone who has visible or painful genital ulcers until they've been evaluated and treated.
- Get partners examined and treated together so the infection isn't bounced back and forth.
- Keep up routine STI testing. It catches infections that have no symptoms, and look-alikes like syphilis often do hide silently.
When should you see a clinician?
See a clinician promptly for any new genital ulcer or sore, especially a painful one or one paired with a tender lump in the groin. Don't try to sort soft chancre from hard chancre on your own; the distinction matters and the tests are quick. Clinics handle genital ulcers daily, and this diagnosis is common and treatable. Getting seen early means a faster cure, less scarring, and lower HIV risk.