From the Guidelines
Intertrigo of the axilla should be treated with topical azoles, such as clotrimazole, and keeping the area dry is crucial. This approach is based on the most recent and relevant guidelines for treating candidiasis, which often complicates intertrigo, as outlined in the practice guidelines for the treatment of candidiasis by the Infectious Diseases Society of America 1.
When managing intertrigo of the axilla, it's essential to consider the following key points:
- Keeping the affected area clean and dry by gently washing with mild soap and water, then thoroughly drying the area.
- Applying absorbent powders like zinc oxide or cornstarch to reduce moisture.
- Using topical antifungals such as clotrimazole 1% cream or miconazole 2% cream applied twice daily for 2-4 weeks, as fungal infections often complicate intertrigo, as noted in the guidelines for treating candidiasis 1.
- If bacterial infection is suspected, considering the use of mupirocin 2% ointment applied three times daily for 7-10 days.
- For inflammation, using low-potency topical corticosteroids like hydrocortisone 1% cream can be applied twice daily for 7-10 days.
Additionally, wearing loose-fitting, breathable clothing and considering the use of antiperspirants to reduce sweating can help prevent recurrence. Barrier creams containing zinc oxide or petrolatum can protect the skin from moisture and friction. For recurrent cases, weight loss if obesity is a factor, and maintaining good hygiene practices are crucial. These treatments work by addressing the underlying causes of intertrigo: reducing skin-to-skin contact, eliminating excess moisture, and treating secondary infections that thrive in the warm, moist environment of the axilla, in line with the principles outlined for managing candidal skin infections 1.
From the Research
Treatment of Intertrigo of Axilla
The treatment of intertrigo of the axilla involves a combination of measures to reduce skin-on-skin friction, prevent moisture accumulation, and manage secondary infections.
- Identify and educate patients on reducing predisposing factors such as obesity 2
- Adopt a structured skin care routine and educate patients on skin fold management 2
- Use moisture-wicking textiles within skin folds to reduce friction and moisture accumulation 2
- Treat secondary infections with appropriate topical agents 2
Management and Prevention
Management and prevention strategies for intertrigo of the axilla include:
- Improving air circulation to reduce moisture accumulation
- Using absorbent powders or barrier creams to reduce friction and moisture
- Wearing loose, breathable clothing to reduce skin-on-skin contact
- Maintaining good hygiene and drying the skin folds thoroughly after bathing or showering 3
Clinical Expert Opinion
Consensus clinical expert opinion suggests that investing in clear skin care and skin fold management protocols can lead to improvements in patient experience and better clinical outcomes 3