From the Guidelines
Intertrigo in infants should be treated with gentle cleansing, keeping the affected areas dry, and applying appropriate medications, prioritizing topical azoles such as clotrimazole or miconazole for fungal infections, as recommended by the Infectious Diseases Society of America 1. To manage intertrigo in infants effectively, consider the following steps:
- Gently wash the affected skin folds with warm water and mild, fragrance-free soap.
- Pat the area completely dry to prevent moisture accumulation.
- Apply a barrier cream containing zinc oxide to protect the skin.
- For mild cases, keep the area clean, dry, and exposed to air when possible.
- If a fungal infection is suspected, use an antifungal cream like clotrimazole 1% or miconazole 2% applied thinly twice daily for 7-10 days, as these are effective treatments for candidal skin infections, including intertrigo, according to guidelines for the treatment of candidiasis 1.
- Prevention is crucial: change diapers frequently, avoid tight clothing, and use cornstarch (not talcum powder) to keep skin folds dry, thereby reducing the ideal conditions for yeast and bacteria to grow and cause inflammation. Given that intertrigo develops in the warm, moist environment of skin folds, creating an ideal condition for yeast and bacteria to grow, the approach should focus on keeping the area dry and using appropriate antifungal or antibacterial treatments as needed, with the most recent and highest quality evidence supporting the use of topical azoles for fungal infections 1.
From the Research
Treatment for Intertrigo in Infants
- The treatment for intertrigo in infants, which may present as diaper rash, involves minimizing moisture and friction with absorptive powders such as cornstarch or with barrier creams 2.
- Infants should wear light, nonconstricting, and absorbent clothing, and caregivers should avoid using wool and synthetic fibers 2.
- Secondary bacterial and fungal infections should be treated with antiseptics, antibiotics, or antifungals, depending on the pathogens 2.
- Topical therapies such as clotrimazole, nystatin, and miconazole have been shown to be effective in treating cutaneous candidiasis, which can cause intertrigo, with complete cure rates of 73%-100% 3.
- In cases of candidal intertrigo, medical treatment usually requires topical administration of nystatin and azole group antifungals 4.
Prevention and Management
- Preventing intertrigo in infants involves identifying and addressing predisposing factors, such as moisture and friction, and educating caregivers on skin fold management and structured skin care routines 5, 6.
- Using moisture-wicking textiles within skin folds can help reduce skin-on-skin friction, wick away moisture, and reduce secondary infection 5.
- Caregivers should be encouraged to keep the affected area clean and dry, and to avoid using harsh soaps or irritants 2.
- In cases of recurrent candidal intertrigo, it is essential to identify and correct predisposing factors, such as obesity, diabetes mellitus, and immunosuppressive conditions, and to provide proper medical management 4.