Hesperian Health Guides

Syphilis and Chancroid

Syphilis is a serious STI that over time affects the whole body. The first sign is a painless sore that goes away. If the person does not notice it and does not get treated, the syphilis will stay in the body. All pregnant women should be tested for syphilis and treated so it does not pass to the baby and cause the baby to be born too early, deformed, or dead. If you have HIV or another STI, often a health worker will test you for syphilis too.

Chancroid is a STI caused by bacteria that causes painful sores on the genitals and enlarged, very painful lymph nodes. Like syphilis, if treated early it can be cured with medicines.

If you are not sure whether a person has one or the other or both syphilis and chancroid, treat for both. Also treat for both if a test shows both or if both are very common in your area. See Medicine Combinations to Treat Both Syphilis and Chancroid. Treat the person’s partner or partners with the same medicines.

Other infections can easily pass through a sore on the genitals, especially hepatitis B, HIV, and other STIs. To prevent spreading or getting these infections, get treatment and avoid sex until the sores heal.

Keep the sores clean while they are healing. Wash them every day with soap and water, and dry carefully. Do not let anyone else use the cloth you dry with.

Syphilis or chancroid sore on a man’s penis Syphilis or chancroid sores on a woman’s genitals
a man's and a woman's genitals with sores
Although syphilis and chancroid both start with sores, sores from syphilis usually are not painful. A chancroid sore is usually painful.
Signs of syphilis

The first sign is usually a small, painless sore, called a chancre, which appears 2 to 5 weeks after sexual contact with a person who has syphilis. The chancre at first looks like a bump, then it breaks open to form a sore. It usually appears in the genital area but may also appear on the mouth or anus. In women, the sore might be inside the vagina and not noticed.

The sore lasts a few days to a few weeks and then goes away without treatment. Weeks or months later, you might get a rash (especially on the palms of the hands and soles of the feet), sore throat, mild fever, or mouth sores. Any strange rash or skin condition that shows up days or weeks after a sore on the genitals may be syphilis. Get tested and treated quickly. Without treatment, syphilis can spread to other parts of the body, causing heart disease, paralysis, mental impairment, and even death. Because syphilis is so dangerous, many countries have free testing programs.

Treatment for syphilis

The best treatment is benzathine penicillin injected in the muscle. If this is not available or the person has an allergy to penicillin, then use doxycycline by mouth. Erythromycin can be used but it is not as effective and the size of the dose can upset the stomach. Women who are pregnant should get help with treatment in a clinic or hospital.

Signs of chancroid

The sores from syphilis and chancroid can look the same but if the sore is painful and bleeds easily, it may be chancroid. Other signs of chancroid are swollen glands in the groin and low fever.

Treatment for chancroid

The best treatment is azithromycin by mouth. Or use one of these: ceftriaxone injected in the muscle, or by mouth, ciprofloxacin, or erythromycin.

This page was updated:16 Oct 2019