What over-the-counter (OTC) antifungal cream is suitable for an infant with intertrigo in Canada?

Over-the-Counter Antifungal Treatment for Infant Intertrigo in Canada

For an infant with intertrigo in Canada, miconazole cream is available over-the-counter and can be safely used as a topical treatment. 1

Understanding Intertrigo in Infants

Intertrigo is an inflammatory condition affecting skin folds caused by skin-to-skin friction. In infants, it commonly occurs in:

• Neck folds
• Axillary (armpit) regions
• Diaper area
• Inguinal (groin) folds 2

The condition can be complicated by secondary fungal infections, most commonly Candida species, which thrive in the warm, moist environment created in skin folds 2.

OTC Antifungal Options for Infants in Canada

First-Line Treatment:

• Miconazole cream (1-2%) - Available OTC in Canada and safe for infants when used as directed 1
  • Apply a thin layer to affected areas 2-3 times daily
  • Continue treatment for at least one week after the rash has visibly cleared 3

Important Considerations for Infant Use:

• Use the minimum effective amount to cover the affected area 1
• Avoid combination products containing corticosteroids (like clotrimazole/betamethasone), as these can worsen fungal infections in children and are not recommended for infants 4
• Wash hands thoroughly before and after application 3

Management Approach

Treatment Protocol:

1. Gently clean the affected area with warm water and pat dry thoroughly 2
2. Ensure complete dryness of skin folds before applying medication 2
3. Apply miconazole cream thinly to affected areas 2-3 times daily 1
4. Continue treatment for at least 7 days after visible improvement 3

Supportive Measures:

• Keep the affected areas clean and dry 2
• Change diapers frequently if the intertrigo affects the diaper area 2
• Use absorbent, breathable clothing 2
• Consider cornstarch-based baby powder to reduce moisture and friction (apply away from the infant to avoid inhalation) 2

When to Seek Medical Attention

• If no improvement is seen after 7 days of treatment 3
• If the rash worsens or spreads despite treatment 3
• If the infant develops fever or appears unwell 2
• If the skin becomes severely red, painful, or develops open sores 2

Prevention Strategies

• Frequent diaper changes 2
• Thorough drying of skin folds after bathing 2
• Loose-fitting, breathable cotton clothing 2
• Regular inspection of skin folds for early signs of irritation 2

Remember that while OTC miconazole is appropriate for most cases of fungal intertrigo in infants, persistent or severe cases should be evaluated by a healthcare provider, who may recommend prescription-strength medications if necessary.