From the Guidelines
The recommended treatment for intertrigo includes keeping the affected skin folds clean, dry, and exposed to air when possible, and using topical azoles and polyenes, such as clotrimazole, miconazole, and nystatin, as effective treatments 1. To manage intertrigo, patients should gently wash the area with mild soap and pat dry thoroughly. Applying barrier creams like zinc oxide or petroleum jelly and using absorbent powders such as cornstarch can help reduce moisture. For mild cases, over-the-counter antifungal creams containing clotrimazole, miconazole, or terbinafine should be applied twice daily for 2-4 weeks. If bacterial infection is present, mupirocin 2% ointment can be applied three times daily for 7-10 days. For fungal infections with inflammation, combination products containing low-potency corticosteroids (like hydrocortisone 1%) with antifungals may be used short-term. Severe or persistent cases may require prescription-strength topical antifungals, antibiotics, or brief courses of low-potency topical steroids. These treatments work by addressing the underlying causes of intertrigo: moisture, friction, and secondary infections, as noted in guidelines for treating candidiasis 1. Patients should also wear loose-fitting, breathable clothing and avoid synthetic fabrics to prevent recurrence. Weight loss may be beneficial for those with obesity-related intertrigo. It's essential to keep the infected area dry, as emphasized in the treatment guidelines for candidiasis 1.
From the Research
Intertrigo Treatment
The recommended treatment for intertrigo involves a combination of measures to reduce moisture, friction, and infection.
- Minimizing moisture and friction with absorptive powders such as cornstarch or with barrier creams 2
- Wearing light, nonconstricting, and absorbent clothing and avoiding wool and synthetic fibers 2
- Educating patients about precautions with regard to heat, humidity, and outside activities 2
- Showering after physical exercise and drying intertriginous areas thoroughly 2
- Wearing open-toed shoes for toe web intertrigo 2
Medical Treatment
Medical treatment of intertrigo usually requires:
- Topical administration of nystatin and azole group antifungals for candidal intertrigo 3, 4
- Topical mupirocin or oral penicillin for secondary streptococcal infections 3
- Oral erythromycin for Corynebacterium infections 3
- Topical antifungal agents such as azoles, terbinafine, or tolnaftate for intertrigo and tinea corporis 5
Management of Predisposing Factors
Identification and correction of predisposing factors is key to managing intertrigo, including: