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Information from Your Family Doctor

Genital Ulcers: What Causes Them?


Am Fam Physician. 2020 Mar 15;101(6):online.

  Related article: Genital Ulcers: Differential Diagnosis and Management

What are genital ulcers?

They are sores found on the vagina or penis or in the surrounding areas. They are usually spread by vaginal, oral, or anal sexual contact. They can also be found in the anus or on the skin around it. Sometimes they hurt or leak fluid.

What causes genital ulcers?

They are usually caused by sexually transmitted infections (STIs), most commonly herpes, less commonly syphilis, and rarely chancroid (SHAN-kroid). For men who have sex with men, syphilis is the most common cause. Rare cases of mononucleosis (MAA-no-noo-klee-OH-suhs) may present with genital ulcers. Ulcers may also be caused by inflammatory diseases (when inflammation arises from an abnormal immune response [e.g., psoriasis, rheumatoid arthritis, lupus]), trauma, or a bad reaction to skin care products.

Who can get genital ulcers?

Risk factors for genital ulcers are the same as those for STIs. They include unprotected sex, not being circumcised, and having more than one sex partner. Genital ulcers caused by inflammatory diseases may run in families.

How can I lower my risk for genital ulcers?

If you have sex, use a condom or dental dam. This lowers the risk, but it is possible to get STIs from infected skin not covered by a condom or dental dam.

How do I know if I have genital ulcers?

Genital ulcers show up in different ways. They may start out as bumps or a rash and may or may not hurt. You may also have swollen glands in the groin area or a fever. Your doctor may treat you based on the look of the ulcers and in some cases may test the area to see if you have an STI.

How are they treated?

Treatment depends on the cause of the ulcers. STIs are usually treated with antibiotic or antiviral pills or shots. If you have an inflammatory disease, you may need a shot or ointment to put on the ulcers. Some genital ulcers go away on their own but may still lead to more serious infection. Your doctor may treat your pain, take care of the ulcer, and test for other STIs.

Where can I get more information?

Your doctor

Centers for Disease Control and Prevention

U.S. Department of Health and Human Services

This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.


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Jan 2022

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