From the Guidelines
The best treatment for under breast intertrigo involves keeping the area clean, dry, and reducing skin-to-skin contact, with the application of topical azoles such as clotrimazole or miconazole, as recommended by the Infectious Diseases Society of America 1. To manage under breast intertrigo effectively, consider the following steps:
- Wash the affected area with gentle, fragrance-free soap and water, then thoroughly dry the skin.
- Apply an antifungal cream such as clotrimazole 1% or miconazole 2% twice daily for 1-2 weeks, as fungal infections often complicate intertrigo.
- For inflammation, a low-potency topical steroid like hydrocortisone 1% cream can be applied sparingly twice daily for up to 7 days.
- Use absorbent powders containing antifungal ingredients (like Zeasorb-AF) to help keep the area dry.
- Wear a supportive cotton bra and place a clean, dry cotton cloth or specialized intertrigo liner between the breasts and chest wall to create a barrier and prevent skin-to-skin contact and moisture accumulation.
- For severe or persistent cases, prescription-strength antifungals or antibiotics may be necessary if secondary bacterial infection develops, as noted in guidelines for treating candidiasis 1. These treatments address the primary causes of intertrigo: moisture, friction, and microbial overgrowth in the warm, moist environment under the breasts, and are supported by guidelines for the treatment of candidiasis 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Gently massage sufficient clotrimazole cream into the affected and surrounding skin areas twice a day, in the morning and evening. The best treatment for under breast intertrigo is applying clotrimazole cream to the affected area twice a day. Key points to consider:
- Apply the cream in the morning and evening
- Gently massage the cream into the affected and surrounding skin areas
- Clinical improvement usually occurs within the first week of treatment 2
From the Research
Treatment Options for Under Breast Intertrigo
The treatment for under breast intertrigo involves a combination of measures to reduce moisture, friction, and secondary infections. Some of the key treatment options include:
- Minimizing moisture and friction with absorptive powders such as cornstarch or with barrier creams 3
- Wearing light, nonconstricting, and absorbent clothing and avoiding wool and synthetic fibers 3
- Educating patients about precautions with regard to heat, humidity, and outside activities 3
- Treating secondary bacterial and fungal infections with antiseptics, antibiotics, or antifungals, depending on the pathogens 3, 4
- Using topical nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole for fungal lesions 4
- Using topical mupirocin or oral penicillin for secondary streptococcal infections 4
- Using oral erythromycin for Corynebacterium infections 4
Prevention and Management
Prevention and management of under breast intertrigo also involve:
- Identifying and educating patients about predisposing factors such as obesity, sweating, and occlusion 5, 6
- Adopting a structured skin care routine and using moisture-wicking textiles within skin folds to reduce skin-on-skin friction and wick away moisture 6
- Considering the use of clear skin care and skin fold management protocols to improve patient experience and clinical outcomes 7
Secondary Infections
Secondary infections should be treated promptly and appropriately, using: