What causes anal ulcers following unprotected anal sex?

Question

Hello doctor,

I am a 23-year-old male with a height of 5 feet 11 inches and a weight of 159 pounds. I engaged in unprotected anal sex a week ago and now have rounded ulcers around my anus. I consulted a dermatologist, who suggested that the ulcers might be due to microtrauma. However, I remain concerned because a week has passed, and the number of ulcers is increasing. They appear round, with one of them being particularly large. Initially pinkish in color, the newer ones are smaller and white. While not extremely painful, they feel uncomfortable when touched. The ulcers do not appear in clusters typical of herpes, and they are not soft but rather hard to the touch. I am currently using a cream for anal fissures containing bioperoxide and Prednisolone, as well as rectal suppositories. Also, I have applied healing cream (Sudocrem) to the ulcers to prevent infection and promote healing. I am uncertain whether these ulcers are caused by herpes or another condition. Any insights or advice would be greatly appreciated.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It appears to be a sexually transmitted infection. I would suggest you do the following.

Apply Mupirocin ointment twice daily for 10 days.
Take Tablet Zifi (Cefixime) 200 mg twice daily after food for five days.
Use Cetrimide soap for bathing for two months.
Clean the area with Povidone-iodine solution and cotton gauze for 10 days.
Avoid scratching or rubbing the lesions.
Maintain proper hygiene.
Wear loose, comfortable, thin cotton undergarments.
Avoid friction and occlusion.
Avoid injury.
Practice safe sex. Use barriers.

I hope this helps you.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

It is a bacterial infection, specifically chancroid. I would suggest the following steps to manage it:

Maintain proper hygiene.
Apply Mupirocin ointment twice daily for 10 days.
Clean the affected area with Povidone iodine solution and cotton gauze before applying the cream.
Ensure to apply the cream with clean hands.
Consider getting the necessary urine routine or culture and microscopy tests or swab tests to identify the organism causing the infection.

I hope this information helps you.

Thank you.