[Question #2957] Syphilis Chancre sore took two months to heal and still hurts months later

41 months ago
A blister appeared on the right side of my penis head around May 23 and then a chancre formed about a week later. I got tested mid-June for STIs all came back negative. The sore did not heal so I retested again and this time I was diagnosed with syphilis. I received treatment July 27 and it worked, the open sore healed about a week afterwards. However, the issue I am having is the chancre took so long to heal and during that time the scab got ripped off and reformed a few times. I was using different lotions at different time's cause dr didn't know what it was. Although the penicillin seems to have sped up the healing, it's still not completely healed. It's not an open sore but now a red splotch where it was.  Since then I often feel a sharp pain like a pinching feeling and lately(Oct 21) it has now developed into a feeling of a constant dull ache in the tip driving me crazy. I have seen my dr to test for other things that may be causing the pain but all have come back negative. He feels it's residual pain from the chancre and will settle down in time. However, everything I've read says chancres are normally painless and heal in 3 to 6 weeks, with or without treatment. But for me it took over two months for the chancre sore to heal and some pain during and after and now 6 months later it is still bothering me and seems to be getting worse. Is this normal? Are there cases like this where the chancre causes pain and lasts so long? Anything I can do to heal it & stop the pain?
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to the Forum.  I'll try to help.  You are correct, syphilis lesions typically are painless and heal without scaring or residual pain.  Rarely lesions due to syphilis will become infected with other bacteria but on those occasions, the sores do not heal as yours has.  Was your blood test positive for Syphilis or was your diagnosis based on the doctor's clinical examination?

My suspicion is that you have a Dermatologic problem other than syphilis.    I would suggest that you see a dermatologist.  

I hope these comments are helpful.  Please feel free to follow-up if this is not clear or there are additional questions.   Up to two follow-up questions are permitted.   EWH
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41 months ago
Thanks for responding Dr Hook, yes it was diagnosed through blood tests, I was also tested for all other STIs as well and all others were negative.  I did go see a dermatologist about the chancre and it was her that suggested that I get retested, which I did and found out it to be syphilis.  I have seen her again recently and she suggests the pains may be the nerves trying to settle down and will take some time.  Unfortunately I find the recent pain unbearable.  I feel the pain radiate throughout the head, it is not sore to the touch it seems more internal. The pain makes me feel like I have to urinate, but I went to a clinic and they tested blood, urine for kidney, prostate issues and said it was fine.  I was also feeling pains in my abdomen but I think that was brought on by the tension and worrying about this sore as that has since dissipated.  It was just odd that it was a random temporary pinching pain for months and then all of a sudden out of the blue this severe constant radiating ache.  I can continue to check with the dermatologist but was not sure if it could be something else going on internally causing it.
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
This is not a complication of syphilis that I have ever seen or heard described.  I think you need to work with a doctor who can examine you and work to address this problem, possibly by trial and error (if you like your current doctors, I would stick with them, I suspect there will be some trial and error involved here and if you change doctors they will likely need to repeat some of what has already been done which may not be the most direct way to address this problem).  I may have more comments depending on the answers to the following questions:

1.  Is the pain on the surface of the penis or internal.
2.  By unbearable do you mean so intense you cannot stand it or do you mean that its persistence is a constant, nagging problem which is always on your mind?
3.  Is the pain continuous (always present).  Does it keep you awake?
4.  Are you urinating more frequently?
5.  Is the pain the sense that you need to urinate frequently or is this a separate part of the problem?

EWH
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41 months ago

1. A: It feels internal to me, it does not hurt when I touch or squeeze the surface.  I thought it may have been triggered by it rubbing against my underwear but I have spent two weeks at home not going out and wearing loose or no clothing and it has persisted.  The doctor checked my urethra and said he did not see any lesions or redness or irritation etc.

2. A: Both, sometimes unbearable I cannot stand it; it is mostly constant and nagging for sure but sometimes calms down, but not completely.  I am having a hard time concentrating on work and tasks.

3. A: I have a hard time sleeping because of it but do eventually sleep around midnight but wake up early around 4:30 a.m. every day due to the pain and then can't get back to sleep

4. A:  I don’t think more than normal as I usual urinate a lot, maybe a bit more because the pain makes me feel like I have to urinate.  With this I noticed mostly there is always some urine, but sometimes just a dribble.  I was concerned about prostatitis but the doctor didn't think it was that as my urine tests came back ok.

5. A: I believe it is the pain in the tip that makes me feel like I have to urinate.  Can oral painkillers help in this situation to minimize the pain?  Dermatologist prescribed Pramox HC lotion that has some pain killer in it but that does not seem to be helping.

Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Thank you for the additional information.  My sense is that all of your discomfort and symptoms are in some way related to the lesion you described and that the best way for you to address it is to work with either your dermatologist and doctor to determine the best approach to finding out what it is so it may be treated.  that is has been present for several months at this time and if anything is worse than before is a strong indicator that doing nothing is not going to be helpful.  There may be some trial and error involved and addressing the problem.  I would assure you however, this really does not sound like an STI.

I would add the both anxiety and continued self-examination/manipulation could be making this worse, acting to heighten whatever abnormal sensations might be present. 

This is my 3rd reply to your questions, this as per Forum guidelines, this thread will be closed later today.  EWH
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