What is the treatment and management for intertrigo?

Patient Education Sheet: Treatment and Management of Intertrigo

What is Intertrigo?

Intertrigo is an inflammatory skin condition that occurs in skin folds where skin surfaces touch and rub against each other. It commonly affects areas such as:

• Under the breasts
• In the armpits
• Between the buttocks
• In groin folds
• Between fingers or toes
• Abdominal folds

Causes of Intertrigo

Intertrigo develops when skin-on-skin friction combines with:

• Moisture trapped in skin folds
• Poor air circulation
• Heat
• Sweat

These conditions create an environment where microorganisms (especially yeast/fungi) can grow, leading to secondary infections.

Treatment Plan

The most effective treatment for intertrigo combines addressing the underlying causes with targeted antimicrobial therapy. 1, 2

Step 1: Keep the Area Clean and Dry

• Gently cleanse affected areas with mild, soap-free cleansers
• Pat dry thoroughly (don't rub)
• Apply absorptive powders like cornstarch (avoid talc-based powders) 1
• Consider using a hair dryer on cool setting to ensure complete drying

Step 2: Treat the Infection

• For fungal (candidal) intertrigo (most common):

  • Apply antifungal cream 2-3 times daily for 7-14 days:
    • Clotrimazole 1% cream OR
    • Miconazole 2% cream OR
    • Ketoconazole 2% cream 1

• For bacterial intertrigo:

  • If greenish-blue staining appears on clothing (sign of Pseudomonas infection), see your doctor for prescription antibiotics 3
  • For other bacterial infections, your doctor may prescribe topical or oral antibiotics

• For severe or resistant cases:

  • Your doctor may prescribe oral antifungal medication like fluconazole 1, 2

Step 3: Protect the Skin

• Apply zinc oxide-based barrier creams after treatment
• Consider petroleum jelly to protect fissures and surrounding skin 1
• For skin fold separation, try:
  • Clean, dry cotton cloth placed between skin folds
  • Moisture-wicking fabrics designed for skin folds 4

Prevention Strategies

1. Clothing choices:

   • Wear light, non-constricting clothes
   • Choose absorbent cotton fabrics
   • Avoid synthetic materials and tight clothing 1, 5
   • Wear open-toed shoes if you have toe web intertrigo 5

2. Weight management:

   • If overweight, gradual weight loss can reduce skin folds 2, 4

3. Activity modifications:

   • Shower after exercise and dry thoroughly
   • Take breaks during hot weather to dry skin folds
   • Change wet clothing promptly

4. Medical management:

   • Control underlying conditions like diabetes 2
   • Follow up with your doctor for persistent or recurrent cases

When to See Your Doctor

• If symptoms don't improve after 7 days of treatment
• If you develop fever or increasing redness, pain, or swelling
• If you have diabetes or a weakened immune system
• If intertrigo keeps coming back despite prevention measures

Remember

Consistent skin care and keeping the affected areas clean and dry are the keys to successful treatment and prevention of intertrigo. 1, 4