From the Guidelines
The treatment for intertrigo involves using topical azoles and polyenes, including clotrimazole, miconazole, and nystatin, and keeping the area dry. This approach is based on the guidelines for treating candidiasis, which includes intertrigo, as outlined in the study by the Infectious Diseases Society of America 1. The key aspects of treatment include:
- Using topical antifungal agents such as clotrimazole, miconazole, and nystatin to address the fungal infection
- Keeping the affected skin folds dry to prevent further moisture accumulation, which can exacerbate the condition
- Reducing friction and skin-on-skin contact in the affected area to promote healing and prevent recurrence
- Considering the patient's overall health, such as managing obesity and diabetes, which can contribute to the development of intertrigo
In terms of specific treatment, topical azoles and polyenes are effective for nonhematogenous primary skin infections, including intertrigo 1. It is essential to note that keeping the area dry is crucial, and this can be achieved by gently washing the area with mild soap and water, then thoroughly drying it. Additionally, absorbent materials like cotton or gauze can be used to maintain dryness between skin folds.
For patients with intertrigo, weight management and wearing loose-fitting, breathable clothing can help reduce skin-on-skin contact and prevent recurrence. It is also important to change out of wet clothes promptly to prevent moisture accumulation. By following these guidelines and using topical antifungal agents, patients with intertrigo can effectively manage their symptoms and prevent future occurrences.
From the Research
Intertrigo Treatment
The treatment for intertrigo involves a combination of measures to reduce moisture, friction, and infection.
- Minimize moisture and friction with absorptive powders such as cornstarch or with barrier creams 2
- Wear light, nonconstricting, and absorbent clothing and avoid wool and synthetic fibers 2
- Educate patients about precautions with regard to heat, humidity, and outside activities 2
- Shower after physical exercise and dry intertriginous areas thoroughly 2
- Wear open-toed shoes for toe web intertrigo 2
- Treat secondary bacterial and fungal infections with antiseptics, antibiotics, or antifungals, depending on the pathogens 2
Topical Antifungal Agents
Topical antifungal agents are used to treat fungal infections associated with intertrigo.
- Treat Candida intertrigo with topical antifungal agents such as nystatin, clotrimazole, or miconazole 3
- Use azoles or selenium sulphur to treat infections caused by Malassezia spp. 3
- Oral ketoconazole is an alternative in severe cases 3
Specific Infections
Specific infections require targeted treatment.
- Candidal intertrigo is commonly diagnosed clinically and may be confirmed using a potassium hydroxide preparation 4
- Resistant cases of candidal intertrigo require oral fluconazole therapy 4
- Bacterial superinfections may be identified with bacterial culture or Wood lamp examination and treated with topical mupirocin or oral penicillin 4
- Corynebacterium infections are treated with oral erythromycin 4
Prevention and Management
Prevention and management of intertrigo involve identifying predisposing factors and educating patients on skin fold management.