From the Guidelines
Intertrigo treatment should prioritize keeping the affected skin folds dry, reducing inflammation, and treating any infections, with topical antifungals like clotrimazole or miconazole being recommended for fungal infections, as supported by 1. When managing intertrigo, it's crucial to start by gently cleansing the area with water and mild soap, then thoroughly drying it. Apply barrier creams like zinc oxide or petroleum jelly to protect the skin. For mild cases, use absorbent powders such as cornstarch (not talc) to reduce moisture. Some key considerations for intertrigo treatment include:
- Keeping the infected area dry, as emphasized in 1
- Using topical antifungals for fungal infections, with options like clotrimazole or miconazole applied twice daily for 2-4 weeks
- Considering low-potency corticosteroids like 1% hydrocortisone for short periods (5-7 days) to reduce inflammation
- Wearing loose-fitting, breathable clothing and changing wet or sweaty clothes promptly to prevent moisture buildup For severe or persistent cases, oral antifungals like fluconazole (150mg weekly for 2-4 weeks) or antibiotics may be necessary, as these treatments address the underlying causes of intertrigo: moisture, friction, and microbial overgrowth in skin folds, which disrupt the skin barrier and lead to inflammation and infection. Additionally, topical calcineurin inhibitors like pimecrolimus or tacrolimus may be used, especially in intertriginous areas, as supported by 1, which highlights their efficacy in treating intertriginous psoriasis.
From the Research
Intertrigo Treatment Options
- Intertrigo is an inflammatory dermatosis of the skin folds of the body, for which a large variety of topical medications may be recommended 2
- Topical antifungal agents are commonly used to treat intertrigo, and are the first choice for treating Candida intertrigo 3
- Treatment of intertrigo may also involve the use of antifungals or disinfectants, although the methodologic quality of studies on these treatments is often poor 2
Specific Treatment Regimens
- A topical antifungal agent such as azoles, terbinafine, or tolnaftate may be used to treat intertrigo 3
- Oral terbinafine (250 mg/day) for 1 week has been shown to be as effective as 1% clotrimazole cream applied twice daily for 4 weeks in the treatment of interdigital tinea pedis, a related condition 4
- Fluconazole and amphotericin B are recommended as topical antifungal agents for adults with oral candidiasis, although the effectiveness of these agents for intertrigo specifically is not well established 5
Considerations for Treatment
- Predisposing factors for intertrigo should be eradicated or amended in order to effectively treat the condition 3
- The choice of treatment regimen may depend on the specific cause of the intertrigo, such as Candida or Malassezia spp. 3
- Further research is needed to establish the effectiveness of different treatment regimens for intertrigo, as the current evidence is limited 2