From the Guidelines
I strongly recommend treating intertrigo with a combination of topical antifungal creams and maintaining dryness in the affected area, as this approach has been shown to be effective in reducing morbidity and improving quality of life. When managing intertrigo, consider the following steps:
- Gently cleanse the area with a mild, fragrance-free soap and water, then thoroughly pat dry, as emphasized by 1.
- Apply an antifungal cream containing clotrimazole 1%, miconazole 2%, or nystatin to the affected area twice daily for 1-2 weeks, as many cases of intertrigo involve fungal overgrowth, and these treatments are effective according to 1.
- For inflammation, use a low-potency over-the-counter hydrocortisone cream (0.5-1%) sparingly for up to 7 days.
- Dust the area with absorbent powders like zinc oxide or cornstarch between applications to keep the skin dry, which is crucial in treating intertrigo, as noted in 1.
- Wear loose-fitting, breathable cotton clothing and change damp clothes promptly to minimize moisture and friction in the affected skin folds. Given that the most recent and highest quality study is not available, I rely on the study from 1, which provides guidance on treating candidal skin infections, including intertrigo, and emphasizes the importance of keeping the area dry and using topical antifungal treatments.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage The treatment plan for intertrigo using bacitracin (TOP) is to:
- Clean the affected area
- Apply a small amount of the product (equal to the surface area of the tip of a finger)
- Apply 1 to 3 times daily
- The area may be covered with a sterile bandage 2
From the Research
Intertrigo Over-the-Counter Treatment Plan
Intertrigo is being treated with various methods, including:
- Identifying and correcting predisposing factors such as obesity, diabetes mellitus, and immunosuppressive conditions 3
- Educating patients in skin fold management and adopting a structured skin care routine 4, 5
- Using moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture, and reduce secondary infection 4
- Treating secondary infection with appropriate topical agents such as antifungals or disinfectants 4, 3, 6
Topical Treatments
Topical treatments are being used to manage intertrigo, including:
- Nystatin and azole group antifungals for candidal intertrigo 3
- Magistral remedies for candidal intertrigo 3
- Antifungals or disinfectants for preventing and treating intertrigo 6
Skin Care and Management
Patients are being educated on skin care and management to prevent and treat intertrigo, including: