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 often presents as intertrigo in skin folds, especially in obese and diabetic patients 1. Key aspects of management include:
- Using topical antifungal agents such as clotrimazole, miconazole, or nystatin to address the fungal infection
- Keeping the affected area dry to prevent further microbial growth
- Considering the patient's overall health, such as managing diabetes and promoting weight loss if applicable, to reduce the risk of recurrence
- Applying these treatments in a manner that is consistent with good clinical practice, such as gently washing the area with mild soap and water before applying the antifungal agents. It's also important to note that intertrigo can be caused by bacterial infections, but the provided evidence primarily supports the use of antifungal treatments 1. Therefore, the focus should be on using topical azoles and polyenes, and maintaining dryness in the affected area.
From the Research
Treatment for Intertrigo
The treatment for intertrigo involves a combination of measures to reduce moisture, friction, and infection. Some key approaches include:
- 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
Topical Treatments
Topical treatments are often used to manage intertrigo, including:
- Topical antifungal agents such as nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole for fungal lesions 3, 4
- Topical mupirocin or oral penicillin for secondary streptococcal infections 3
- Topical azoles or selenium sulphur for infections with Malassezia spp. 4
Systemic Treatments
Systemic treatments may be necessary for severe or resistant cases, including:
- Oral fluconazole therapy for resistant candidal intertrigo 3
- Oral erythromycin for Corynebacterium infections 3
- Novel systemic agents with higher potency for predisposing immunosuppressive conditions or generalized infections 5
Management of Predisposing Factors
Management of predisposing factors is crucial in preventing and treating intertrigo, including: