From the Guidelines
Intertrigo is a common inflammatory skin condition that occurs when skin rubs against skin, typically in warm, moist body folds. It appears as red, raw-looking skin that may be painful, itchy, and sometimes accompanied by a foul odor. This condition is especially prevalent in obese and diabetic patients, as noted in a study published in the Clinical Infectious Diseases journal 1. The warm, moist environment in skin folds creates ideal conditions for friction damage and overgrowth of microorganisms like yeast and bacteria, which worsen the inflammation and can lead to secondary infections if not properly managed. Treatment typically involves keeping the affected areas clean and dry, using barrier creams like zinc oxide or petroleum jelly, and applying antifungal creams such as clotrimazole or miconazole if fungal infection is present, as recommended by guidelines for the treatment of candidiasis 1. Some key points to consider in managing intertrigo include:
- Keeping the infected area dry is important, as emphasized in the guidelines for treatment of candidiasis 1.
- Using topical azoles and polyenes, including clotrimazole, miconazole, and nystatin, can be effective in treating intertrigo, especially when fungal infection is present 1.
- Prevention strategies include wearing loose-fitting clothing, using absorbent powders in skin folds, changing out of wet clothes promptly, and maintaining a healthy weight. The most effective approach to managing intertrigo involves a combination of these strategies, prioritizing the reduction of moisture and friction in skin folds, and addressing any underlying infections or conditions that may be contributing to the development of intertrigo. In terms of specific treatments, a study published in 2004 provides guidance on the use of topical antifungal agents, such as clotrimazole and miconazole, which can be effective in treating intertrigo, especially when fungal infection is present 1. However, it's worth noting that an earlier study published in 2000 also discussed the importance of keeping the area dry and using topical azoles and polyenes, including clotrimazole, miconazole, and nystatin, but the more recent study 1 provides more up-to-date guidance on the management of intertrigo.
From the Research
Definition of Intertrigo
- Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation 2, 3.
- It can occur in any area of the body where two skin surfaces are in close contact with each other, such as the axillary, inframammary, umbilical, and inguinal areas 2, 3.
Causes of Intertrigo
- Skin-on-skin friction and moisture trapped in deep skin folds where air circulation is limited are the primary causes of intertrigo 2, 4.
- Obesity, heat, and humidity can facilitate the development of intertrigo 4, 3.
- Bodily secretions, including perspiration, urine, and feces, can exacerbate skin inflammation 5.
Prevention and Management of Intertrigo
- Identifying predisposing factors and educating patients in reducing these can help prevent intertrigo 2.
- Educating patients in skin fold management and adopting a structured skin care routine can also help prevent intertrigo 2.
- Using moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture, and reduce secondary infection can be beneficial 2.
- Treating secondary infections with appropriate topical agents is also important 2, 5.
- Minimizing moisture and friction with absorptive powders or barrier creams, wearing light and absorbent clothing, and avoiding wool and synthetic fibers can help manage intertrigo 6.