From the Guidelines
The treatment for intertrigo involves keeping the affected skin folds clean, dry, and separated, and applying topical antifungal or antibacterial agents as needed, with the most recent guidelines recommending the use of topical azoles and polyenes, including clotrimazole, miconazole, and nystatin, for fungal infections 1.
Key Components of Treatment
- Keeping the area dry is crucial, as moisture can exacerbate the condition 1
- Topical antifungal creams such as clotrimazole 1% or miconazole 2% can be applied twice daily for 2-4 weeks for fungal infections
- If bacterial infection is present, mupirocin 2% ointment may be used three times daily for 7-10 days
- For inflammation, low-potency topical steroids like hydrocortisone 1% can be applied sparingly twice daily for up to 7 days
Prevention
- Absorbent cotton clothing, moisture-wicking fabrics, and placing clean cotton cloth or gauze between skin folds can prevent skin-to-skin contact
- Weight loss may help reduce recurrence in overweight individuals
- Intertrigo develops when moisture, heat, and friction in skin folds create an environment conducive to microbial overgrowth, so keeping the area dry and reducing friction are essential for both treatment and prevention 1
Recent Guidelines
- The most recent guidelines from 2018 recommend the use of topical antibiotics against Gram-positive bacteria for superficial infections, including impetigo, erysipelas, and cellulitis 1
- Empiric therapy for community-acquired MRSA (CA-MRSA) should be recommended for patients at risk for CA-MRSA or who do not respond to first-line therapy 1
From the Research
Treatment for Intertrigo
The treatment for intertrigo involves a combination of measures to reduce moisture, friction, and infection in the affected skin folds. Some key treatment options include:
- Topical antifungal agents, such as nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole, to treat fungal infections 2, 3, 4
- Topical antibiotics, such as mupirocin, to treat bacterial superinfections 2
- Oral antifungal agents, such as fluconazole, for resistant cases of candidal intertrigo 2
- Oral antibiotics, such as penicillin or erythromycin, to treat secondary streptococcal or Corynebacterium infections 2
- Moisture-wicking textiles to reduce skin-on-skin friction and wick away moisture 5
- Structured skin care routines to keep the skin folds clean and dry 5, 6
Management of Intertrigo
Effective management of intertrigo also involves identifying and addressing predisposing factors, such as obesity, poor air circulation, and skin-on-skin friction 5, 6. Patients should be educated on how to reduce these factors and adopt good skin fold management practices. Additionally, healthcare professionals should consider using clear skin care and skin fold management protocols to improve patient outcomes 6.
Prevention of Intertrigo
Preventing intertrigo involves reducing moisture, friction, and infection in the skin folds. This can be achieved by: