From the Guidelines
Intertrigo treatment should prioritize keeping the affected skin folds dry, reducing inflammation, and treating any infections, with topical calcineurin inhibitors like pimecrolimus or tacrolimus being effective options for intertriginous areas, as supported by recent studies 1. When managing intertrigo, it's essential to consider the following key points:
- Keeping the area dry is crucial, and moisture-absorbing powders like zinc oxide, cornstarch, or antifungal powders can be applied to keep the area dry.
- For mild cases, over-the-counter antifungal creams containing clotrimazole, miconazole, or terbinafine can be applied twice daily for 2-4 weeks, as recommended by earlier guidelines 1.
- If bacterial infection is present, mupirocin 2% ointment can be applied three times daily for 7-10 days.
- For inflamed areas, low-potency corticosteroids like hydrocortisone 1% cream can be used sparingly twice daily for up to 7 days.
- Combination products like Mycolog (nystatin and triamcinolone) may be used for both fungal infection and inflammation.
- Prevention is crucial, and patients should wear loose-fitting, breathable clothing, change out of wet clothes promptly, and use absorbent materials between skin folds.
- For overweight patients, weight loss can help reduce skin fold contact, as intertrigo often occurs in skin folds, especially in obese and diabetic patients 1. The most recent study 1 provides strong evidence for the use of topical calcineurin inhibitors in intertriginous areas, making them a valuable addition to the treatment options for intertrigo.
From the Research
Treatment for Intertrigo
The treatment for intertrigo typically involves a combination of measures to reduce moisture, friction, and inflammation, as well as addressing any secondary infections that may be present.
- Topical antifungal agents such as nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole may be used to treat fungal lesions 2.
- Bacterial superinfections may be treated with topical mupirocin or oral penicillin for streptococcal infections, or oral erythromycin for Corynebacterium infections 2.
- In cases of candidal intertrigo, oral fluconazole therapy may be necessary for resistant cases 2.
- The use of moisture-wicking textiles within skin folds can help reduce skin-on-skin friction, wick away moisture, and reduce secondary infection 3.
- A structured skin care routine and education on skin fold management can also help prevent and manage intertrigo 3, 4.
Management and Prevention
The management and prevention of intertrigo involve identifying and addressing predisposing factors, such as obesity, and educating patients on skin fold management and skin care routines 3, 4.
- Consensus clinical expert opinion suggests that investment in the development and adoption of clear skin care and skin fold management protocols can lead to improvements in the patient experience and better clinical outcomes 4.
- It is also important to consider the potential for antifungal hypersensitivity reactions and cross-reactivity patterns when selecting treatment options 5.