Quick Answer: Donovanosis, also called granuloma inguinale, is a rare bacterial STD that causes painless, flesh-colored or red ulcers on the genitals and surrounding skin. Left untreated, it can cause severe tissue damage, but it’s curable with antibiotics.
The First Signs Often Go Ignored
Elvira first noticed it as a small, firm bump near her inner thigh. It wasn’t painful, didn’t itch, and didn’t look especially threatening. She thought it might be an ingrown hair or a pimple from a recent waxing session. Over the next few weeks, the bump grew, the skin around it became red and velvety, and it started to bleed easily. Still, there was no pain, just a quiet, creeping change she couldn’t quite explain.
By the time she saw a doctor, the lesion had turned into a shallow ulcer, and the skin edges looked rolled and smooth, almost polished. That detail alone, plus the fact that it bled when touched, was enough for the doctor to suspect something unusual. Lab tests confirmed it: Donovanosis.
People were also reading: What STDs Can You Test for at Home?
What Donovanosis Actually Is
Donovanosis is caused by the bacterium Klebsiella granulomatis, a slow-growing organism that works its damage under the radar. Instead of causing sudden swelling or pus like many infections, it triggers a gradual breakdown of skin and soft tissue. The result: beefy-red ulcers that spread if left untreated, sometimes merging into large open areas.
Despite its “flesh-eating” label, the bacteria don’t melt skin in the way a horror headline might suggest. Instead, they cause ongoing inflammation that destroys tissue over time. This slow erosion can be devastating if ignored, especially because, unlike many STDs, Donovanosis ulcers are usually painless. That lack of pain is exactly what tricks people into waiting far too long to get checked.
Where in the World It Shows Up
In countries like the U.S. or U.K., Donovanosis is so rare it barely makes it into medical training. But in parts of India, Papua New Guinea, southern Africa, and some coastal regions of Australia, it’s known well enough to be part of routine STD screening. Travel history often holds the first clue, someone returning from a tropical area with a persistent, painless genital ulcer gets a different kind of attention from a clinician who’s seen it before.
Recently, public health reports have noted sporadic cases in non-endemic countries, sometimes with no travel history at all. This may be due to better testing, increased awareness, or the quiet spread of bacteria through interconnected sexual networks.
How Donovanosis Spreads
The most common route is through unprotected vaginal or anal sex with an infected partner. Oral transmission is possible but rare. The bacteria enter through small breaks in the skin, often too tiny to see. Once inside, they set up shop in the cells of the skin and slowly multiply.
It’s worth noting that, while it’s classified as an STD, close skin-to-skin contact outside of sex could theoretically spread the bacteria. But in most documented cases, sexual contact is the clear cause. This is one of those infections where protection, condoms, dental dams, dramatically cuts risk but isn’t a 100% guarantee, especially if lesions are outside the areas they cover.
Check Your STD Status in Minutes
Test at Home with RemediumSyphilis Test Kit
For Men & Women
Results in Minutes
No Lab Needed
Private & DiscreetOrder Now $33.99 $49.00
From First Spot to Full Ulcer: How It Progresses
Donovanosis doesn’t explode onto the scene the way some STDs do. It’s a slow-burner. At first, there’s just a firm, painless nodule under the skin. Then, over weeks or months, that bump breaks down into a shallow ulcer with sharply defined edges and a raw red base. The surface can look moist, even shiny, and the lesion bleeds easily when touched or rubbed by clothing.
As the bacteria spread, new ulcers can form nearby. In advanced cases, the skin between them can erode until two or more merge into one large area of tissue loss. If the infection spreads to the groin folds or perianal area, walking, sitting, and even gentle movement can cause friction that slows healing. The bacteria don’t stop at the genitals, they’ve been known to affect skin on the thighs, lower abdomen, and, in rare cases, even the face.
Why It Gets Misdiagnosed
Because Donovanosis is so rare in many countries, it’s often mistaken for other conditions, especially syphilis, chancroid, or even certain skin cancers. A painless ulcer immediately makes most doctors think of syphilis first, which is far more common. If the ulcer doesn’t respond to syphilis treatment, only then do some clinicians consider more exotic possibilities.
