From the Guidelines
Intertrigo is primarily caused by a combination of skin-to-skin friction, moisture, and microbial overgrowth in warm, moist body fold areas, particularly in obese and diabetic patients, as noted in studies such as 1 and 1. This condition commonly occurs in areas like the groin, armpits, under breasts, between toes, and in abdominal folds. The friction damages the skin barrier, allowing moisture to accumulate and creating an ideal environment for microorganisms to thrive.
- Common infectious agents include:
- Candida (yeast)
- Bacteria like Staphylococcus and Streptococcus
- Dermatophytes Risk factors that significantly increase susceptibility include:
- Obesity
- Diabetes
- Hot humid weather
- Poor hygiene
- Tight clothing
- Excessive sweating Certain medical conditions that cause immobility or incontinence can also contribute to intertrigo development. The fundamental mechanism involves the combination of friction, moisture, heat, and subsequent microbial overgrowth, which leads to the characteristic redness, maceration, and sometimes painful rash in affected skin folds, as discussed in 1 and further supported by 1.
From the Research
Intertrigo Causes
- Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation 2, 3, 4, 5.
- It can occur in any area of the body where two skin surfaces are in close contact with each other, such as the axillary, inframammary, umbilical and inguinal areas 2, 3, 4, 5.
- The condition is strongly associated with obesity 3.
- Bodily secretions, including perspiration, urine, and feces, often exacerbate skin inflammation 5.
- Excessive friction and inflammation can cause skin breakdown and create an entry point for secondary fungal and bacterial infections 5.
Risk Factors
- Skin-on-skin friction within skin folds 2, 3, 4, 5.
- Moisture becoming trapped because of poor air circulation 2, 3, 4, 5.
- Obesity 3.
- Bodily secretions, including perspiration, urine, and feces 5.
Secondary Infections
- Secondary bacterial or fungal infections can occur due to friction in skin folds 4, 5.
- Candidal intertrigo is commonly diagnosed clinically, based on the characteristic appearance of satellite lesions 5.
- Bacterial superinfections may be identified with bacterial culture or Wood lamp examination 5.
- Fungal lesions are treated with topical nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole 5, 6.