Hesperian Health Guides
Sores and growths on the genitals (genital ulcers)
HealthWiki > A Book for Midwives > Chapter 18: Sexually transmitted infections > Sores on the genitals (genital ulcers)
Sores on the genitals should be kept clean. Wash them with soap and water. Dry them carefully. Wash any cloth that you dry them with before you use it again.
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WARNING! Other infections, especially HIV, can easily pass through sores on the genitals during sex. The best way to prevent passing infections from one person to another is to not have sex until your or your partner’s sores have healed. |
Contents
Syphilis
Syphilis is a serious STI that affects the whole body. It can last for many years, getting worse and worse. Syphilis can be cured if it is treated early.
Signs of syphilis
- The first sign is a sore that may look like a pimple, a blister, or an open sore. It usually appears about 3 weeks after sex with a person who has syphilis, but sores can appear from 1 week to 3 months after sex. This sore is full of germs, which pass easily to another person.
syphilis sore on a penis
The sore does not hurt, and if it is in a place that a person doesn't notice it (inside the vagina, the anus, or the throat) a person may not know she has it. But she can still infect anyone she has sex with. The sore lasts for only a few days or weeks and then goes away. But the infection is still there and continues to spread throughout the body. - Weeks or months later, the infected person may get a sore throat, mild fever, swollen joints, or a rash — especially on the palms of their hands, soles of their feet, belly, and sides. This rash contains syphilis germs which can be passed to others.
Other signs are white patches or gray warts in the mouth or near the genitals. These contain large amounts of syphilis germs which can be passed to others. - All of these signs usually go away by themselves, but the disease continues. If a person with syphilis does not get treatment early, the syphilis germs can cause heart disease, paralysis, mental illness, and death.
Syphilis and pregnancy
blood test to
be sure you
do not have
syphilis.
If a woman has syphilis when she is pregnant, her baby can be born too early, with a disability, or dead. Every pregnant woman should get a blood test to check for syphilis — especially if she has ever had sores on her genitals.
| To treat syphilis |  |
 | |||
| If the person has had syphilis less than 2 years | |||||
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in the muscle, 1 time only | ||||
| or if the person is allergic to penicillin: | |||||
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by mouth, 4 times a day for 14 days | ||||
| or | |||||
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by mouth, 1 time only | ||||
| If the person has had syphilis for 2 years or more, or if you don’t know how long the person has had syphilis | |||||
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in the muscle, 1 time a week for 3 weeks | ||||
| or if the person is allergic to penicillin: | |||||
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by mouth, 4 times a day for 30 days | ||||
| Also give the same medicines to the woman’s partner. The erythromycin or azithromycin will treat the pregnant person but will not treat the baby. You will need to treat the newborn baby for syphilis soon after delivery. | |||||
WARNING! It is very hard to tell the difference between syphilis and chancroid. If you are not sure whether the woman has syphilis or chancroid or both, treat for both. Also treat for both if both are common in your area.
Chancroid
Chancroid is an STI that causes sores on the genitals. It is easily confused with syphilis.
Signs of chancroid
- one or more soft, painful sores on the genitals or anus that bleed easily
- enlarged, painful glands (buboes) in the groin
- slight fever
| To treat chancroid |  |
 | |||
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by mouth, 1 time only | ||||
| or | |||||
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in the muscle, 1 time only | ||||
| or | |||||
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by mouth, 4 times a day for 7 days | ||||
Genital herpes
Genital herpes is caused by a virus that produces painful blisters which burst and turn into sores on the skin (an outbreak). Herpes spreads when skin touches skin, as with vaginal or anal sex. Genital herpes usually affects the genitals or anus. Rarely do the sores spread to the mouth during oral sex.
Signs of herpes
- tingling, itching, or pain on the genitals
- small blisters that burst and form painful open sores on the genitals
Once a person has the virus, they can get sores many times. The first time a person has herpes sores, they can last 3 weeks or more. The person may also have fever, headaches, body aches, chills, and swollen lymph nodes near the genitals. Later outbreaks are usually not as bad as the first one.