Leon experienced this firsthand. He spent months bouncing between clinics after developing a painless red sore on his scrotum. Each time, he was tested for the “usual suspects”, herpes, syphilis, chlamydia, and each time the results came back negative. Meanwhile, the ulcer grew. It wasn’t until a dermatologist took a tissue sample and looked under a microscope that the diagnosis became clear. By then, the ulcer was the size of a nickel, and he was furious no one had caught it sooner. “If it had hurt, I would have pushed harder for answers,” he admitted. “The fact that it didn’t made it too easy to ignore.”
The Emotional Toll of a Rare STD
The words “flesh-eating” hit differently when they’re about your own body. Even when doctors explain that Donovanosis works slowly and can be cured, the image is hard to shake. Many people experience deep shame, as if having something so rare and dramatic marks them as reckless. Others withdraw from sexual relationships entirely, terrified of passing it on.
There’s also the frustration of dealing with an infection that most people, including some healthcare providers, haven’t heard of. Patients often end up educating their friends, partners, and sometimes even their clinicians about what Donovanosis is and how it’s treated. That burden can add to the sense of isolation.
People are also reading: When a Sore Throat Is More Than Just Strep
Why Quick Action Matters
Here’s the thing: untreated Donovanosis can cause serious complications. Ulcers can destroy underlying tissue, leading to scarring, permanent skin changes, and even disfigurement. In rare cases, the bacteria spread to the bones or internal organs. There’s also evidence that having open ulcers increases your risk of acquiring or transmitting HIV, since the skin barrier is compromised.
The good news? Once diagnosed, Donovanosis responds well to antibiotics. But the longer you wait, the longer the course of treatment and the more extensive the healing process. Catch it early, and you might only need a few weeks of medication. Wait until the ulcers are large, and you could be looking at months of therapy and a more challenging recovery.
Treatment: Slowing the Bacteria, Healing the Skin
The mainstay of Donovanosis treatment is antibiotics, specifically prolonged courses that give your body time to fully eradicate the bacteria hiding in skin cells. The most common options are doxycycline or azithromycin, taken for at least three weeks and often longer if the ulcers are extensive. Unlike a quick 7-day antibiotic for a UTI, Donovanosis demands patience; stopping too soon can allow the bacteria to bounce back.
Elvira, whose infection had spread from her inner thigh to her labia, took antibiotics for nearly eight weeks. “I felt like I was counting down to the end of a bad dream,” she said. “Each week, the ulcers shrank a little more, and the angry red edges started to fade.” By the end of her treatment, the skin had healed enough that she could move without discomfort, but she still needed follow-up visits to monitor for recurrence.
What Healing Actually Looks Like
It takes time for Donovanosis to heal. The first thing that happens is that the raw beefy-red base of the ulcer starts to flatten and get lighter. When you touch the edges, the bleeding stops, and new skin starts to grow in from the edges. This skin can be thin and fragile at first, and if it gets irritated, it can reopen. That's why doctors often tell patients to keep the area clean, dry, and away from friction.
Some people still have faint scars or patches of skin that are a little darker or lighter than the rest of their skin even after the bacteria are gone. Reconstructive surgery may be an option for people who have lost a lot of tissue, but for most people, time and gentle care are all they need to get their normal function and appearance back.
Check Your STD Status in Minutes
Test at Home with Remedium7-in-1 STD Test Kit
For Men & WomenResults in MinutesNo Lab NeededPrivate & DiscreetOrder Now $129.00 $343.00
For all 7 tests
Living Life During Treatment
While you’re being treated, it’s critical to avoid sexual contact, even with a condom, until your doctor confirms the infection is fully resolved. This protects your partners and prevents reinfection. It can be a frustrating pause, especially in new relationships, but open conversations about your diagnosis and timeline can make a huge difference.
Leon, after finally getting his diagnosis, was upfront with his partner from day one. “I told him, ‘This isn’t forever, but it is serious, and I need your patience.’ He surprised me by researching it and texting me articles about recovery. It made me feel less like a walking disease and more like someone who was getting through something with support.”
