Small lesions called genital ulcers can develop on your vagina, penis, or anus. Sexually transmitted infections are the most common cause. However, there are many more potential causes. You can fully recover if your treatment is effective.

Causes:

Ulcers in the genital area can form if you have:

• Chancroid is a bacterial disease that causes open sores.
• Chlamydia.
• Genital herpes.
• Human immunodeficiency virus (HIV).
• Syphilis.

Genital Herpes:

The most common STI in teens that causes ulcers is a chronic, lifelong viral infection that is herpes. HSV-1 and HSV-2 are the two HSV types that are sexually transmitted. HSV-2 is responsible for the majority of recurrent genital herpes cases. HSV-1 has become more prevalent in genital herpes among Homosexuals (men) and young women.

Most HSV-2-infected people are unaware of their infection since they only sometimes shed the virus in the genital canal and only experience moderate or unnoticed infections. Therefore, asymptomatic individuals unaware of their infection are the primary carriers of genital herpes infections.

Syphilis:

Compared to adults, it is a less frequent cause of genital ulcers in teenagers. However, outbreaks do happen in homosexuals (men).

Chancroid:

Chancroid and donovanosis are unusual infectious causes of vaginal, anal, or perianal ulcers.

Diagnosis:

Getting a complete evaluation is crucial because genital ulcer illness can have many underlying causes. The first thing your healthcare practitioner will do is find out more about your medical background and way of living. They could ask about your sexual activity to assess your risk for STIs.

A physical examination will be part of the evaluation. The ulcers and surrounding skin will be examined by your medical professional. They might also check the lymph nodes in your groin or other parts of your pelvis.

To identify the cause of the ulcers, diagnostic tests may be necessary. They might consist of:

• Biopsy
• Blood test
• Urine analysis

How to know I have genital ulcers?

Genital ulcers show symptoms differently.

• Ulcers may start as bumps or a rash.
• You may remain asymptomatic.
• May have swollen glands in the groin area
• You may show signs of fever.

The only way to be sure about the condition is to get yourself checked by a doctor.

How can I avoid developing genital ulcers?

You can take precautions to stop some of the causes of genital ulcers. These consist of:

• Wear loose-fitting underwear or pants instead.
• Don’t get intimate with multiple partners. 
• Use a dental dam or condom each time to engage in safe sexual activity.
• Keep up with treatments for persistent illnesses that might cause genital ulcers.
• Wash and clean your genital area with simple water daily

Treatment of genital ulcers:

Genital herpes:

Local therapy Cleaning the area with soap and water.

Antiviral therapy Aciclovir is taken orally.

When administered within five days of the onset of symptoms in patients with a first episode, therapy may decrease the duration of symptoms: 400 mg 3 times daily for seven days.

Give the same amount for five days to patients who experience recurrence, but remember that treatment is only successful if it begins during the prodromal phase ( the period after incubation and before the characteristic symptoms of infection occur) or within 24 hours of the onset of symptoms.

Syphilis:

2.4 MUI of benzathine benzylpenicillin are injected intramuscularly (IM) (half the dose in each buttock) [1]

Single dosage for early syphilis (primary, secondary, or early latent infection lasting less than a year).

One injection every week for three weeks is recommended for late latent syphilis (infection lasting more than 12 months or of undetermined duration); in the case of penicillin allergies or the absence of penicillin.

Alternative treatments include:

Either 1 g twice daily or 500 mg four times daily for 14 days (early syphilis) or 30 days of erythromycin oral (late latent syphilis)

Doxycycline PO: 100 mg twice daily for either 30 days or 14 days to treat early syphilis.

If the strain is susceptible and early syphilis is present,

azithromycin PO: 2 g single dose.

Chancroid:

azithromycin PO: 1 g one dose 

Ceftriaxone IM: one dose of 250 mg

1 g or 500 mg of erythromycin orally once daily for seven days

As needed, fluid-filled lymph nodes can be aspirated through healthy skin. Do not cut or drain lymph nodes.

Since both syphilis and chancroid are common and cannot be appropriately separated based on clinical criteria, treat both conditions simultaneously.

Pain management:

Paracetamol is given orally

Self-care measures:

It also provides quick relief.

These consist of:

Hot compress: Soak a hand towel in warm water to use as a warm compress for pain or itching. Before putting it to your skin, wring it out. Use light pressure.

Cold compress: An alternative to a warm compress for swelling is a cool compress that uses cool water.

Sitz bath: Fill a bathtub with enough water to cover your hips as you sit down for a Sitz Bath to relieve overall discomfort. Water that is warm but not hot may feel good. Every day, soak for at least 15 to 30 minutes.

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