Herpes is more likely to spread when someone has a sore, but it can also spread when there are no signs. People with herpes should not have sex when they have a sore and should use condoms when they do not have sores. Internal (female) condoms may work better because they cover more of the genitals.
Treatment
To make the sores feel better:
- Put ice on the sore as soon as you feel it. This may stop the sore from getting worse.
- Soak a cloth in cooled black tea or tea made of cloves. Hold the wet cloth on the sores.
- Sit in a pan or bath of clean cool water.
- Mix water and baking soda or cornstarch into a paste and put it on the sore area.
- Apply witch hazel or a local plant that makes the skin dry.
There is no cure for herpes but these medicines may lessen the length and pain of outbreaks.
| For a first herpes outbreak |  | ||||
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by mouth, 3 times a day for 7 to 10 days | ||||
| For continuing herpes outbreaks | |||||
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by mouth, 3 times a day for 5 days | ||||
| For a woman with more than 6 herpes outbreaks a year | |||||
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by mouth, 2 times every day for 1 year. Then stop and see if the medicine is still needed. | ||||
| For a pregnant woman who has a herpes outbreak during her pregnancy | |||||
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by mouth, 4 times every day during the last month of pregnancy | ||||
| To help with pain | |||||
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by mouth, every 4-6 hours, until the pain goes away (do not take more than 4000 mg in a day) | ||||
A person with a lot of stress or other health problems is likely to get sores more often. People with herpes should try to get plenty of rest and eat healthy food.
WARNING! Herpes is very dangerous for the eyes and can cause blindness. After touching a herpes sore, always wash your hands with soap and water.
Herpes and pregnancy
It is possible for herpes to be passed from mother to baby, usually during birth if the mother has vaginal sores at that time. A first-time infection during pregnancy is even more likely to pass to the baby. For this reason, a woman in labor with an active herpes sore should give birth in a hospital, usually by caesarean surgery. Risk can be reduced or prevented by treating a first-time herpes outbreak immediately with acyclovir, whenever during pregnancy it occurs. A woman who already has herpes and experienced an outbreak during pregnancy can use acyclovir daily during the last month of pregnancy.
Genital warts
Warts on the genitals or anus are caused by a virus (human papillomavirus, HPV). It is possible to have warts and not know it, especially if they are growing inside the vagina or inside the tip of the penis. The warts are not dangerous, but they can be uncomfortable.
Signs of genital warts
- Itching.
- Small, dry bumps on or near the genitals or anus. The bumps do not hurt and may be red, brown, white, or the color of your skin.
To test for HPV: touch the warts with a mixture of plain vinegar and water. The warts will turn a whitish color if they are caused by HPV. Learn how to test the cervix for other medical problems caused by HPV.
WARNING! Large, flat, wet growths that look like warts are not usually HPV. They may be caused by syphilis. Anyone with these growths should be tested for syphilis and not use the following treatment.
Treatment
- To protect the healthy skin, put petroleum jelly (Vaseline) or another greasy ointment on the skin around each wart.
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With a small stick, put a little trichloroacetic acid (TCA) 80% to 90% solution or bichloroacetic acid (BCA) on the wart. Leave the acid on until the wart turns white. Be careful not to spill the acid on the healthy skin. Wash the acid off after 30 minutes or if the burning feeling is very painful.
The acid should burn the wart off and leave a painful sore where the wart used to be.
Repeat the treatment once a week for 4-6 weeks for the wart to go away completely. Keep the sore clean and dry until it heals. The woman should not have sex until the sore heals.
Another medicine that treats genital warts is called podofilox. It is easier to use than TCA or BCA. For more information about podofilox, see Where There Is No Doctor or Where Women Have No Doctor.
There are vaccines that protect against HPV infection. All protect against the types of HPV that cause most of the cervical cancer in the world and the types that cause most genital warts. It is best to vaccinate all children and young people against HPV before they become sexually active.