Ulcus molle, the soft chancre: what you should know

January 27, 2020

As far as sexually transmitted infections are concerned, most people know the 5 most common ones: Chlamydia, Gonorrhea, Genital Herpes, Genital Warts and HIV. However, there are a whole bunch of other sexually transmitted infections that most people know very little about, such as hepatitis B, trichomoniasis and syphilis, to name a few. Another little-known sexually transmitted infection is Ulcus molle, also called soft chancre. Would you be able to recognize the signs of this or know how to treat it?

The symptoms

Ulcus molle is an ulcerative disease, which is convenient in a certain way, as it makes it easy to diagnose. Unlike its silent relatives (chlamydia and Gonorrhoea, for example, are often asymptomatic), Ulcus molle causes various symptoms, but mostly causes painful ulcers in the private genital area.

The symptoms differ slightly between men and women. It is important, to know what to look for based on gender.

Men often develop only a single genital ulcer ( penile ulcer ), which starts as a small red bump and develops into an open wound within 1-2 days. Men can develop more than one ulcer, but this is unusual. The ulcer often appears at the tip of the penis, but can also appear in other parts of the genital area.

Women often feel no symptoms at all, or do not notice the symptoms at first. When symptoms become noticeable, it is the same type of genital ulcer as in men, but it is not unlikely that women will have 4 or more of them. They are often found on the inner and outer vaginal lips and can lie in a quasi symmetrical form on both sides of the vagina -these are called contact ulcers.

If you notice sore spots on your genitals, you may immediately think of genital herpes. However, it is important to make a correct diagnosis, as the treatment methods for the two diseases are quite different.


using condom to prevent STDs
While the sores caused by genital herpes look like small fluid vesicles and appear in groups, the ulcers caused by ulcer molle appear one by one. Initially they are small red bumps that look like pimples and develop into open wounds within a few days. Once the ulcer has burst open, it usually has a clear edge, a jagged or irregular shape and a deep-lying core that appears white or grey.

If the ulcers appear first, they can easily be confused with the abscesses caused by syphilis, but the difference is pain. Syphilis usually causes little or no pain, but ulcers caused by Ulcus molle are very painful and can start bleeding when touched or scratched. Their size also varies; they can range in size from 3 millimetres to 5 centimetres.

Additional symptoms for both men and women are swollen glands and pain when urinating or having sex (although sex with Ulcus molle is of course not recommended).

The causes

Like other sexually transmitted diseases, Ulcus molle is transmitted through sexual intercourse or other sexual contact - the term "sexually transmitted disease" already indicates this.


The trigger for this disease is a bacterium called Haemophilus ducreyi, although diagnosing the bacterium can be difficult. There is no standard test for ulcer molle, but the disease usually is diagnosed by observing the symptoms and excluding other sexually transmitted diseases by running tests.


The symptoms of Ulcus molle start within 3-10 days after infection. Ulcus molle is highly contagious, and although it is rare in developed countries, it is the more common cause of genital ulcers worldwide.

Treatment methods

Although ulcer molle is painful and the disease can be very disturbing due to its rarity and unfamiliarity, the good news is that it is curable.


Due to the fact that the infection is caused by a bacterium, Ulcus molle can be eliminated with a short course of antibiotic treatment. This means that you either take 1 gram of azithromycin once or 500 mg ciprofloxacin for 3 days.

Assuming that you are taking the medication properly and the bacterial strain you are infected with is not resistant to antibiotics, your condition should improve within 3-7 days. The full recovery time depends on the degree of ulcer disease; larger ulcers may take 2 weeks to heal completely.


Ulcus molle is highly contagious; therefore it is important that you maintain good hygiene while genital ulcers are present, otherwise they can spread to other parts of the body. Ulcus molle must be treated as the infection may increase the risk of contracting other sexually transmitted infections, especially HIV.


After infection, you should engage in protected sexual intercourse to prevent another case of Ulcus molle. Use condoms and get tested regularly.

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