Why Donovanosis Is Still Rare, And Why That Could Change
Global travel, shifts in sexual networks, and underdiagnosis mean Donovanosis could be more common than the numbers suggest. Public health officials in Australia have reported small clusters in recent years, and isolated cases have been documented in the U.S. and U.K. Increased awareness among clinicians and the public is key to catching it early, before it can cause the kind of tissue damage that earns it its grim nickname.
But rarity also comes with a downside: many people, and even some doctors, don’t recognize the early signs. That’s why accurate, stigma-free information matters. The faster we take Donovanosis out of the shadows, the faster we can get people treated and healed.
You Can’t Treat What You Don’t Name
Donovanosis has a way of staying hidden, not just in your skin, but in our conversations about sexual health. Its painless early stages make it easy to dismiss. Its rarity means it slips under the radar. And its scary nickname can make people avoid talking about it altogether. But ignoring it doesn’t make it go away, it just gives it more time to spread.
The truth you should remember is that Donovanosis can be treated. You can get better completely with the right antibiotics and some time. The sooner you do something, the smaller the scar will be, both physically and emotionally.
People are also reading: How STDs Reactivate: The Science of Dormancy and Symptoms
FAQs
1. Does Donovanosis actually eat flesh?
Sort of, but not like a horror movie. It’s not melting skin in minutes, it’s more like an uninvited guest slowly rearranging the furniture in your house, except the “furniture” is your skin. The bacteria cause inflammation that breaks down tissue over time. Creepy? Yes. Treatable? Absolutely.
2. Will it hurt?
That’s the wild part, usually, no. People expect burning pain if something’s serious, but Donovanosis can sneak along silently. I’ve seen patients with ulcers the size of coins who swore they didn’t feel a thing… until the bleeding started.
3. Can I get it from oral sex?
Rare, but possible. If someone has an open sore in their mouth or on their genitals, the bacteria can find a way in. It’s much more common through vaginal or anal sex, but never say never in sexual health.
4. How fast does it spread?
Slowly, we’re talking weeks to months, but it doesn’t take breaks. Ignore it and those small ulcers can merge into one big, messy situation. This is one of those times where procrastination is not your friend.
5. Will I have scars?
Small ulcers? Probably not, maybe just a faint mark that only you notice. Big or deep ulcers? You might end up with lighter or darker skin patches, like a faded memory on your body. They don’t define you, but yeah, they can stick around.
6. Can it come back?
If you ghost your antibiotics before the end, yes. Finish the full course even if things look healed, Donovanosis is good at pretending it’s gone when it’s just hiding.
7. Do condoms protect against Donovanosis?
They help a lot, but they’re not magical force fields. If an ulcer is outside the area the condom covers, you can still pass it on. Think of them as your main armor, not your only one.
8. Is it only in tropical countries?
Mostly, but it’s shown up in the U.S., U.K., and other non-tropical places. Travel, global hookups, and underdiagnosis mean it’s not just a “somewhere else” problem anymore.
9. How do I know for sure if it’s Donovanosis?
You can’t just eyeball it, trust me, I’ve seen people swear they knew, and they were way off. A lab test on a small tissue sample is the only way to be certain.
10. Can I have sex while on treatment?
Nope. No sex until your doctor says it’s gone. Even “just once” can pass it on, and then you’ve both got the same long antibiotic date ahead of you.
Sources
1. Cleveland Clinic – Granuloma Inguinale (Donovanosis): Symptoms & Treatment
2. Medical News Today – Donovanosis (the so-called “flesh-eating” STD)
3. CDC – Donovanosis (Granuloma Inguinale): Clinical Features & Diagnosis
4. Indian Journal of Sexually Transmitted Diseases & AIDS – Case Series on Donovanosis (2024)
5. Verywell Health – Treating Donovanosis: What's Actually Going On
6. American Dermatological Association – Donovanosis: Not a Flesh-Eater, But Still Dangerous
